A cross-sectional study examining associations between foundation school and MRCS performance

Abstract

Background Reports of surgical training and experiences vary across the 16 UK foundation schools. Little is known about whether foundation school choice is associated with later performance in surgical training. We investigated choice of school in relation to performance in the MRCS Part A. Materials and methods A retrospective cohort study of foundation programme trainees who attempted MRCS Part A between 2017 and 2020 (n = 553). Chi-square tests examined associations between foundation programme school and first–attempt MRCS Part A performance. Multinomial regression models identified the likelihood of MRCS part A success depending on foundation school. Results A statistically significant association was found between MRCS Part A first attempt pass rates and foundation school (P < 0.001). Mean Part A pass rates ranged from 23.8% to 81.8% between schools. Two foundation schools – Thames Valley and North, Central and East London – were found to be independent predictors of success at MRCS Part A at first attempt after adjusting for age, gender and ethnicity (P < 0.05). There was no significant correlation between MRCS Part A performance and subjective reports of training quality (the National Training Survey training satisfaction scores; P = 0.256). Conclusions MRCS success is associated with foundation school but not subjective reports of training quality. Given that more competitive foundation schools attract the highest-achieving applicants, Occam's razor suggests this pattern is most likely due to individual differences such as innate academic ability rather than foundation school training experiences.