Exploring UK medical school differences: the MedDifs study of selection, teaching, student and F1 perceptions, postgraduate outcomes and fitness to practise.

McManus, I C and Harborne, Andrew Christopher and Horsfall, Hugo Layard and Joseph, Tobin and Smith, Daniel T and Marshall-Andon, Tess and Samuels, Ryan and Kearsley, Joshua William and Abbas, Nadine and Baig, Hassan and Beecham, Joseph and Benons, Natasha and Caird, Charlie and Clark, Ryan and Cope, Thomas and Coultas, James and Debenham, Luke and Douglas, Sarah and Eldridge, Jack and Hughes-Gooding, Thomas and Jakubowska, Agnieszka and Jones, Oliver and Lancaster, Eve and MacMillan, Calum and McAllister, Ross and Merzougui, Wassim and Phillips, Ben and Phillips, Simon and Risk, Omar and Sage, Adam and Sooltangos, Aisha and Spencer, Robert and Tajbakhsh, Roxanne and Adesalu, Oluseyi and Aganin, Ivan and Ahmed, Ammar and Aiken, Katherine and Akeredolu, Alimatu-Sadia and Alam, Ibrahim and Ali, Aamna and Anderson, Richard and Ang, Jia Jun and Anis, Fady Sameh and Aojula, Sonam and Arthur, Catherine and Ashby, Alena and Ashraf, Ahmed and Aspinall, Emma and Awad, Mark and Yahaya, Abdul-Muiz Azri and Badhrinarayanan, Shreya and Bandyopadhyay, Soham and Barnes, Sam and Bassey-Duke, Daisy and Boreham, Charlotte and Braine, Rebecca and Brandreth, Joseph and Carrington, Zoe and Cashin, Zoe and Chatterjee, Shaunak and Chawla, Mehar and Chean, Chung Shen and Clements, Chris and Clough, Richard and Coulthurst, Jessica and Curry, Liam and Daniels, Vinnie Christine and Davies, Simon and Davis, Rebecca and De Waal, Hanelie and Desai, Nasreen and Douglas, Hannah and Druce, James and Ejamike, Lady-Namera and Esere, Meron and Eyre, Alex and Fazmin, Ibrahim Talal and Fitzgerald-Smith, Sophia and Ford, Verity and Freeston, Sarah and Garnett, Katherine and General, Whitney and Gilbert, Helen and Gowie, Zein and Grafton-Clarke, Ciaran and Gudka, Keshni and Gumber, Leher and Gupta, Rishi and Harlow, Chris and Harrington, Amy and Heaney, Adele and Ho, Wing Hang Serene and Holloway, Lucy and Hood, Christina and Houghton, Eleanor and Houshangi, Saba and Howard, Emma and Human, Benjamin and Hunter, Harriet and Hussain, Ifrah and Hussain, Sami and Jackson-Taylor, Richard Thomas and Jacob-Ramsdale, Bronwen and Janjuha, Ryan and Jawad, Saleh and Jelani, Muzzamil and Johnston, David and Jones, Mike and Kalidindi, Sadhana and Kalsi, Savraj and Kalyanasundaram, Asanish and Kane, Anna and Kaur, Sahaj and Al-Othman, Othman Khaled and Khan, Qaisar and Khullar, Sajan and Kirkland, Priscilla and Lawrence-Smith, Hannah and Leeson, Charlotte and Lenaerts, Julius Elisabeth Richard and Long, Kerry and Lubbock, Simon and Burrell, Jamie Mac Donald and Maguire, Rachel and Mahendran, Praveen and Majeed, Saad and Malhotra, Prabhjot Singh and Mandagere, Vinay and Mantelakis, Angelos and McGovern, Sophie and Mosuro, Anjola and Moxley, Adam and Mustoe, Sophie and Myers, Sam and Nadeem, Kiran and Nasseri, Reza and Newman, Tom and Nzewi, Richard and Ogborne, Rosalie and Omatseye, Joyce and Paddock, Sophie and Parkin, James and Patel, Mohit and Pawar, Sohini and Pearce, Stuart and Penrice, Samuel and Purdy, Julian and Ramjan, Raisa and Randhawa, Ratan and Rasul, Usman and Raymond-Taggert, Elliot and Razey, Rebecca and Razzaghi, Carmel and Reel, Eimear and Revell, Elliot John and Rigbye, Joanna and Rotimi, Oloruntobi and Said, Abdelrahman and Sanders, Emma and Sangal, Pranoy and Grandal, Nora Sangvik and Shah, Aadam and Shah, Rahul Atul and Shotton, Oliver and Sims, Daniel and Smart, Katie and Smith, Martha Amy and Smith, Nick and Sopian, Aninditya Salma and South, Matthew and Speller, Jessica and Syer, Tom J and Ta, Ngan Hong and Tadross, Daniel and Thompson, Benjamin and Trevett, Jess and Tyler, Matthew and Ullah, Roshan and Utukuri, Mrudula and Vadera, Shree and Van Den Tooren, Harriet and Venturini, Sara and Vijayakumar, Aradhya and Vine, Melanie and Wellbelove, Zoe and Wittner, Liora and Yong, Geoffrey Hong Kiat and Ziyada, Farris and Devine, Oliver Patrick (2020) Exploring UK medical school differences: the MedDifs study of selection, teaching, student and F1 perceptions, postgraduate outcomes and fitness to practise. BMC medicine, 18 (1). p. 136. ISSN 1741-7015. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Medical schools differ, particularly in their teaching, but it is unclear whether such differences matter, although influential claims are often made. The Medical School Differences (MedDifs) study brings together a wide range of measures of UK medical schools, including postgraduate performance, fitness to practise issues, specialty choice, preparedness, satisfaction, teaching styles, entry criteria and institutional factors.


Aggregated data were collected for 50 measures across 29 UK medical schools. Data include institutional history (e.g. rate of production of hospital and GP specialists in the past), curricular influences (e.g. PBL schools, spend per student, staff-student ratio), selection measures (e.g. entry grades), teaching and assessment (e.g. traditional vs PBL, specialty teaching, self-regulated learning), student satisfaction, Foundation selection scores, Foundation satisfaction, postgraduate examination performance and fitness to practise (postgraduate progression, GMC sanctions). Six specialties (General Practice, Psychiatry, Anaesthetics, Obstetrics and Gynaecology, Internal Medicine, Surgery) were examined in more detail.


Medical school differences are stable across time (median alpha = 0.835). The 50 measures were highly correlated, 395 (32.2%) of 1225 correlations being significant with p < 0.05, and 201 (16.4%) reached a Tukey-adjusted criterion of p < 0.0025. Problem-based learning (PBL) schools differ on many measures, including lower performance on postgraduate assessments. While these are in part explained by lower entry grades, a surprising finding is that schools such as PBL schools which reported greater student satisfaction with feedback also showed lower performance at postgraduate examinations. More medical school teaching of psychiatry, surgery and anaesthetics did not result in more specialist trainees. Schools that taught more general practice did have more graduates entering GP training, but those graduates performed less well in MRCGP examinations, the negative correlation resulting from numbers of GP trainees and exam outcomes being affected both by non-traditional teaching and by greater historical production of GPs. Postgraduate exam outcomes were also higher in schools with more self-regulated learning, but lower in larger medical schools. A path model for 29 measures found a complex causal nexus, most measures causing or being caused by other measures. Postgraduate exam performance was influenced by earlier attainment, at entry to Foundation and entry to medical school (the so-called academic backbone), and by self-regulated learning. Foundation measures of satisfaction, including preparedness, had no subsequent influence on outcomes. Fitness to practise issues were more frequent in schools producing more male graduates and more GPs.


Medical schools differ in large numbers of ways that are causally interconnected. Differences between schools in postgraduate examination performance, training problems and GMC sanctions have important implications for the quality of patient care and patient safety.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WB Practice of medicine
Divisions: Planned IP Care > Trauma and Orthopaedics
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Depositing User: Mrs Yolande Brookes
Date Deposited: 20 May 2020 13:10
Last Modified: 21 May 2020 13:50
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3092

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