Robust, defensible, and fair: The AMEE guide to selection into medical school: AMEE Guide No. 153

Abstract

Selection is the first assessment of medical education and training. Medical schools must select from a pool of academically successful applicants and ensure that the way in which they choose future clinicians is robust, defensible, fair to all who apply and cost-effective. However, there is no comprehensive and evidence-informed guide to help those tasked with setting up or rejuvenating their local selection process. To address this gap, our guide draws on the latest research, international case studies and consideration of common dilemmas to provide practical guidance for designing, implementing and evaluating an effective medical school selection system. We draw on a model from the field of instructional design to frame the many different activities involved in doing so: the ADDIE model. ADDIE provides a systematic framework of Analysis (of the outcomes to be achieved by the selection process, and the barriers and facilitators to achieving these), Design (what tools and content are needed so the goals of selection are achieved), Development (what materials and resources are needed and available), Implementation (plan [including piloting], do study and adjust) and Evaluation (quality assurance is embedded throughout but the last step involves extensive evaluation of the entire process and its outcomes).

HIGHLIGHTS

• Robust, defensible and fair selection into medical school is essential. This guide systematically covers the processes required to achieve this, from needs analysis through design, development and implementation, to evaluation of the success of a selection process.

Keywords:

• Best evidence medical education
• medicine
• medical education research
• selection
• undergraduate

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Correction

Acknowledgements

Our thanks to all the colleagues who we have worked with over the years on various selections and widening access to medicine projects. Particular thanks to Professors Anna Pulimood and Anand Zachariah of Christian Medical College Vellore, India, and Dr You You, Institute of Medical Education, Peking University, China, for educating us on selection processes in India and China respectively, and for CMC’s example of values-based recruitment. Our thanks also to Dr Ruth Choe and Ms Jowe Chu, Lee Kong Chian School of Medicine Singapore, for reviewing this manuscript for us.

Ethical approval

This work did not involve primary research so ethics approval was not required.

Addendum

Although we are based in four very different countries across three continents, we appreciate that there will be geographical differences in medical school selection of which we are unaware. We welcome communications and discussions on this topic from colleagues across the globe, to bring in diverse views and opinions and overcome our own limitations.

Author contributions

JC and FP conceptualised this paper. All authors contributed substantial parts of the text. The final product is the result of many discussion and review sessions. All authors reviewed the final manuscript and agreed to be accountable for all aspects of the work.

Disclosure statement

Fiona Patterson is a Director for Work Psychology Group Ltd, a consulting practice that provides advice on selection methodologies (such as SJTs, interviews, aptitude tests, knowledge tests, and selection centres). The other authors declare that they have no competing interests.

We did not seek funding for this project.

Correction Statement

This article has been corrected with minor changes that do not impact the academic content of the article. A correction has also been made on the Disclosure Statement in the online version. Please see Correction (http://dx.doi.org/10.1080/0142159X.2023.2206724)

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

J. Cleland

Jennifer Cleland, D Clin Psychol, PhD, is a leading expert in the fields of selection and widening access to medicine, performance, and medical careers decision making. She is Vice-Dean Education and Director of the Medical Education Research and Scholarship Unit, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore.

J. Blitz

Julia Blitz, MBBCh, PhD, was Vice-Dean: Learning and Teaching in Stellenbosch University’s Faculty of Medicine and Health Sciences (FMHS), Capetown, South Africa. Her clinical specialty is Family Medicine. She has a have a strong interest in medical education research, particularly faculty development, clinical teaching, and assessment.

K. B. J. M. Cleutjens

Kitty Cleutjens, PhD, is Associate Professor of Pathology, School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, University of Maastricht, The Netherlands. Kitty juggles an active involvement in health professions education research alongside her discipline-specific research interest.

M. G. A. oude Egbrink

Mirjam Oude Egbrink, PhD, is Professor on Implementation of Educational Innovations in the School for Health Professions Education (SHE), University of Maastricht, The Netherlands. She is currently involved in research on education, with a special interest in student selection and in quality culture and management in higher education.

S. Schreurs

Sanne Schreurs, PhD, works at the Department of Educational Research and Development at Maastricht University, The Netherlands. She is a member of the taskforce Assessment at the Faculty of Health, Medicine and Life Sciences, where she focuses on the domain of knowledge testing.

F. Patterson

Fiona Patterson, PhD, is a Visiting Professor to City, University of London. Prior to this. Fiona held academic posts at the University of Nottingham, the University of Sheffield, and the University of Cambridge.