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Adv Health Sci Educ Theory Pract. 2016 Mar;21(1):51-61. doi: 10.1007/s10459-015-9610-4. Epub 2015 May 3.

Non-cognitive selected students do not outperform lottery-admitted students in the pre-clinical stage of medical school.

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Institute of Medical Education Research Rotterdam, Erasmus MC, Room AE-239, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
Institute of Medical Education Research Rotterdam, Erasmus MC, Room AE-239, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
Department of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands.
Department of Social Sciences, University College Roosevelt, Utrecht University, Middelburg, The Netherlands.
Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands.


Medical schools all over the world select applicants using non-cognitive and cognitive criteria. The predictive value of these different types of selection criteria has however never been investigated within the same curriculum while using a control group. We therefore set up a study that enabled us to compare the academic performance of three different admission groups, all composed of school-leaver entry students, and all enrolled in the same Bachelor curriculum: students selected on non-cognitive criteria, students selected on cognitive criteria and students admitted by lottery. First-year GPA and number of course credits (ECTS) at 52 weeks after enrollment of non-cognitive selected students (N = 102), cognitive selected students (N = 92) and lottery-admitted students (N = 356) were analyzed. In addition, chances of dropping out, probability of passing the third-year OSCE, and completing the Bachelor program in 3 years were compared. Although there were no significant differences between the admission groups in first-year GPA, cognitive selected students had obtained significantly more ECTS at 52 weeks and dropped out less often than lottery-admitted students. Probabilities of passing the OSCE and completing the bachelor program in 3 years did not significantly differ between the groups. These findings indicate that the use of only non-cognitive selection criteria is not sufficient to select the best academically performing students, most probably because a minimal cognitive basis is needed to succeed in medical school.


Academic performance; Cognitive selection; Control group; Medical school; Non-cognitive selection

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