The selection procedures used in Auckland have been reviewed, and the characteristics of those admitted over 25 years analysed. Students are admitted either as school-leavers, mature entrants, or through an affirmative action scheme. A further small number are admitted as part of overseas development assistance. School-leavers are invited for interview on the basis of their academic achievement. Mature students and the affirmative group must have a minimum acceptable academic standard, with the interview playing a dominant role. Two thousand four hundred and forty-eight students have been admitted. The mean age was 18.6 years, and 39.7% were women. Over one half of the students had a parent who had attended university and 13% had a medical parent. One in ten students failed to complete the course, academic failure and withdrawal being of equal importance. The high loss seen in the affirmative group was due to academic failure and has led to the introduction of extra tuition and support for these students. The emphasis on academic achievement by school-leavers has excluded many applicants with outstanding personal qualities. The academic staff has therefore decided to modify the selection procedure, the final rank order of these applicants being based on their personal attributes and life experiences.

The major focus in the selection of entrants for medical school has traditionally been on academic achievement in school-leaving examinations in which certain science subjects are a requirement. A longitudinal study of 413 successful applicants was undertaken to determine the relationship of these admission criteria to subsequent performance. The findings support a correlation between overall marks in the school-leaving examination and the annual Grade Point Averages. Those students in the top quartile for marks showed a significant advantage in terms of achievement but only in the preclinical years. Despite the significant correlations no predictions could be made on the basis of overall marks. No correlation was found with levels of clinical competence during the ward clerkships or with the interdisciplinary objective structured clinical examination (OSCE) in the final examination. Marks in individual school-leaving examination subjects correlated with performance during different parts of the course but only those entrants in the top quartile for marks in physics and biology showed an advantage through to the clinical years. English marks were the least correlated and failed to confer an advantage in any year of the course. None of the correlations between school-leaving marks and grades in medical school exceeded 0.4. The predictive value of school-leaving examination marks therefore accounted for only 16% of the variance in subsequent examinations. Selection of medical students on the basis of academic criteria alone is inadequate and should be accompanied by assessment of personal qualities. This School no longer uses school-leaving marks as the primary selection instrument.(ABSTRACT TRUNCATED AT 250 WORDS)

SUMMARY An affirmative‐action programme was introduced in Auckland in 1972 to increase the proportion and absolute number of entrants to medical school from the indigenous or Maori population and those of Pacific Island ancestry. One hundred and forty‐seven students have entered the course through this programme, the percentage of females being higher than that of the non‐affirmative category. Seventy‐five have graduated – a graduation rate of 78%. Twenty‐seven (18%) have been lost from the course mainly through academic failure, This loss is much higher than the 8% found for the remaining medical student population. The subsequent careers of those lost from the course has been satisfactory, some graduating from other faculties and some from polytechnics. Although such a programme remains controversial it has enabled a large number of persons to enter medical school who would not have been able to do so through the standard admitting process.

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