Like a Surgeon? A letter commenting on Grosse and Thomas's 'Selection into training will always be an inexact process: a survey of Directors of Physician Education on selection into Basic Physician Training in Australia and New Zealand'

Does basic physician trainee selection predict successful progression in the Royal Australasian College of Physicians adult medicine training programme? A retrospective cohort study

BACKGROUND

The optimal selection process for basic physician trainees (BPTs) is unclear.

AIMS

To assess an adult BPT selection process, including a standardised recruitment interview assessing clinical decision-making and situational judgement.

METHODS

A retrospective multi-year cohort study of applicants who were selected for interview during the annual recruitment for 2011-2015 clinical years in an adult basic physician training network in NSW. The predictive capacity of the final recruitment assessment score was compared with success in the Royal Australasian College of Physicians (RACP) adult medicine clinical examination within 2 years.

RESULTS

Four hundred thirty-six applicants were selected for interview (84-91 in each year). Summary mean post-interview scores ranged from 1.25 to 10, with the median ranging between 7 and 8. Median scores were higher in those who passed the examination than those who did not (7.75 vs 6.43, P < 0.0001). Those who did not sit for the examination in the relevant year or never sat for the examination had similar median scores (7 vs 6.75, P = 0.11). Those not deemed eligible for recruitment were less likely to pass the clinical examination within 2 years than those on the eligibility list (odds ratio (OR) = 0.38, 95% confidence interval (CI) = 0.25-0.57). Applicants with mean scores lower than 8 were less likely to pass than those in the top band (8.1-10); scores between 6.1 and 8 OR 0.42 (95% CI = 0.26-0.68), 4.1-6 OR 0.23 (95% CI = 0.13-0.41) and 2.1-4 OR 0.24 (95% CI = 0.10-0.60).

CONCLUSION(S)

The predictive capacity of the selection process for success in the RACP clinical examination within the minimum time period is high.