gms | German Medical Science

14. Grazer Konferenz – Qualität der Lehre: New Horizons in Teaching and Learning

22. - 24.04.2010, Wien, Österreich

Impact of a knowledge-based admission test on study dropout rates of medical students


14. Grazer Konferenz – Qualität der Lehre: New Horizons in Teaching and Learning. Wien, Österreich, 22.-24.04.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10grako39

doi: 10.3205/10grako39, urn:nbn:de:0183-10grako399

Veröffentlicht: 18. November 2010

© 2010 Reibnegger et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



A previous investigation has revealed a dramatic impact of the introduction of a knowledge-based admission test on the time-dependent probabilities for successfully completing the first part of the study programme [1]. Cumulative probability of study success was dramatically better in students selected by the admission test versus those admitted freely (P < 0.0001). While only between 20.1% and 26.4% of freely admitted students completed the first two study semesters within the minimum time of one year, the respective percentages raised to a range between 75.6% and 91.9% for those selected by admission tests.

Here, we show the impact of admission test implementation on dropout rates, observed in the same student population. Data on 2532 students admitted to the diploma programme Human Medicine during academic years 2002/03 to 2007/08 were analysed in terms of dropout rates. 2000 of these students were admitted openly during years 2002/03 to 2004/05; 532 were selected by a knowledge-based admission test. Data analysis was performed using nonparametric (Kaplan-Meier technique) and semiparametric (Cox regression) statistical techniques stemming from survival analysis.

As the Figure (see Figure 1 (A) [Fig. 1]) shows, the risk of dropout was significantly smaller (the cumulative "survival" probabilities of students remaining active accordingly was higher) in selected students versus those admitted openly (P < 0.0001). Relative dropout hazard ratio of selected versus openly admitted students was only 0.13 (0.08 to 0.20; 95% c.i.) Univariate as well as multivariate techniques revealed that before implementation of admission tests, the cumulative "survival" probabilities were lower for female (P < 0.0001) as well as for older-aged (cut-off level 20.86 years according to the 75th percentile of all ages) students (P < 0.0001). In students having passed the admission tests, no such differences could be observed (P = 0.95 and 0.47, respectively). Among openly admitted students, German and, to a lesser extent, other foreign students had significantly poorer "survival" probabilities for dropout than their Austrian colleagues (P < 0.0001). Again, in students admitted after admission tests, no such difference was observed (P = 0.15).

For the students admitted openly, the Figure (see Figure 1 (B) [Fig. 1]) shows the combined effects of age and sex on cumulative "survival" probabilities. While about 75% of men aged below 20.86 years after an observation time of six years were still active students, the respective percentage in women aged above 20.86 years was only about 30%.

The observation of a significantly higher dropout risk in women openly admitted may be of particular relevance in the context of the fact that women regularly achieve poorer results than men in the admission tests.


Reibnegger G, Caluba HC, Ithaler D, Manhal S, Neges HM, Smolle J. Progress of medical students after open admission or admission based on knowledge tests. Med Educ. 2010;44(5):205-214. DOI: 10.1111/j.1365-2923.2009.03576.x Externer Link