How do mature non-graduate students compare to the rest of the cohort in medical training? A UKMED study

Background

Widening participation in medicine is a key societal priority. To improve representation of non-traditional applicants, UK medical schools use contextual admissions, although definitions of under-represented groups vary across institutions. This study examined the educational and training trajectories of one such group—mature non-graduates. We aimed to determine whether their progression was comparable to that of school-leavers and graduate entrants, whether they progressed through medical school non-inferiorly, and whether they were equally likely to secure postgraduate training posts.

Methods

Data on UK medical students and resident doctors (2007–2015) were extracted from the UK Medical Education Database (UKMED). Undergraduate performance (Educational Performance Measure (EPM), Prescribing Safety Assessment (PSA), Foundation Programme Situational Judgement Test (FP-SJT) and postgraduate performance (Membership of the Royal College of Physicians, MRCP and MRCGP Applied Knowledge Test, MRCGP AKT), Annual Review of Competency Progression (ARCP), and obtaining an offer for a Level 1 training post) were compared across the three groups using multivariate statistical analyses, including Kruskal–Wallis tests where appropriate.

Results

Across all measures of undergraduate academic attainment (EPM, PSA and FP-SJT) and postgraduate examination performance (MRCP Part 1, Part 2 and PACES), mature non-graduates performed less well than school-leavers or graduates. They were more frequently released from training (ARCP Outcome 4) and received higher numbers of Developmental ARCP outcomes. Mature non-graduates were also less likely to receive an offer for competitive specialty training on their first application; however, the likelihood of them applying exclusively to General Practice did not differ from that of school-leavers or graduates.

Conclusions

Although performance differences persist for a subset of widening-participation candidates named here as mature non-graduates, they still progress through training, obtain Certificates of Completion of Training, and contribute to the medical workforce. Further research is needed to examine how their life experience and non-traditional educational trajectories influence their long-term practice.