Do school exams predict doctors' success?

Editor—McManus et al studied A levels and intelligence as predictors of medical careers in UK doctors.¹ It is important to know that A levels as a test of academic achievement can predict a successful career in medicine. The authors measured career success as more rapid career progression, greater research output, and opting for hospital based practice. As they acknowledge in their paper, they cannot comment on the interaction between doctor and patient. Neither could they comment on any important aspect of the hands-on practice of clinical medicine of those doctors in their study.

In important aspects therefore, this study looks at career success rather than success as a clinician. No information was presented to indicate that the doctor who becomes a consultant more quickly will be a better clinician than a more slowly advancing colleague, although this might well be the case. Although research in medicine is crucial, I doubt that the number of papers published is always an indicator that the research is actually of any great value.

Figure 1.

This study emphasises the importance of selecting medical students to include those in the ranks of the academically most able. However, the medical profession cannot afford to look solely to career success as a measure of the doctor without considering what the public looks for in that doctor. I doubt that my patients care much about my career progress or my research.

In their discussion McManus et al note that A levels should not be the only basis for selection. This must be right. We cannot afford to use career achievements as the sole measure of our success as a profession.