Impact of University Mergers on Admission of Medical Students in China

OBJECTIVE: Mergers of health science faculties in China have resulted in two different admission pathways for medical students. A uniform-code model prioritizes admission to a specific institution with secondary assignment to major. A separate-code model prioritizes admission directly to a school within an institution. This study investigates the impact of these two admission pathways on medical student selection and on the satisfaction of students with their major. METHODS: Medical students at 16 medical schools across China completed a questionnaire survey. Descriptive calculation, chi-square tests, and probit models were used for analysing the data. RESULTS: A total of 3132 completed surveys were included in the analysis. Compared with the students admitted under the uniform-code pathway, a significantly larger proportion of the students admitted under the separate-code pathway had medicine as the first preferred major (89.6% vs 79.6%, p=0.000); compared with those students enrolled into medicine not as their first preferred major, a significantly larger proportion of students enrolled into medicine as their first preferred major were willing to study medicine if choosing again (80.1% vs 62.4%, p=0.000) or to recommend the major to other students (73.3% vs 65.2%, p=0.000). Probit models showed that medical students admitted under the separate-code admission pathway were more likely to choose medicine as their first preferred major at application (β=0.96, p=0.000); medical students admitted into medical school as their first preferred major were more likely to be willing to study medicine if choosing again (β=0.53, p=0.000) or to recommend the medical major to other students (β=0.18, p=0.010). CONCLUSION: Separate-code admission is more likely to result in matriculants who choose medicine as their first preferred major and are more likely to be intrinsically interested in medicine than those applicants assigned to medicine from the uniform admission process.