title: Longitudinal assessment of the impact of the use of the UK clinical aptitude test for medical student selection.
abstract: BACKGROUND
  Medical schools are increasingly using novel tools to select applicants. The UK Clinical Aptitude Test (UKCAT) is one such tool and measures mental abilities, attitudes and professional behaviour conducive to being a doctor using constructs likely to be less affected by socio-demographic factors than traditional measures of potential. Universities are free to use UKCAT as they see fit but three broad modalities have been observed: 'borderline', 'factor' and 'threshold'. This paper aims to provide the first longitudinal analyses assessing the impact of the different uses of UKCAT on making offers to applicants with different socio-demographic characteristics.
  
  
  METHODS
  Multilevel regression was used to model the outcome of applications to UK medical schools during the period 2004-2011 (data obtained from UCAS), adjusted for sex, ethnicity, schooling, parental occupation, educational attainment, year of application and UKCAT use (borderline, factor and threshold).
  
  
  RESULTS
  The three ways of using the UKCAT did not differ in their impact on making the selection process more equitable, other than a marked reversal for female advantage when applied in a 'threshold' manner. Our attempt to model the longitudinal impact of the use of the UKCAT in its threshold format found again the reversal of female advantage, but did not demonstrate similar statistically significant reductions of the advantages associated with White ethnicity, higher social class and selective schooling.
  
  
  CONCLUSIONS
  Our findings demonstrate attenuation of the advantage of being female but no changes in admission rates based on White ethnicity, higher social class and selective schooling. In view of this, the utility of the UKCAT as a means to widen access to medical schools among non-White and less advantaged applicants remains unproven.
authors.affiliation: Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, UK. j.m.mathers@bham.ac.uk.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Mathers
authors.affiliation: Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, UK.
authors.forename: Alice
authors.initials: A
authors.lastname: Sitch
authors.affiliation: Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, UK.
authors.forename: Jayne
authors.initials: J
authors.lastname: Parry
mesh_terms: D000293:Adolescent; D001077:Aptitude Tests / Q000592:standards*; D004521:Educational Measurement; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012570:School Admission Criteria / Q000706:statistics & numerical data*; D012577:Schools, Medical / Q000458:organization & administration / Q000706:statistics & numerical data; D012923:Social Class; D013337:Students, Medical / Q000706:statistics & numerical data*; D006113:United Kingdom; D055815:Young Adult