Objectives To compare the power of three traditional selection procedures (A levels, personal statements, and references) and one non-traditional selection procedure (personality) to predict performance over the five years of a medical degree. Design Cohort study over five years. Setting Nottingham medical school. Participants Entrants in 1995. Main outcome measures A level grades, amounts of information contained in teacher's reference and the student's personal statement, and personality scores examined in relation to 18 different assessments. Results Information in the teacher's reference did not consistently predict performance. Information in the personal statement was predictive of clinical aspects of training, whereas A level grades primarily predicted preclinical performance. The personality domain of conscientiousness was consistently the best predictor across the course. A structural model indicated that conscientiousness was positively related to A level grades and preclinical performance but was negatively related to clinical grades. Conclusion A teacher's reference is of no practical use in predicting clinical performance of medical students, in contrast to the amount of information contained in the personal statement. Therefore, simple quantification of the personal statement should aid selection. Personality factors, in particular conscientiousness, need to be considered and integrated into selection procedures.

This paper explores the role of personality, and the predictive validities of personal statements (PSs) and previous academic performance in relation to future performance in medical training. One hundred and seventy-six medical students had their application PSs coded into information categories and were followed over a 1-year period and assessed on (1) 21 diVerent assessments (observations, exams, essays, etc.) and (2) the dimensions of the ve-factor model (FFM) of personality. Neither the PS information categories nor the amount of information in PSs were found to be predictive of future performance. However, both previous academic performance (Betas .41 and .45) and conscientiousness (Betas .58 and .49), from the FFM, were related to success in medical training. Conscientiousness also demonstrated incremental validity over previous academic performance. Implications concerning the role of personality in medical selection are discussed in terms of trait complexes and trait facets.