gms | German Medical Science

Due to the fact that in Austria the access to university studies is not limited by law, every year about 1600 beginners enrol medical studies at the Medical University of Vienna. In 2002 a new curriculum with a highly selective summative integrative exam at the end of the first study-year (SIP1) was implemented. Students who pass this exam at the first or second date can progress into second study year. Therefore passing this test is the first important success criterion. Freshmen of this study-year were allowed to take this exam four times but they had to succeed at the first or second date to continue their studies without loss of time.

In two consecutive prospective studies of first-year students of two study years we were able to prove that in comparison to their male colleagues female students were discriminated by the above mentioned decisive exam (see table 1 [Tab. 1]). These analyses additionally generated three predictors of succeeding the SIP1 at time, namely German mother tongue, good school performance, and high learning capacity [1], [2]. All other issues (socio-demographic variables, family background, economic situation, living conditions, social integration and health, study-motivation, and the ability to cope with stress) consistently showed no influence. The reliability of these results was ensured by analysis of the data of the entailing beginner’s cohort [3].

The highly remarkable sex-effect, which stands in contradiction to international findings [4] caused us to analyze the further study-progress of the first (2002) cohort. In this paper we report the results of their "transition” characteristics.

In this study the four predictors (taken from data of the questionnaires of the 2002/03 cohort, see table 2 [Tab. 2]) were merged with the admission data of the following study years. We examined if students

1.

feature the previously found predictors of success [1], [2], [3],

2.

show study activity, and if so,

3.

in which semester they are registered.

Considering the fact that passing the SIP2 is not conditional for pursuing studies (SIP2 can be taken until the end of the third year) the following constellations for the 2002/03 beginners are possible:

• Group 1: Students appear in 7^th semester (SIP 1 passed in time)
• Group 2: Students appear in 5^th semester (SIP 1 or SIP 2 not passed in time)
• Group 3: Students appear in 3^rd semester (SIP1 passed, but not in time)
• Group 4: Students do not appear in the admission sheets of the 3^rd, 5^th or 7^th semester (SIP 1 not yet passed or drop-out).

1.

Differences between students who show up in the 7^th semester (group 1) and all others (group 2, 3, 4).

2.

Differences between those who passed SIP1 (groups 1, 2, 3) and the rest of the cohort (group 4).

To prove these hypotheses the statistical tests of successful and unsuccessful groups comprise Chi-square and (in case of LAS) t-tests, analyzed in SPSS 11.5 at the level of P=0.05 (adjusted for multiple testing).

The socio-demographic variables (age, sex) of the 2002 cohort are given in table 3 [Tab. 3]. Approximately two thirds of the first-year students are females.

Hypothesis a): For students in the 7^th semester (group 1) the same predictors of study success are relevant (sex: female vs. male, 38.8% vs. 48.5%, P=0.022; German mother tongue: yes vs. no, 43.2% vs. 30.8%, P=0.013; good school performance: sum of school marks, lower value is better, 7.7 vs. 9.4, P<0.001; and high learning capacity: three items on LAS/hours, P<0.001, P=0.044, P<0.001, see Table 4 [Tab. 4]). Almost all students who passed SIP1 in time (and therefore were allowed to continue studies without lack of time) show up in 7^th semester (diminished by only 11.1% by SIP2 compared to a minus of 62.7% at SIP 1). We conclude that like in SIP1, in SIP2 the same predictors are effective, in other words, subjects who passed SIP1 have a high chance to succeed SIP2.

Hypothesis b): When examining the groups of students who passed SIP1 at any time (groups 1, 2, 3) three of the four predictors mentioned above remain effective (see Table 5 [Tab. 5]). The sex difference is neutralized by the fact that female students show up again but after a loss of at least one year (P=0.397). Of the freshmen 37.3% continue according to study plan, 14.5% with one year’s loss, and 0.5% with a loss of two years. In the following year and even up to three years later students of the examined cohort (2002/03) show up in the admission sheets and thus must have passed SIP1 at a later date.

To examine the annihilation of the sex effect we compared the 3rd semester admission sheets of the three consecutive study years (see table 6 [Tab. 6]): 43.7 % of male students passed SIP1 in time but only 37.1% of females. 11.6% of male beginners but 15.5% of females show up one year later. After a loss of two study years an equal percentage of 0.5% of the cohort examined are admitted (see table 6 [Tab. 6]).

Facing the fact that selection of students in Austria look place during studies (and not before) we not only are interested in the quantification of selection but also in its specificity. Previously we were able to show that female students –- reliably – perform worse in this selective exam and consequently we now are interested in their further study-advances. The results of this „students’ transition analysis“ yielded – in addition to our previous findings (four predictors: male sex, school performance, German mother tongue, high learning capacity [1], [2], [3]) – two new observations:

1.

analogously to a master key the above mentioned predictors “open” the door not only the third but also to higher semesters.

2.

female students who did not succeed SIP 1 in the first run, show up in registers again after a stand-by time of one year or even more.

This may stem from two causes: either they have adapted their learning strategies to the demands of SIP or they succeeded after an additional investment of learning efforts which would not have been doable within time given. Within the group examined, there may also be a small number of students who intermitted studies because of pregnancy, granting of leaves or illness but their number certainly is negligible. Furthermore, the opportunity for the non-successful of taking elective courses in the mean time does not compensate their loss of time.

We conclude that female students do not suffer a loss of time because of lacking cognitive competence, but because of an interaction of SIP-specific demands and a supposed sex-specific learning-behaviour.

From the present point of view we assume that a splitting of SIP into several smaller exams would reduce the obvious disadvantage of female students: data from the Medical University of Graz (yet unpublished) where a similar curriculum is implemented but with several small exams do not show this sex-effect. Furthermore, we hope that the – currently undertaken – analysis of the influence of sex-specific learning strategies on success at SIP1 will bring light into matters.

The authors would like to acknowledge the financial contribution of the ÖGHD (Austrian Society for didactics in higher education) and of the Department of Further Education of the Austrian Chamber of Physicians, who support our studies.