The roles of personal interview and cognitive abilities at medical school admission in predicting the performance of medical students in their internal medicine sub-course | BMC medical training
A fundamental question for medical schools around the world is how to select applicants most likely to become excellent physicians. In the past, it was common to rely solely on the cognitive abilities of applicants and their previous academic achievement, as cognitive skills and academic grades were thought to predict academic and career success in medicine. . However, the association between academic performance and success beyond medical school is relatively weak. . Some studies [3, 4] provide clear evidence that applicants selected on the basis of high academic achievement alone are significantly more likely to drop out of medical school than applicants selected through a more complex admissions process. Additionally, relying only on tools that measure cognitive abilities introduces significant socioeconomic class bias. [5, 6]. Therefore, in recent years there has been a growing consensus that medical school admissions processes aimed at selecting applicants most likely to become excellent physicians should include the assessment of two main domains, (1) basic intelligence and cognitive abilities, and (2) personality. , including conscientiousness, extroversion, self-esteem and sociability of candidates . A variety of tools have been developed to examine these traits, including personal interviews, biographical questionnaires, situational judgment tests, multiple mini-interviews, and other methods. Processes vary from medical school to medical school, country to country, and within Israel, reflecting the diversity of vision and mission of some schools.
The Ben Gurion University Goldman Medical School Admission Process
Since its inception in 1974, the six-year program at Goldman Medical School at Ben-Gurion University (BGU) has emphasized the personal traits and skills of prospective students, and has therefore focused intensely on the personality assessments as the first domain. priority once the basic intelligence criterion (although very high) has been met [8,9,10,11]. The admissions process is open to all high school graduates and consists of three stages (Fig. 1). The first step is to present a sufficient “Sekhem” score. This score represents the weighted average of an applicant’s Israel National Matriculation Examination score and the score obtained on the psychometric test administered by Israel’s National Institute for Testing and Assessment. A sufficient Sekhem score is a prerequisite for applying for admission to medical schools in Israel. At BGU, Sekhem’s average has always been lower than other medical schools in Israel, since BGU believes that the highest Sekhem scores do not necessarily predict the best medical students and doctors. . Additionally, a slightly lower Sekhem requirement promotes greater socio-economic diversity among applicants.
Applicants with sufficient Sekhem scores move on to the second stage of the admissions process, which includes a computer-based questionnaire based on the “Big Five” , which assesses different personality variables, including conscientiousness, extroversion, agreeableness, openness to experience, and emotional stability. This tool “expands the funnel” so that all candidates with the necessary basic cognitive abilities have the opportunity to be further considered based on strong personal traits and skills.
Candidates with the highest scores on the computerized questionnaire are called for an interview by two trained interviewers during a session that can last up to one hour (step 3). One investigator is a doctor and the other is a community representative. Community representatives must have earned at least a bachelor’s degree Community representatives come from many disciplines, including law, research, engineering, psychology, social welfare, education, and other fields . All interviewers must be approved by the Admissions Committee and attend workshops on interview skills and protocol. Approximately 120 investigators are involved in each admission.
Interviews focus on applicants’ pre-written structured CVs and interview questions that address specific aspects of applicants’ qualifications, including thinking ability, emotional ability, social skills, social awareness and social skills. social involvement, as well as the ability to perform well under pressure.
In an effort to achieve maximum reliability and validity of interview notes, interviewers are trained to adhere to the predetermined scope and content of interview questions.
Additionally, the scores from each of the interviews are standardized separately for each interviewer by calculating a t-score relative to the particular interviewer’s scoring history. Thus, the t-score of the rating indicates how high or low a candidate scored compared to other assessments from the same interviewer. The average t-scores of the two interviewers represent the final interview score. The scores are transformed back into scores 0 to 10 for a final comparison.
Over the years, the admissions process has varied in terms of interview protocol. It generally comprised 2 consecutive interviews (involving 4 interviewers), the second interview being administered only to candidates who obtained the necessary threshold score during the first. The “2 interview” protocol has always been preferred to the “1 interview” structure, but has depended on the ability of the admissions committee to provide a sufficient number of interviewers from one year to the next.
Of approximately 1,800 applicants, the 120 applicants with the highest overall score are admitted, representing an acceptance rate of approximately 7%. Goldman Medical School graduates have become known for their excellent clinical and interpersonal skills. Former BGU Faculty Members, Friedberg & Glick (1997)  analyzed ratings made by department heads at hospitals across Israel comparing BGU graduates to their counterparts trained at other Israeli medical schools. Seventy-four percent (74%) of department heads thought BGU graduates were better at doctor-patient relationships, and 49% felt they excelled at doctor-team relationships, compared to those trained elsewhere . Although these are favorable results, the relationship between BGU’s emphasis on human factors assessment in the medical school admissions process and actual student performance has never been evaluated. quantitatively.
We examined the association between admissions process ratings of applicants’ personal traits and skills, as determined by personal interviews during the admissions process, and students’ performance ratings after completing the 6e rotation year in internal medicine. The rotation is practically a six-week sub-course designed to prepare students for their role as in-house internists. During the rotation, students are required to function as a first-year resident would under the supervision of senior medical staff. Thus, students bear primary responsibility for the patients that students admit to the department. Students are assessed on their skills to accurately and efficiently assess patients, diagnose, provide immediate care, treat general medical conditions requiring hospitalization, and ensure appropriate discharge and safe transition to community care. Students are assessed on the problem-solving skills necessary to facilitate future medical care/compliance in a patient population frequently without prior medical care, and to communicate effectively with patients, families, colleagues, consultants, primary care physicians and allied health professionals. The skills assessed in the 6th year internal medicine rotations present a high fidelity with those necessary for their career. Therefore, performance ratings in this rotation can be viewed as an indirect measure of future performance as a physician.