Educational Performance Measure, or EPM, is one of the ways applicants for the UK Foundation Programme (UKFPO) are ranked on a combination of clinical and non-clinical skills, comprising the knowledge and performance of the the medical student.

On application to the programme, students are given a decile (‘EPM decile score’) ranked against the other students from their medical school who are applying for UKFPO in the same year. Each decile correlates to 34-43 points (i.e. 1st decile = 43 points, 5th decile = 39 points etc.) and this is combined with 7 points available for educational achievements (these include additional degrees (maximum 5 points) and publications (maximum 2 points)). Thus, the maximum score for EPM is 50 points, 43 of which are directly affected by the ranking system used at each medical school. The remainder of the application score is a maximum of 50 points owing to the result of a student’s Situational Judgement Test (SJT).

There is no common system between medical schools in the UK, so each has the freedom to decide how they rank their students into equally-sized deciles based on academic performance. Recently – based on requests by BL medical students for a review of the current system – the medical school (in collaboration with the BLSA) has conducted a consultation on how BL calculates EPM deciles. Of 1731 students, 618 responded (35% response rate).

Prior to the results of this consultation, BL students were ranked into deciles each year based on their results from Papers B, C and D (End of Year (EoY) Written Paper - Key Knowledge and its Application, EoY Data Interpretation and EoY OSCE, respectively). In other words, these deciles are based upon EoYs, and the continuous assessment (Paper A) and SSCs (Paper E) are not included in the calculation. The EPM ranking is cumulative, thus taking into consideration a student’s marks from the previous years upon calculation of a yearly decile. I.e. at the end of Part 3 (Year 3 or GEP Year 2) the EPM decile is calculated in combination with the student’s deciles in Part 1 and Part 2 of the course. This is not the aspect of the process that students disagreed with.

Instead, students were concerned with how the years are weighted within the process. In other words, in the system prior to the consultation, each year is weighted equally to the next (with years 1-4 each making up 25% of a student’s EPM point score, or years 1-3 weighing 33% each in the case of GEP students). That is to say, Barts utilised a non-weighted calculation system. This was of concern to a number of students as many believed that a more accurate representation of clinical competence is examined during the clinical years of the course. Conversely, others felt that it would be unfair to change the current system given that they had already worked hard in their first and second years, believing that their ranking would reflect this equally.

The results of the EPM consultation showed that 69% of students preferred a weighted system. Furthermore, 49% agreed on the weighting system where Y1 = 15% of EPM decile, Y2 = 25%, Y3 = 30% and Y4 = 30%. With regards to when the students wished for this weighted system to come into action, students in years 1, 2 and 3 preferred for it to be implemented for all current cohorts at 70%, 74% and 67% respectively. In opposition, 53% of current fourth year students preferred for the weighting system to be implemented for new cohorts only.

The consultation results were discussed by the Junior and Senior Student-Staff Liaison Committees (which comprise of the Pre-Clinical and Clinical representatives, Sidhant Singh and Artemis Mantzavinou respectively, student representatives from all years, and a variety of relevant staff members). Following these discussions, a final view was taken forward to the Medical Assessment Committee for recommendation to the Medical Education Committee. This final view was that a weighted system of 15%, 25%, 30%, 30% would be implemented for all students starting Part 4 (Year 4 or GEP Year 3) from September 2020 onwards. Thus, in line with the responses from the fourth year students, students starting year 5 in September 2020 will not be affected and will remain on the current non-weighted system. For GEP students, the weightings will be 30%, 35%, 35% for years 1 through 3, and for those on the 3-year direct entry programme, years 1 and 2 will be weighted equally (50% each).