Situational judgement tests for medical students: Really the best way to determine your future?

Dear Sir

Final year of medical school represents a period of intense anguish for students in the United Kingdom (UK). In addition to pressure that examinations exert, students must also spend time applying for their first job to the Foundation Programme. Infamously, this system has been fraught with complications since its inception in 2005. From the debacle of Modernising Medical Careers and the negative ramifications that this had on student applications, to the 2007 scandal in which hundreds of students' confidential details were inadvertently leaked; the entire scheme has been surrounded by controversy (Day 2007). There has been a significant new addition to the process for final year students applying in 2012 – the Situational Judgement Test (SJT). We perceive this as a concerning change to an already complicated procedure and that a brief discussion is highly pertinent.

SJTs are a well-validated and highly regarded method of assessing applicants' ability and prowess at analysing situations and determining most appropriate courses of action (Koczwara et al. 2012). They are used in a range of different fields outside of medicine, but within healthcare, their assessment in application to general practice is most prominent. SJTs are not used routinely in undergraduate education and have never been used as a selection tool for the Foundation Programme. As of 2012, SJTs will form 50% of the application process for final year medical students, and as such, will play an enormous role in determining students' immediate future: greater than the medical degree itself, performance throughout medical school, publications, presentations, posters or prizes. We find this fact somewhat alarming. As applicant numbers continue to soar, we must strive for optimal methods of evaluation and aim to evolve our assessment tools; often, this will warrant introduction of new examinations, but this must be done with utmost care. An informal pilot scheme was run to gauge final year medical students’ reactions to the SJT and some positive feedback was received. Whether those who genuinely take the test will share these feelings shall emerge in early 2013.

Hopefully, the UK Foundation Programme Office's bold decision to introduce the SJT into the tumultuous process of appointing junior doctors shall transpire to be a success story – but only time will tell. In the meantime, we urge UK medical schools to offer support, advice and preparation for their students approaching this enigmatic examination, in what must be a tremendously nerve-wracking period of their education.