Notes for Contributors

Editorials Selection methods in medicine: a case for replacement surgery? With myopic faith the medical profession persists in using systems of selection at all levels that have for more than 70 years revealed no signs ofreaching more than a minimum level of predictive validity. Several pleas have appeared regularly for the use of more scientific methods'-4. Three major publications during the past ten years5-7 have demonstrated the validity of psychological assessment, in particular using a multi-method approach. The NHS, however, blessed with a sense of omniscient divinity, continues to depend on application forms, references and large, untrained, and consequently fairly incompetent committees. Over the past 10 years the authors have been able to validate a multi-method selection procedure forjunior anaesthetists, to apply a personality questionnaire to 129 medical students and follow-up their performance and behaviour, to collect personality data on 150 senior registrars in all disciplines, and on some 275 trainees and consultants in anaesthesia. The findings from the latter cast serious doubt on the effectiveness of current selection policies. Medical schools have for a long time been able to attract above five applicants for every place available, although demographic changes may alter this dramatically. The prime determinant for entry is A level performance, a minimum of 2 Bs and an A being usually required. Some schools interview candidates, but the lack of a specification and lack of trained interviewers make this more an expensive public relations exercise than a serious selection method. A literature search over the past decade, has unearthed no UK validation studies of medical student selection, despite several from other countries8-'2. In 1988 we invited 129 final year students (some of whom had been interviewed) to undergo a personality evaluation using Cattell's 16PF question-naire13 and this year we examined their overall performance during their undergraduate training and during their house officer posts. The group contained 66 males and 63 females-92% of those taking their final examinations. The mean personality profile conformed to the mean for British undergraduates on 11 of Cattell's 16 personality factors. The remaining factors revealed that they were less intelligent, less conscientious, more insecure, less stable and more tense. Just over 50% (66) demonstrated some degree ofpsychological disability. The most prevalent traits were neuroticism and anxiety. Certain combinations of factors revealed below average interpersonal contact capacity, above average extraversion and low levels of creativity. Forty-two (33%) performed well, having more than satisfactory results; …