To the Editor: We read with interest the article by Griffin and colleagues,1 which provides valuable insight into the practice effects of coaching on medical school selection tests.

As senior clinical students, we have watched with more than a passing interest the introduction and growing popularity of coaching courses in recent years. What was once regarded as a costly, unnecessary and potentially disadvantageous exercise has, in recent years, given rise to a flourishing industry. As the authors point out, alternative selection tests such as the Undergraduate Medicine and Health Sciences Admission Test (UMAT) and entry interviews were devised in part to overcome the socioeconomic bias associated with using matriculation results alone.2,3 Ironically, these overpriced coaching courses are often available only to those from higher socioeconomic backgrounds, jeopardising the equity of access that the tests aimed to improve. At many independent high schools, in fact, attendance at coaching courses is now often the norm, in contrast to schools from lower socioeconomic backgrounds. Many students now opt to undertake coaching for fear of “missing out” on what may potentially be an edge obtained by other prospective students. It is the psychological comfort provided to students that they have done some preparation that marketers of coaching courses have been exploiting, as evidenced by the finding from the Australian Medical Students’ Association Medical Education Survey in 2006 that 70% of students felt better prepared for the UMAT as a result of coaching.4

In light of this, data provided by Griffin and colleagues thus provides welcome reassurance that expensive coaching courses may provide little or no benefit in relation to UMAT or interview outcomes.

Although their study reported a slight increase in interview scores on the second attempt at entry to medical school, what was not discussed by the authors was the students who undertake coaching before resitting either an interview or the UMAT. While they mention that a proportion of students resit the UMAT, there was also no discussion on the effect of simply repeating the UMAT.

Further analysis of the effects of repetition and coaching on candidates who resit the UMAT or interview would circumvent the limitation of directly comparing coached and non-coached groups that are unlikely to be equivalent, given that coaching is voluntary and may be linked with personality, ability and socioeconomic factors. It would be interesting to observe what effect, if any, coaching might have had on these candidates’ results. This might provide further evidence in support of the authors’ findings.