How Does the Entrance Exam Have Influence on Educational Success of Doctoral Medical Students in Basic Science Grade?

INTRODUCTION

In different countries, schools of medicine have different admission procedure, including cognitive and non-cognitive domains (1). Reforming admission procedures in different majors such as medicine, dentistry and pharmacology might lead to success in profession and as a result improve public health.  

Among different academic fields of study, these three majors play a crucial role in public health. It is attempted that motivated and interested students pass entrance exam and study these majors.

One of the problems of admission procedure via entrance exam is range of acceptance criteria; only the participants who have gained special ranges pass the exam. According to the current condition, the question is whether this type of admission is right or not.

In a study conducted in Britain, it was concluded that there is a significant relationship between the results of academic achievement tests and medical students’ future profession (2).

In Iran, medical, dental and pharmacology students pass basic sciences courses for 2 – 2.5 years after entering the system of professional doctorate; then they should prepare for the comprehensive examination of basic sciences which is a nationwide and standard exam. Students’ educational achievement is assessed based on this exam. According to the study of Fatehi (1) and Roodbari (3), the influential factors of comprehensive exam were age, marital status, proportion, time of basic sciences course, and average of basic sciences courses (1, 3). Ferduson et al. study had a systematic review over the previous studies and realized that there were also other influential factors that lead to medical students’ educational achievement including learning method, female gender and White race (4).   

Since the educational system of Iran in admitting the students and basic sciences comprehensive examination is different from other countries, few studies have been conducted to find correlation between entrance exam grade and comprehensive basic sciences exam. For instance, a study conducted in 2000 showed that chemistry (correlation coefficient: 0.56) had the highest correlation with the students’ educational achievement. Mathematics, physic, biology, and language correlation coefficient were 0.53, 0.50, 0.48, and 0.39, respectively. In regression analysis, among professional examination, language and gender variables, only chemistry and mathematics had significant correlation in basic sciences test (5). Another study was done in Kuwait to determine factors of medical students’ performance and concluded that average of high school and average of medicine courses had no statistical significant relationship (6).

In other countries, university entrance examination are assessed differently. For example, the study of Kreiter et al (2007) showed that Medical College Admission Test (MCAT) and Grade Point Average (GPA) had positive predictive relationship with clinical skills in these majors (7). Shahidi and his colleague essay showed that most of the students who had different proportion (42.8 %) and entered the university, had worse educational achievement. Among the students who had the proportion of region 2, 57.6% of 

them whose diploma average was higher than 15 and lower than 18, gained good grade in basic sciences test and were good at educational achievement (8). Another study held in Iran concluded that creativity, responsibility and the excellence should be considered in selecting talented students (3). Therefore, it could be concluded that in selecting students in the mentioned majors that are especially important, beside average, other factors should be considered as well. 

Accordingly, in order to determine the influence of entrance exam scores on educational achievement, the correlation between entrance exam and basic sciences test was analyzed in Kerman University of Medical Sciences (2008 – 2009).

METHODS

This is a retrospective cohort study. Firstly, the required data of medical, dental and pharmacology students, who entered the university in 2005 – 2006 were gathered including age, gender, proportion of the mentioned year, number of participation in the entrance exam, their grade in the country, and their scores in specific and general courses. The data were collected from the files in Central Evaluation Office; then, for each person, the raw score of basic sciences test was received form Directorate General of Kerman University of Medical Sciences.  

On the condition that the person could not pass the exam in the first time, his/her first score is considered in this study. Moreover, demographic data of the participants were collected form the files. The data were organized based on a checklist that was specially designed for the study and were analyzed.

Meanwhile, the students who had serious physical or mental problems, the ones whose information were not complete or those who transferred to another place during studying basic sciences were extracted from the study. T-test, chi-square test and analysis of variance were used in the study, also, all the variants were evaluated by multivariate linear regression model and the one that were not significant were omitted through stepwise method. Determine coefficient was used to present goodness of fit. Inclusion criteria for each variant was less than 0.1 p-value. SPSS (15th version) analyzed the data.

RESULTS

In this study, 156 medical, 78 dental and 116 pharmacy students, who have passed the entrance exam and were accepted in Kerman University of Medical Sciences in 2005 – 2006, were analyzed.

Gender, the year of entrance to university, their grade in the country, their scores in specific and general courses were analyzed (Table 1).

The total number of students was 212 from three fields of studies, 94 were female and 118 were male. The number of male students was significantly higher than girls. (P <0.05).

There was a significant difference between the three majors in literature, Arabic language, theology, biology, physics, chemistry and geology; in all mentioned subjects, the dental students gained better scores except for geology, while the pharmacy students gained better score 

in geology.

There was also significant difference (P<0.05) in comparing proportion’s grade in medical, dentistry and pharmacology majors; the dental students gained the lowest score.

In the first part of Table 2, the average of basic sciences in three majors, genders and the entrance year are presented. In the second part of it, each variant is analyzed by a linear regression model. Biology is the most important subject, since the score of basic sciences has 0.37 increase for one percent boost of biology, while literature and mathematics had the lowest importance in basic sciences.

The overall marks were skewed, the overall mark of 25 people were higher than 10000.

Moreover, the current study revealed that there is negative relationship between the overall mark of university entrance exam and the score of basic sciences test that present the higher mark has negative influence on basic sciences exam. It means that the higher scores in entrance exam, the less success in basic sciences examination.

Table 3 presents the complete model based on all subjects, gender and the year of entrance. The coefficient of determination in medical, dental, pharmacology and the total were 0.55, 0.65, 0.56, and 0.46, respectively (the coefficient of determination indicates how well data points fit a statistical model, the closer it is to number 1, the better the model is). The statistics show that these variables can accurately estimate the mark of basic sciences of dental students. However, when non-significant variables were deleted from the model via stepwise regression, only 

biology and Arabic were left (CD = 0.44); in dentistry, only chemistry predicted the basic sciences’ mark (CD = 0.48); and biology and physics were influential in pharmacology (CD = 0.46). In general, biology, geology and Arabic (coefficient determine = 0.42) remained among all of the professional doctorate students.

In table 3, the highest regression coefficient is for chemistry in dentistry (0.76), that shows for every one percent increase in the score in entrance exam, the dental students’ score of basic sciences increases for 0.76. On the contrary, the lowest regression coefficient is for Arabic among all of the professional doctorate students (0,12) which reveals although there is significant relations, the increase of Arabic score in entrance exam has the least significant relation with the score of basic sciences.  

DISCUSSION

The main and most significant purpose of university entrance examination is to select qualified students, so that students gain better achievements and career according to their knowledge and interests. In fact, the entrance exam should predict students’ educational achievements as far as possible.  

The results of the study shows that the students who had higher score were less successful in basic sciences exam. Moreover, it presented the lessons of entrance exam that can estimate the score of basic sciences exam: biology and Arabic in medicine, chemistry in dentistry and biology and physics in pharmacology.