The impact of changes in medical school admission procedures on study success: A comparative analysis at Hannover Medical School.

Background: In the academic year 2020/21, alterations were introduced in the admission procedures for medical studies, particularly within the selection quota (AdH). These changes reduced the significance of school-leaving grades (the Abitur) in favor of the Test for Medical Studies (TMS) and considerations of professional training & voluntary service as non-cognitive criteria. The waiting time regulation (WQ) was replaced by a "Special Aptitude Quota" (ZEQ), where experienced professionals were classified based on TMS results. This article examines whether and how those changes have influenced study success in the first two years of medical studies. Methods: We compare the cohorts of 2020 and 2021 (new admission procedure) with the preceding three cohorts, admitted through the old admission process at Hannover Medical School (MHH). Dimensions of study success include dropout rates, progression in studies (completion of the first section within the standard study period), and performance in all written module examinations during the first two study years. The quota of high school top performers (AQ) serves as the reference group. Using ANOVA and comparative statistics, we investigate changes within and between quotas. Results: Alterations in admission procedures resulted in ZEQ and AdH cohorts being admitted with significantly poorer Abitur grades. While dropout rates decreased in all considered quotas, it is not statistically significant. ZEQ students were more likely to complete the first section on time compared to WQ. AdH entrants after 2020 achieved significantly higher scores in examinations than cohorts from 2017-2019, closing the gap with high school top performers. Both groups consistently outperform WQ/ZEQ in examinations. Discussion: Historically, Abitur grades have been a reliable predictor of study success. However, recent years have seen an inflation of excellent high school diplomas. We have demonstrated that a shift away from the Abitur toward aptitude tests and even explicitly non-cognitive criteria does not jeopardize success in medical studies. On the contrary, our findings suggest a trend toward increased study success among ZEQ and AdH. The gap towards AQ, however, remains sizeable.