New evidence on the validity of the selection methods for recruitment to general practice training: a cohort study

Background: Selection into UK- based GP training has used the Multi- Specialty Recruitment Assessment (MSRA) and a face- to- face selection centre (SC). The MSRA comprises of a situational judgement test and clinical problem- solving test. The SC was suspended during the COVID- 19 pandemic. Evidence is needed to guide national and international selection policy. Aim: To evaluate the validity of GP training selection. Design & setting: A retrospective cohort study using data from UK- based national recruitment to GP training, from 2015-2021. Method: Data were available for 32 215 GP training applicants. The ability of scores from the specialty selection process to predict subsequent performance in the Clinical Skills Assessment (CSA) of the Membership of the Royal College of General Practitioners examination was modelled using path analysis. The effect sizes for sex, professional family background, and world region of qualification were estimated. Results: All component scores of the selection process demonstrated statistically significant independent relationships with CSA performance (P<0.001), P <0.001), thus establishing their predictive validity. All were sensitive to demographic factors. The SC scores had the weakest relationship with future CSA performance. However, for candidates with MSRA scores below the lowest quartile, the relative contribution of the SC scores to predicting CSA performance was similar to that observed for MSRA components. Conclusion: The MSRA has predictive validity in this context. Re- instituting an SC for those with relatively low MSRA scores should be considered. However, the relative costs and potential advantages and disadvantages should be carefully weighed.