nm0321: i've been asked a question by one of my colleagues as to how we get to 
lunch when this session has ended obviously lunch is a very important event 
today [laughter] er should it be raining and hopefully it won't be raining it 
we would be able to er offer sort of minibus transport but the idea is that 
we'll walk er [laughter] past the ducks near the lake and on towards the Arts 
Centre and myself and a few of my colleagues i'm sure will lead you in the 
direction to to Eat restaurant you'll certainly need to walk back because 
you'll need to walk off some of the excess lunch that you [laughter] er have 
eaten 
nm0322: [laughter] 
nm0321: now i'm going to introduce our next speaker er namex has led into this 
session very nicely er posing questions about medical student selection and 
particularly in relation to attitudes and what part 
that may play in the selection process my colleague Dr namex is a lecturer here 
at the medical school in general practice and he's also a general practitioner 
in namex and for this session Dr namex has joined us as well who's the 
admissions tutor for the medical school here so i shall pass over to 
nm0323: okay thank you 
nm0321: to namex 
nm0323: yeah thanks very much er er the earlier session on attitudes of er 
medical students and er medical professionals is a important lead-in to this 
particular topic er i'm quite interested in this and er i've been looking into 
our selection procedure at namex Medical School okay for the purpose of this 
presentation what i thought i would do is i'd look at current issues in the 
selection process which are in the literature at present time er i will give 
you an overview of the selection process at namex and then now that 
will be about twenty slides so i'll be going fairly fast at that stage and most 
os-, most of us have been through the er selection process so we'll understand 
it fairly quickly and er in the third section i'll look at some possible areas 
of research in the selection procedure and also report on a statistical 
analysis we've done of the interviewer scores okay current issues in selection 
you may have come across wider access for underprivileged er educational and 
social background people er then there's the personal qualities assessment and 
common admissions tests for all graduate entry courses which has really b-, er 
just been talked about but i thought it would be useful to bring it to your 
attention the underprivileged er is quite contentious and problematic it is 
desirable but it's really addressing inequality with further inequality er but 
it's worth noting that 
something like seventy per cent of medical students are from very privileged 
sort of backgrounds and the first university who er started looking at this 
area was Bristol around about two-thousand-and-one it was reported in the news 
items er they were giving something like two Bs and a C er gradings for entry 
into their medical course for pupils from inner city secondary schools and 
things like that or comprehensive schools and this year Saint George's er 
Hospital have er this sort of policy i don't know whether it's a general policy 
or whether they're just kind of looking at a certain percentage say ten per 
cent or fifteen per cent i'm not entirely sure but it was in the in the press 
that they are looking at it this year psychometric testing quite a lot of work 
currently going on it's quite prevalent and the origins are from U-S-A and 
Australia and basically it focuses on students who have empathic attitudes and 
if you are looking at this area one wonders that perhaps you could give lower 
grade offers and Durham this year i i think Professor Hamilton is is reporting 
that he would look at look at students who have this sort of empathic attitude 
much more favourably and perhaps give lower grade offers and of course when 
you're looking at this area you begin to think whether it might be a useful 
tool er to look at low numbers to interview because it is very labour intensive 
er at namex we had er five-hundred interviews and i-, i-, it is hard work the 
Scottish universities have got two cohorts of er five-hundred voluntary P-Q-A 
assessment er this is the the there are five universities involved and er there 
is er 
nm0324: sorry what's P-Q-A 
nm0323: er P-Q-A personality er personal qualities assessment it's sort of 
attitudes really er they're they're looking at er five-hundred volunteers okay 
h-, who have taken this P-Q-A test and of 
course er there is a long study which i'll describe in a minute and the areas 
of interest er primarily are problem solving capability and personality traits 
and this study which has yet to be er reported upon the preliminary resu-, 
results will be out say in the autumn time but the prelim-, preliminary results 
are already being talked about and that's where i come in there's a lady called 
Dr Lumsden from Glasgow University she's the admissions tutor i guess and they 
looked at two cohorts of er five-hundred students in two-thousand-and-two 
intake and the two-thousand-and-three intake and they're hoping to follow up 
these students er for up to ten years and this is to assess whether pre-
admission psychometric scores can accurately predict their medical performance 
I-E the area they go into and how high they kind of rise in the ranks as i said 
the preliminary results will be reported later on this year but the 
interesting remark was according to the testing they've done so far something 
like a hundred-and-twenty-eight out of the five-hundred-and-ten that's quite a 
high percentage er are judged to be unsuitable for a career in medicine 
actually just going back the areas of interest er the P-Q-A test they did find 
er that the test was much more useful for problem solving capability than it 
was for personality traits but i ask you to bear in mind that these people are 
fairly intelligent but they have been chosen okay so they may ha-, already have 
the right sort of personality traits it's not kind of er er a whole population 
study it is very much focused on the people who've already been accepted the 
common admissions test er we have a graduate entry programme at er namex and 
there is a proposal from Oxford for a common admissions test at the present 
time er i'm aware of 
another workshop for for development of this common admissions test on fourth 
of July and i think this is towards the end of June and namex has been invited 
to this essentially the workshop er is being held and they hope to agree on 
what core knowledge skills and values are important in medical students and 
they would obviously look at the quality issues and validity and reliability 
and they will monitor all of that and they're hoping to tender er to a test 
contractor and they're thinking of implementing this by two-thousand-and-five 
it's it's a tall order but i thought i'll bring it to your attention that these 
things are being talked about and what the rights and wrongs that may be okay 
now i'm going to really speed up er the selection procedure at namex it's based 
on the Leicester model er this is the fourth year of selection we're going 
through er it's based on the best current evidence and advice that is 
available and i make reference to the er the Committee of Heads of Medical 
Schools er Tomorrow's Doctors the General Medical Council i think fairly 
familiar with that and How To Do It er an article in the B-M-J by Powis and it 
was in nineteen-ninety-eight not nineteen-eighty-eight that's an error on my 
part the heads of medical schools essentially say that the selection process 
must be transparent i mean that's political correctness and everything else and 
fairness too really er the process must identify core qualities those are both 
academic and personal and we're looking at er highest standards of personal 
conduct for obvious reason and it's er incumbent for for er potential students 
the applicants to disclose criminal records and equally primary du-, duty being 
to the patient they've got to disclose infectious diseases and any disability 
now this does not bar them from entry into medical school but there is a panel 
which assesses what sort of disability and 
whether they would be suitable for a medical career and i think the same would 
apply what sort of criminal record there is but it is incumbent for them to 
disclose that the entry criteria as i said academic ability and a suitable 
personality and the selection process involves er written application through 
UCAS i'm sure you remember and nowadays er it involves a personal statement er 
there's a competitive interview finally it's an admission tutor's decision 
whether they are offered a place or rejected er the written application again 
looking at academic ability er from biological sciences we don't have any arts 
students or engineering students here er we're looking at two-one upwards er 
supportive referee is important and some personal qualities and a strong bias 
towards works experience in the medical profession and 
i'll come to that a little bit further on er what do we mean by personality 
[laugh] communication skills and empathy with patients are very important er 
settled and demonstrable motivation to the profession and a suitable 
personality which is kind of an overall assessment for the practice of medicine 
and we judge these through a referee's report and the written material which 
they provide i'll come on to that in a minute and of course the interview and 
it's not an exact science i think everybody admits that er we give them a 
supplementary er application form which allows them to expand er on their 
personal statement in a very structured way and i'm going to quickly run 
through the the the huge number of questions about ten of them we we ask why do 
they want to do medicine what sort of recrecationa-, recreational activities 
they might be involved with some sort of insight into medicine what's kind of 
important er ethical issues for the current sort of times er works experience 
we're looking at patient centred er explicit dates and details because somebody 
can go there for an afternoon versus you know a very close observational and 
active role in a hospice say and more importantly what did they learn from this 
and how do they feel about it er more importantly for namex this one is to 
describe their degree course because you can then assess whether that is 
suitable for er for for our intake or not and i know for a fact that he goes to 
great lengths trying to find out you know what the structure of the c-, degree 
course is at various universities to make a more informed decision and this all 
of this helps to decide who interview and also how we structure the interview 
and i'll come 
to that in a minute the assessment of the written application is done by a pair 
of course selectors er up till this year it used to be two people now there are 
two pairs involved er if there is a discrepancy er because they give a 
numerical score er then an adjudicator comes in to decide whether they 
interview or not er so far er i mean we only had er one pair now we've got two 
pairs there's fairly good concordance at the present and i'll put a question 
mark this is something we will be looking at and seeing how it sort of evolves 
and er something in italics i thought well it's interesting er if you could er 
look at the concordance between the er the the er numerical scores from the 
written application and the interview score and if they concord very well one 
wonders whether we need to interview at all maybe that's just a question 
[laugh] why interview historically it's always been er the 
selection was on academic grounds and it was really to reject the seriously 
unsuitable and of course there's a lot of literature and a lot of commentary 
that er er academic performance is not necessarily a good predictor of the 
personal qualities that we're looking for and those mentioned in the er 
document Tomorrow's Doctors okay the interviewers er i did this presentation 
only two days ago and one comment was well the interviewers they must have 
certain sort of biases and that sort of thing maybe they should also sa-, some 
sort of psychometric testing so er that's an interesting comment er last year 
we had er two training sessions one was a workshop and then we had a training 
session looking at er simulated er interviews and the aim was to really 
calibrate numerical scores how to assess the students and er the whole process 
er last 
year we had forty-two interviews er mainly academic staff clinical staff and 
some medical students and i think the future we may be looking at some lay 
interviewers not completely lay sort of thinking like maybe social workers 
maybe nurses and that sort of thing with appropriate training and how that 
would work out and pan out we don't know this is just a proposal at this stage 
we have two interviewers we try to mix the clinical and the academic er it 
lasts twenty minutes we're not supposed to give any indication to the student 
how well they've done they might go with the false idea that they've got in and 
they may not have and could cause problems and we give independent numerical 
scores er they're on three three three er levels and i'll come to that in a 
minute but it's important for the interviewers to write down comments of what 
their base their their scores are so that if there's comeback they're able to 
actually say why they did well or did not do well i guess it'll be the people 
who are rejected who might come back so it's important that we do that this is 
just a process now w-, we we we the the the two interviewers have a game plan 
and er one goes out er gets the er candidate tries to make them relax the usual 
introductions you know have you had a decent journey that sort of thing and in 
cer-, essentially we pick up on topics and we try and judge all the qualities 
that we're supposed to be judging through a discussion of topics related to 
medicine it's not an academic test and that that's an important consideration 
er namex Medical School has no set questions however all the interviews do have 
ready prepared questions that we use and of course the S-F-A which is the er 
supplementary application form with all the details we use some of the material 
and we ask questions from that 
and like i said you need some sort of game plan as to who's going first and 
what sort of things they might be asking so that er you're not repeating 
yourself the criterion to be judged by are communication skills motivation to 
do medicine and general suitability and this is what we mean by communication 
skills it really comes out as a by-product it's not something you directly ask 
we're really looking at good presentation and issues about being good listeners 
and their ability to develop discussion and so forth er we talk about non-
verbal communication again it's the way they sit it's the way they come across 
the way they relate to you it's all important motivation for medicine obviously 
important er we're we expect the s-, candidates to have some idea what the 
curriculum is and one of the questions asked is what do you 
think about the sociology modules which are which are er er taught very early 
on in the course and that is usually a good discussion point realistic er 
commitment to a career in medicine appreciate the challenge a knowledge of 
career structures you know sort of houseman S-H-Os registrar grades and that 
sort of thing and awareness of current issues in medicine and the sort of 
things that come up is er if you were the er Minister of Health you know how 
would you do his job differently and why general suitability we're looking for 
determination perseverance tenacity and have an interest in other people and 
how their decisions may affect other people er ability to manage stress and 
look for advice and also this feeling that they can share difficult problems 
with other people okay er the decision well if they they've already passed the 
written application assessment so if they get 
high scores like twenty-nine thirty er we score one to five in the three 
categories so if they get twenty-nine thirty they're likely to get an immediate 
offer if their scores are low round the twenty-five they'll probably get a r-, 
rejection immediately and the ones in between going to the hold list which is 
dependent on just how the interviews are going how the other people are 
responding because if we select a candidate they may reject us of course so 
that's all important and finally to aim at a precise figure rejected candidates 
have a right to know why the admission tutor gives written feedback on request 
and if they've fallen down on communication skills and things like that they 
can be encouraged to apply again do we get it right i guess we need to know er 
have some knowledge what happens to the people we reject if they get accepted 
on other courses 
maybe they're really are good candidates and we're not picking them up er 
feedback from those who reject namex i know that that some questionnaire has 
been sent but i haven't got enough er information on that as yet we would look 
at the dropout rate and the failure rate in subsequent sort of years the 
research question i pose is that there are two interviewers how well do we 
assess the candidate and what's the level of concordance between the two 
interviewer scores obviously that would need some sort of regression er data 
analysis what level of concordance would be acceptable and we really tried 
focusing on sort of further training of interviewers in terms of how to pose 
the questions and that sort of thing i think most people are pretty impressed 
with the way they pose questions in the orals for the M-R-C-G-P examination 
they use five minute time slots and they usually flag up the theme first and 
then 
follow it up with the specific question all the usual things open questions 
first set the scenario and then follow up with discussion and then you close it 
up with closed questions and may actually say what would you do in that 
situation and you know get them to sort of commit themselves er this sort of 
approach may be seen as problematic by some people I-E if you have a theme to 
discuss and an area to discuss and if this candidate does freeze well do you 
stick with that same game plan it's open to discussion at the present time er 
if we do do this sort of training i guess we could follow it up with some 
qualitative interviews of the selectors has it improved their technique do they 
feel more comfortable do they think the outcomes are better we could do a 
further analysis of the concordance factor okay er now this is interesting we 
did look at er at the the statistical analysis of er nine 
interviewers er these are nine interviewers who've done the majority of the 
interviews they've done more than twenty each and it's only meaningful if 
they've done a lot of interviews so it is it's only applicable to those here 
are the anonymous interviewers here these are the number of interviews they 
actually did and this is their mean scores and this is the standard deviation 
of their scores now using this particular test called Kruskal-Wallis test 
you're able to compare the scores of A independently with B C D and so forth 
and if the difference is significant and for three of them it came as 
significant from that we identified er three significant outliers of which we 
two er identify two doves and one hawk so it's a bit of advice from the 
admissions tutor to them say if they're in any doubt the the the hawk might up 
the mark and the doves might sort of lower the mark 
okay i've covered a lot of things here and i'm open to questions and to back me 
up namex will join in as well thank you 
nm0321: a-, an-, any questions for for for namex or the the admissions tutor 
nm0325: as a as a non-medical person here er what what information would you 
expect to get from the psychometric test you prefer to have er probably a silly 
thing to say but because they're graduates do you expect a more mature 
personable mature attitude than you would if they were coming in at an 
undergraduate level 
nm0323: right er the the er there were two areas that primarily focused on okay 
er one was their ability to problem solve okay from that they did find a good 
range and the deduction was there was a number who weren't good problem solvers 
and equally with the personality traits but i did point 
out er w-, with the personality traits the attitudes er we had a discussion 
earlier on they may know how to answer the questions so it may not be an honest 
response and the other thing is they're already a selected group okay they've 
already been admitted so in a way you would expect them to have the right sort 
of attitudes but if they were given to sixth-formers a thousand sixth-formers 
say then it might actually help you to discriminate who would be more suitable 
for the interview stage 
nm0326: er can i jump in about the P-Q-A 'cause there's a whole bundle of P-Q-A 
tests out in that run as you probably know the one that's being used this 
summer that i know about was used by Queen Mary University London Bart's and 
the London Hospital it's personal-, personality personal qualities assessment 
test is basically aimed at trying to discover whether the candidate 
has the right abilities of empathy and things like that and the point of the 
test really is to exclude those who do not have er these suitable traits for 
medicine rather than to rank order them so it's a useful thing to get rid of 
those with two heads but it's not a useful thing to decide those who we should 
call to interview 
nm0323: that's right 
nm0326: er the i have actually looked at that test er and the way the sort of 
questions it formulates really aren't so much problem solving and as indeed 
personality testing the sorts of questions that you that that they pose a 
scenario scenario i remember is that you are a a man with a relatively modest 
salary u-, r-, living and working in a country where there's no National Health 
Service and your wife is seriously ill and you need so many thousand dollars in 
order to buy the treatment you haven't got that money but you have the 
opportunity to embezzle it from your firm and then a whole string of questions 
are asked about that and 
then the scenario is slightly changed er another string of questions is asked 
about it and they're actually quite subtle and quite interesting i f-, well 
there's no failing but i f-, rather feel i did dismally badly in it [laughter] 
er okay the point is with this you get you put if you think of a dot plot of 
personality characteristics you you will get a cluster of dots in the middle 
who are the people that you would regard as suitable and some guys on the 
periphery who would you you would regard as not suitable at Queen Mary's er 
they applied the test to i think a thousand candidates and excluded three-
hundred-and-fifty-odd er on that basis now that might be a f-, a fine way of 
going about things if you're wanting to homogenize the profession and end up 
with a bundle of guys and gals who are right sort of touchy-feely sort of 
things but inevitably by taking that approach you run the risk of excluding 
those who are going to be excellent histopathologists and so one has 
that sort of doubt about it there are other doubts [laughter] the other doubts 
are that people can learn how to do these things and the experience in 
countries where this sort of testing has been used is that fairly fairly 
quickly there have sprung up private schools which will train you for a price 
how to pass that test and so on er though the question was asked whether it 
gives us information we don't already know the answer is of course not really 
but it quantifies it and makes it transparent i mean if you spend enough time 
in interviewing and and getting people to write essays as they can for example 
in Oxford spend two or three days with candidates in Oxford don't they if 
you've got that sort of time available then i'm quite sure you can f-, do the 
same sorts of things as a P-Q-A test would do quite sure of it we can't don't 
have the time so there is an argument that to exclude the outliers if that's 
what you want to do you can 
use P-Q-A testing but there's no need to do that it's not not for ranking you 
were also asking about something about whether we feel that graduates should be 
more mature indeed we do er er one of the things that namex has mentioned is 
this issue about er work experience when we say work experience what we mean is 
that they should have got real hands-on some sort of caring experience hands-on 
working with people in some sort of fashion it doesn't have to be in a medical 
environment although that's obviously preferable thing about our candidates 
since they're in their early twenties we would have expected them to have got 
this sort of er experience of their own volition er to candidates that come 
from school that have done this they've been told to do it by their teachers 
okay so there is a difference and and that's how we how we look for this sort 
of more mature attitude er that's how we do that i think certainly graduates 
should be regarded as potentially well potentially more 
than more mature than school leavers 
nm0325: thank you 
nf0327: can i just ask has anybody ever done P-Q-A on people coming out the 
other side of a medical degree 'cause i would say all of us when i went through 
it 
nm0326: yeah 
nf0327: changed a lot personalitywise 
nm0326: yes no not yet er well i don't know about Australia what you're saying 
is a comparative test 
nf0327: mm 
nm0326: to see how the personality changes over the five years of medical 
training i'm not aware i that that may be out there but i'm not aware of it the 
P-Q-A testing 'cause it's a fairly recent phenomenon of course the United 
States have been doing er all sorts of testing for medical school entry for 
years and years and years now but they're different kinds of tests they're not 
really personality tests they're cognitive tests cognitive ability tests and 
reasoning tests that have been done there not so much i think we have to 
clearly distinguish between er the empathic dare i say it touchy-feely 
characteristics and the problem solving characteristics which are both equally 
important but separate and the the first kind the empa-, you know empa-, the 
touchy-feely stuff hasn't properly been got into yet 
nm0328: can i just ask have the interviewing panel done them 
nm0326: done what 
nm0328: personality tests 
nm0329: 
nm0326: er 
nm0330: 
nm0328: can can i tell you why i'm asking the question 
nm0330: 
nm0328: i'm asking the question because i think if you're measuring the empathy 
and you kind of need to do the test yourself so you can measure it 
nm0326: 
i do entirely agree you're absolutely right and i say i have sat it but i think 
i did dismally badly to be honest [laughter] er but from a practical point of 
view it simply isn't possible er we we 
nm0328: yeah 
nm0326: have been faced with er vast numbers of candidates to interview to get 
an interviewing system up and running from scratch from nothing 
nm0328: yeah 
nm0326: in a very short period of time in an ideal world er i would what i 
would want to do is s-, indeed select the interviewers and the criteria for 
selecting the interviewers are going to be difficult to decide upon er namex 
did mention that we're thinking about taking some lay interviewers this this 
year er i shall probably start that off by looking for half a dozen people er 
and i shall ask them to provide C-Vs and references and i shall int-, we shall 
interview them and take it from there but i'm find it diffi-, well er i i i 
don't know if i would find it 
difficult to ask er lecturers from the G-P unit here to go through that 
procedure er i i might find it fairly easy to ask them but whether they would 
find it easy to do it acceptable to do it i'm not sure er there is a an element 
of difficulty so if i 
nm0328: yeah i just think it's an interesting question because it's a measure 
nm0326: yeah 
nm0328: against what what's happening for the students so the students are 
going through that process 
nm0326: yeah 
nm0328: and this test is saying 
nm0326: yeah 
nm0328: you can't you are clearly am-, empathic person 
nm0326: yes 
nm0328: that may not meet with the interviewers' expectations 
nm0328: indeed indeed 
nm0328: 
and you and therefore 
nm0326: i mean you have 
nm0326: you've got issues running the test haven't you 
nm0326: you have touched on a very serious issue which is training interviewers 
how do we train interviewers er and to be honest er i'm open to advice 
[laughter] absolutely 
nm0331: i don't know [laugh] 
nf0332: i was wondering the same thing about communication skills because i 
think it's it's relatively easy relatively easy for any professional to make a 
judgement about how they felt about the candidate in front of them but and i 
think the training issue's really really key 'cause when you talk about 
communication skills a shared understanding what would of what level of 
communication skills can be expected from or are appropriate to a candidate 
will be helpful 'cause just from observing people i've got a theory that people 
tend to rate highly communication skills that are similar to their own which 
means that 
an interviewer who whose own personal style is to be very professional sit up 
very straight 
nm0326: yeah 
nf0332: and behave in a ver-, in in a particular way would actively prefer a 
candidate doing the same a very expressive interviewer 
nm0326: well yes 
nf0332: might feel naturally drawn to a very expressive candidate 
nm0326: i i again i take your point er 
nf0332: i think the training's crucial i mean 
nm0326: training is and the the way we did w-, the way we trained er was we put 
up er er dummy interviews er and they're very good dummy interviews 'cause one 
candidate interviewed very badly and the other candi-, candidate these are 
actual students not candidates 
nf0332: yeah 
nm0326: 
obviously we couldn't do it with candidates er the one student interviewed very 
well and the other student interviewed rather badly er and we got the 
interviewer er interviewers we were training to score er all the various 
criteria we were interested in in the way we do in a standard interview and 
surprisingly the the they were quite tight scores er i should have brought 
along the data er which i'm going to accumulate over the coming years but in 
fact there was not much experience er and it looked as if er the interviewers 
were all doing much the same thing well now you can come back quite rightly and 
say well that's not at all surprising 'cause all these interviewers are the 
same people basically they're all medics middle-aged mostly white all of them 
European no not all of them you can see what i mean a a rather homogeneous 
group of 
nf0332: yeah that's where your lay panel come in presumably which i think is a 
great idea 
nm0326: 
beg your pardon 
nf0332: that's where you lay panel come in presumably it's well it's a great 
idea 
nm0326: well well yes there there are serious constraints upon on the whole 
business of interviewing and and that is resources er because i feel it's very 
important that it should be at least one medic on the interviewing panel 
without any question the other person we only have two i would prefer to have 
three the other person i feel should be non-medical but 
nf0332: yes 
nm0326: i'm very broad-minded about what non-medical means you know i'm not i'm 
i'm a biochemist by training er but i've been so much associated with medicine 
so for such a long time i can't really call myself non-medical 
nf0332: mm 
nm0326: er but i know er er a J-P not a G-P a J-P whom i feel would make a very 
good interviewer er in this situation so i would like to have the variety in 
the interviewing panel to do what you what you suggested we do but in practice 
i think i'm going to be strapped to two interviewers for ever 
nf0332: i hope you get three 'cause it sounds a really good combination 
nm0333: it does it sounds brilliant 
nm0326: yes [laughter] 
nm0334: namex can i ask er sorry i'm chatting through er how many of these 
students have had interviewing er done er practice before like for senior 
registrars and and junior doctors we they ask we train them up for interviewing 
i'm sure when they go for their interviews they do quite well do the er er 
schools provide them interviewing it's all very good when you look at their 
marks everything they do 
nm0326: mm 
nm0334: er they've been selected in a particular way i'm sure if they've had 
training in interviewing and communication skills they'll come and perform 
better then and the second comment was so many er managerial and professional 
one i interviewed one this gentleman said i'm i'm i'm er from a labouring 
family and straight away made me empathic towards him 
nm0323: mm 
nm0334: i i i actually 
felt er he he was making a case er that he's coming from a poor family 
nm0323: sure 
nm0334: and and er it's such a small number are there and i think those people 
will make better doctors i think er er a-, and and i wonder whether you've got 
any comments whether we should give them a special er er er approach 
nm0323: well the second part i think namex will answer the first part er i will 
answer we don't have any real idea how much training they actually have had i 
know for the local schools er i am invited to do some interviews for them and 
some of the consultant colleagues there so yes they do get a lot of practice so 
this goes back to the age-old argument that if we're looking for certain 
personality traits or certain ty-, er way to interview we can train them but 
one could argue and that's just er a view that i hold i mean even attitudes can 
be taught but certainly communication skills can be taught i mean although 
there's a little argument over the attitudes but 
they do shift in a way so if somebody has got bad communication skills at say 
point A if they go through Clinical Methods course the DISC course and all the 
the ones that's run by the Department of General Practice we improve all of 
those so they are we are able to teach them that so one wonders they whether 
that should actually be a bar or whether that's just a value judgement we make 
at a point in time and we've got to really give preference to the people who've 
already got these traits and the right sort of communication skills so we don't 
know what level of er er training they're being given 
nm0326: when when we have a group of candidates in for interview about thirty 
or so at a time i often ask them how many of you have been to competitive 
interview before er and it's about half have had some sort of experience of 
competitive interviewing have been competitively interviewed i should say the 
other half have not because these days er it's very rare for people to go into 
serious competitive 
interviews in a university for example er in the Department of Biological 
Sciences er we wanted to attract them in we aren't trying to sort out sheep and 
goats [laughter] so i suspect that the answer is that those who have been to 
competitive interviews especially if they've got a middle class background and 
gone to private schools will have had some training a lot of our candidates 
have not been through that situation and i do not know how we can compensate 
for that i wish we could compensate for that i don't know how we can er but 
what i try try to do is if a guy has bounced and he asks me why er and he's 
done badly in the interview because of his er communication skills i make that 
very clear to him and i say if you want to do better you've got to do something 
about that get some practice and advice on how to how to how to er present 
yourself at an interview so the issue you bring up is very important sadly 
there's nothing we can do about it because we can 
only judge what's in front of us at the time we can't we cannot judge potential 
there's no way no way we can we we can can imagine that we could so if a guy 
communicates badly at interview sadly that's it however good he might be 
[sniff] going to 
nf0335: 
nm0326: people ask 
nm0336: 
nm0326: but er sorry 
nm0336: yeah sorry er er i mean just just extending on to that point i mean er 
er er looking at the er er the explanation of the process the the it's a twenty 
minute interview but ten minutes are used for paperwork and so effectively it's 
only ten minutes 
nm0326: no no no 
nm0323: no that's additional 
nm0326: twenty minutes interview plus plus ten minutes 
nm0336: oh okay 
nm0326: er the ten minutes is intended so that the interviewers can develop 
strategy for the interview and think about the assessment afterwards 
nm0336: okay 
nm0326: 
there are two possible ap-, there are two strategies for interview broadly 
speaking one is the situation where you the the interviewers go in completely 
cold without any background information and develop a d-, er er er a discourse 
with the candidate now that takes time 'cause you've got to explore and you ask 
the guy what his name is for example 
nm0336: yeah 
nm0326: the other approach is that you use prior information to structure the 
interview if you've got lots of time then the first is very good if you haven't 
got lots of time then you have to use prior information to decide how you're 
going to organize so the five minutes before the interview for the guys to do 
that 
nm0336: yeah 
nm0326: er so we have a chat you say i've noticed such and such and such from 
the papers i i will kick off by saying such and such why don't you follow up by 
such and such and that's how it goes 
then after the interview we spend two or three minutes thinking about it and we 
put our scores down okay 
nm0336: so so it lasts ten to twenty minutes so 
nm0326: twenty minutes 
nm0336: i i i was going to er s-, my point was you know is it i-, i-, is it er 
er er enough time for them to do interviews is fine and that's sufficient time 
for doing justice to the candidates 
nm0326: i have thought about this and i have talked to people about this er 
particularly i er namex put up very quickly er the name D Powis P-O-W-I-S he is 
his background i-, he's English but he's moved to er er Newcastle in New South 
Wales some time ago he's dean of admissions there and he's been very much 
involved in development of interviewing techniques and so there's lots of stuff 
in the literature if you want to find it er he says that if you define the the 
personality traits you're actually looking for motivation suitability er ten 
minutes in a properly organized interview you can make some s-, objective 
judgement on those traits he says one trait per ten minutes provided it's 
properly structured properly thought about and the interviewers are trained so 
in our twenty minutes we can look at two traits communication comes as a bonus 
you don't need to separately judge communication because if the guy can't 
answer your questions then he can't communicate so that comes as a bonus so 
given the limitations of resources er the way we thought about it i think it's 
practical and works 
nm0334: you one this social cul-, er racial thing about er er i-, in this er 
way 
nm0326: sorry 
nm0334: er er in people from ethnic backgrounds er have anybody looked at this 
i-, in terms 
nm0326: 
nm0334: of communication skills 
nm0326: i know 
nm0334: are they at a disadvantage in terms of 
nm0326: 
well it's very early days you er thi-, this is h-, how many 
nm0334: okay 
nm0326: samples have we been through this is our of the cohort 
nm0323: four 
nm0326: four 
nm0323: four 
nm0326: four now you see it's not much 
nm0334: the the students have been very empathic towards people from ethnic 
backgrounds 
nm0326: mm 
nm0334: i i sometimes feel they're not performing well 
nm0326: mm-hmm 
nm0334: i ask the students they they tend to be very empathic towards Afro-
Caribbean people and they give them er i notice they give a score that is even 
more better than my score sometimes 
nm0326: you shouldn't be looking at the scores [laughter] 
nm0334: when when we compare later on s-, it does [laughter] come through that 
they but i think this is important 'cause people who are come from deprived 
background who may be performing 
nm0326: yes 
nm0334: 
badly but they can become good doctors later on 
nm0326: possibly but how can we judge that i mean we can be empathic can be 
sympathetic i think is perhaps the right word in this 
nm0334: yeah 
nm0326: context to somebody who isn't speaking well because English isn't his 
first language or whatever but you know well this guy eventually has got to 
work with patients and if he can't communicate then er then he's not going to 
make a good doctor so we can only judge on the information we have at the time 
and as i say if somebody bounces and asks me and i say it's because you didn't 
communicate well well if he then fixes himself up properly and applies again 
you know and he s-, does better fine but i i can't i think we must not be we 
must be very careful to guard against being overly sympathetic 
nm0321: can we just can we just have one more question i think namex was going 
to ask a question 
nm0337: 
er well it's well it's partly a question and and partly an answer perhaps 
[sneeze] er i-, it seems 
nm0326: thank you [laughter] 
nm0337: thinking about it it s-, it seems that training people to be 
interviewers is very analagous to training medical students to have good 
consultation skills it's an element of interpersonal skills and then there is 
also an element of problem solving you have got to gather some data and you've 
got to analyse it and interpret it and possibly gather some more data so it i 
would have thought that the best training programme would be something that was 
modelled on how we train consultation skills i mean given that we come from 
medical schools we should be very good at that so i'd have thought that the the 
the training would use the similar s-, range of techniques er 
nm0326: er absolutely you you're you're right er actually i've only been 
involved with training once 
so far previously the training was done from namex er and it i i'm very keen 
that we should develop our training programme and this is precisely what namex 
and i are are talking about right now is how we should develop the training 
process you you're very right to to separate the these two things about being 
able to communicate and being able to assess data you're absolutely right and 
that's a very sensible structure 
nm0321: big thank you to namex and namex for that session i'm sure the 
conversations will continue over lunch er we will now lead you down to Eat at 
main campus could i just say anybody who is speaking from two o'clock onwards 
if we could get if they could get back here for one-fifty then we can load 
their disks for Powerpoint if that's okay otherwise we'll restart at at two 
o'clock er if you want namex at the back and myself will [laughter] lead you 
lead you to lunch