An evaluation of demographic factors affecting performance in a paediatric membership multiple-choice examination.

Objective: To determine if demographic factors are associated with outcome in a multiple-choice, electronically marked paediatric postgraduate examination.

Method: Retrospective analysis of pass rates of UK trainees sitting Membership of the Royal College of Paediatrics and Child Health (MRCPCH) part 1B from 2007 to 2011. Data collected by the RCPCH from examination candidates were analysed to assess the effects of gender, age, and country and university of medical qualification on examination outcome.

Results: At first attempt at MRCPCH part 1B, the overall pass rate from 2007 to 2011 was 843/2056 (41.0%). In univariate analysis, passing the examination was associated with being a UK graduate (649/1376 (47.2%)) compared with being an international medical graduate (130/520 (25.0%)) (OR 2.68 (95% CI 2.14 to 3.36), p<0.001). There was strong evidence that the proportion of candidates passing the examination differed for graduates of the 19 different UK medical schools (Fisher's exact test p<0.001). In multivariate logistic regression analysis, after adjustment for age, sex and whether the part 1A examination was taken concurrently, being a UK graduate was still strongly associated with passing the examination (OR 3.17 (95% CI 2.41 to 4.17), p<0.001). UK graduates performed best at 26-27 years of age (52.4% pass rate), whereas overseas graduates performed best at ≥38 years of age (50.8% pass rate).

Conclusions: MRCPCH part 1B outcome was related to place of primary medical qualification, with a significantly lower pass rate for international medical graduates compared with UK graduates, as well as significant variation in examination outcome between graduates from different UK medical schools. These data may be used to guide new initiatives to improve support and education for these trainees and to inform development of undergraduate curricula and help trainees prepare more successfully for postgraduate examinations.