{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T20:52:34Z","timestamp":1783975954716,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,10,15]],"date-time":"2018-10-15T00:00:00Z","timestamp":1539561600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["asmepublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Education"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Resources for medical education are becoming more constrained, whereas accountability in medical education is increasing. In this constrictive environment, medical schools need to consider and justify their selection procedures in terms of costs and benefits. To date, there have been no studies focusing on this aspect of selection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aimed to examine and compare the costs and benefits of two different approaches to admission into medical school: a tailored, multimethod selection process versus a lottery procedure. Our goal was to assess the relative effectiveness of each approach and to compare these in terms of benefits and costs from the perspective of the medical school.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study was conducted at Maastricht University Medical School, at which the selection process and a weighted lottery procedure ran in parallel for 3\u00a0years (2011\u20132013). The costs and benefits of the selection process were compared with those of the lottery procedure over three student cohorts throughout the Bachelor's programme. The extra costs of selection represented the monetary investment of the medical school in conducting the selection procedure; the benefits were derived from the increase in income generated by the prevention of dropout and the reductions in extra costs facilitated by decreases in the repetition of blocks and objective structured clinical examinations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The tailor\u2010made selection procedure cost about \u20ac139\u00a0000 when extrapolated to a full cohort of students (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0286). The lottery procedure came with negligible costs for the medical school. However, the average benefits of selection compared with the lottery system added up to almost \u20ac207\u00a0000.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study not only shows that conducting a cost\u2013benefit comparison is feasible in the context of selection for medical school, but also that an \u2018expensive\u2019 selection process can be cost\u2010beneficial in comparison with an \u2018inexpensive\u2019 lottery system. We encourage other medical schools to examine the cost\u2010effectiveness of their own selection processes in relation to student outcomes in order to extend knowledge on this important topic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/medu.13698","type":"journal-article","created":{"date-parts":[[2018,10,15]],"date-time":"2018-10-15T23:28:18Z","timestamp":1539646098000},"page":"1240-1248","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Does selection pay off? A cost\u2013benefit comparison of medical school selection and lottery systems"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0233-9775","authenticated-orcid":false,"given":"Sanne","family":"Schreurs","sequence":"first","affiliation":[{"name":"Department of Educational Development and Research Institute for Education and School of Health Professions Education Faculty of Health, Medicine and Life Sciences Maastricht University Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1433-9323","authenticated-orcid":false,"given":"Jennifer","family":"Cleland","sequence":"additional","affiliation":[{"name":"Centre for Healthcare Education Research and Innovation (CHERI) Institute of Education for Medical and Dental Sciences University of Aberdeen Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arno M M","family":"Muijtjens","sequence":"additional","affiliation":[{"name":"Department of Educational Development and Research Institute for Education and School of Health Professions Education Faculty of Health, Medicine and Life Sciences Maastricht University Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam G A","family":"oude Egbrink","sequence":"additional","affiliation":[{"name":"Department of Physiology Institute for Education Faculty of Health, Medicine and Life Sciences Maastricht University Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kitty","family":"Cleutjens","sequence":"additional","affiliation":[{"name":"Department of Pathology Faculty of Health, Medicine and Life Sciences Maastricht University Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/medu.12817"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10459-016-9750-1"},{"key":"e_1_2_10_4_1","article-title":"AMEE Guide no. *: An Educational Decision\u2010Makers Guide to Evaluating and Applying Studies of Educational Costs","author":"Maloney S","journal-title":"Med Teach"},{"key":"e_1_2_10_5_1","unstructured":"ClelandJ DowellJ McLachlanJ NicholsonS PattersonF.Identifying best practice in the selection of medical students (literature review and interview survey).2012.https:\/\/www.sgptg.org\/app\/download\/7964849\/Identifying_best_practice_in_the_selection_of_medical_students.pdf_51119804.pdf. [Accessed 02 July 2015.]"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6920-14-54"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03056579"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0b013e3181ed442b"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10459-017-9752-7"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/medu.13139"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/medu.13462"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/medu.12537"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10459-017-9762-5"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/0142159X.2017.1410123"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/medu.13505"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f1049"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2013.02.002"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-018-1316-x"},{"key":"e_1_2_10_19_1","unstructured":"FrankJR.The CanMEDS 2005 physician competency framework: better standards better physicians better care.2005.http:\/\/www.ub.edu\/medicina_unitateducaciomedica\/documentos\/CanMeds.pdf. [Accessed 25 August 2015.]"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/medu.13266"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.3109\/0142159X.2015.1033389"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41077-016-0020-3"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10459-016-9672-y"}],"container-title":["Medical Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fmedu.13698","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/asmepublications.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/medu.13698","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T17:55:06Z","timestamp":1762278906000},"score":1,"resource":{"primary":{"URL":"https:\/\/asmepublications.onlinelibrary.wiley.com\/doi\/10.1111\/medu.13698"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,15]]},"references-count":22,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2018,12]]}},"alternative-id":["10.1111\/medu.13698"],"URL":"https:\/\/doi.org\/10.1111\/medu.13698","archive":["Portico"],"relation":{},"ISSN":["0308-0110","1365-2923"],"issn-type":[{"value":"0308-0110","type":"print"},{"value":"1365-2923","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,15]]},"assertion":[{"value":"2018-05-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-07-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}