Do students from public schools fare better in medical school than their colleagues from private schools? If so, what can we learn from this?

Internal grade inflation is a documented practice in secondary schools (mostly in private schools) that jeopardises fairness with regard to access to medical school. However, it is frequently assumed that the higher internal grades are in fact justifiable, as they correspond to better preparation of students in private schools in areas that national exams do not cover but nevertheless are important. Consequently, it is expected that students from private schools will succeed better in medical school than their colleagues, or at least not perform worse. We aimed to study whether students from private schools do fare better in medical school than their colleagues from public schools, even after adjusting for internal grade inflation. We analysed all students that entered into a medical course from 2007 to 2014. A linear regression was performed using mean grades for the 1st-year curse units (CU) of the medical school curriculum as a dependent variable and student gender, the nature of students' secondary school (public/private), and whether their secondary school highly inflated grades as independent variables. A logistic regression was also performed, modelling whether or not students failed at least one CU exam during the 1st year of medical school as a function of the aforementioned independent variables. Of the 1709 students analysed, 55% came from public secondary schools. Private (vs. public) secondary school (β = - 0.459, p