Balanced scale representing the Educational Performance Measure and Situational Judgement Test in the UK Foundation Programme.

The EPM Edge: Leveling the Playing Field for Future Doctors in the UK

Avery Sinclair in Mind & Education August 2025 • 4 min read.

"Is the Educational Performance Measure truly a fair way to rank medical students?"

Securing a spot in the UK Foundation Programme is a crucial step for aspiring doctors. While the Situational Judgement Test (SJT) has been a focal point of discussion regarding fairness, it's equally important to examine the Educational Performance Measure (EPM). This measure carries a comparable weight to the SJT in the ranking process, making it essential to understand its role in determining the allocation of training positions for newly qualified doctors.

The EPM aims to acknowledge students who have demonstrated consistent academic achievement throughout their university careers. A significant portion of the EPM is based on a student's ranking within their university, promoting an environment where diligent effort is rewarded. This contrasts with concerns raised about the SJT, where students have expressed unease regarding score weighting, ranking formats, and potential subjectivity.

While debates around the SJT continue, the EPM serves as a complementary tool designed to assess students based on their overall academic performance. This article dives into how the EPM functions, its strengths, and how it addresses some of the limitations associated with standardized testing.

Academic Ranking: Rewarding Consistent Performance

Balanced scale representing the Educational Performance Measure and Situational Judgement Test in the UK Foundation Programme.

The UK Foundation Programme uses academic performance as a key indicator of a student's potential. Unlike a one-time exam, the EPM considers a student's intra-university ranking, aiming to foster healthy competition and reward consistent hard work. This approach seeks to identify students who have shown dedication and commitment throughout their academic journey.

Critics of standardized tests often point to the potential for a single “off-day” to negatively impact a student's score. The EPM, by considering a broader range of academic achievements, aims to mitigate this risk. It acknowledges that a student's overall performance is a more reliable indicator of their capabilities than a single test score.

Intra-University Ranking: Focuses on a student's performance relative to their peers within the same institution.
Consistent Performance: Aims to reward students who have consistently excelled throughout their academic careers.
Healthy Competition: Encourages students to strive for excellence in their studies.

However, the EPM is not without its critics. Concerns have been raised about potential disparities between universities. While the EPM rewards students who rank highly within their specific university, it may not fully capture the achievements of top-performing students nationwide. A 2008 study analyzing the performance of 5,287 doctors in Royal College of Physicians postgraduate examinations revealed significant differences in results across university cohorts. For instance, 76% and 67% of graduates from Cambridge and Newcastle universities, respectively, passed their written examination on the first attempt, compared to 32% for Liverpool, 38% for Dundee, and 37% for Belfast. This highlights the need for a standardized evaluation system across all medical schools in the UK, similar to the standardized medical licensing examinations in the United States.

A Balanced Approach to Evaluating Future Doctors

Both the SJT and EPM have their strengths and weaknesses. The EPM acknowledges a broader range of academic achievements, potentially mitigating the impact of a single “off-day” on a student's overall ranking. However, concerns about inter-university disparities remain. The UK Foundation Programme is continuously evolving, and further research and refinement of both the SJT and EPM are essential to ensure a fair and comprehensive evaluation process.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.2147/amep.s121242, Alternate LINK

Title: Parallel To The Situational Judgement Test: Is The Educational Performance Measure Fair In Ranking Medical Students On The Uk Foundation Programme?

Subject: Education

Journal: Advances in Medical Education and Practice

Publisher: Informa UK Limited

Authors: Harmeet Singh Sidhu, Adil Mahmood, Ranjodh Sanghera, Jay Mandan

Published: 2016-10-01

Everything You Need To Know

What is the Educational Performance Measure (EPM), and how does it relate to the Situational Judgement Test (SJT) in the UK Foundation Programme application process?

The Educational Performance Measure (EPM) is a tool used in the UK Foundation Programme to evaluate and rank medical students. It carries a weight comparable to the Situational Judgement Test (SJT) in determining training position allocations. While the SJT has faced scrutiny regarding fairness, the EPM complements it by acknowledging consistent academic achievements throughout a student's university career. The EPM aims to offer a balanced approach by considering a student's intra-university ranking, rewarding diligent effort, and mitigating some limitations associated with standardized testing like the SJT.

How does the Educational Performance Measure (EPM) assess medical students, and what specific aspects of their academic record are considered?

The Educational Performance Measure (EPM) assesses medical students primarily based on their academic performance during their university studies. A significant portion of the EPM relies on a student's intra-university ranking, which focuses on their performance relative to their peers within the same institution. This approach aims to reward consistent performance and dedication throughout their academic journey, identifying students who have shown commitment over time. Unlike a one-time exam, the EPM considers a broader range of academic achievements, striving to provide a more reliable indicator of a student's capabilities.

What are the criticisms of the Educational Performance Measure (EPM), particularly concerning disparities between different universities in the UK?

One of the main criticisms of the Educational Performance Measure (EPM) revolves around potential disparities between universities. While the EPM rewards students who rank highly within their specific university, it may not fully capture the achievements of top-performing students nationwide. A 2008 study revealed significant differences in postgraduate examination results across university cohorts, highlighting the need for a standardized evaluation system across all medical schools in the UK. The concern is that a student from a less competitive university might be ranked higher within their institution but perform less well compared to a student from a more competitive university.

How does the Educational Performance Measure (EPM) aim to address the potential shortcomings of relying solely on standardized tests like the Situational Judgement Test (SJT) for evaluating future doctors?

The Educational Performance Measure (EPM) aims to mitigate the potential for a single "off-day" to negatively impact a student's score, which can be a concern with standardized tests like the Situational Judgement Test (SJT). By considering a broader range of academic achievements, the EPM acknowledges that a student's overall performance is a more reliable indicator of their capabilities. This approach seeks to reward consistent hard work and dedication throughout a student's academic career, providing a more balanced assessment than relying solely on a one-time examination.

Given the strengths and weaknesses of both the Situational Judgement Test (SJT) and the Educational Performance Measure (EPM), what improvements or further research could enhance the fairness and comprehensiveness of the UK Foundation Programme's evaluation process?

To enhance the fairness and comprehensiveness of the UK Foundation Programme's evaluation process, further research and refinement of both the Situational Judgement Test (SJT) and the Educational Performance Measure (EPM) are essential. Addressing concerns about inter-university disparities within the EPM could involve standardizing evaluation criteria or incorporating a normalizing factor to account for differences in academic rigor across institutions. For the SJT, ongoing analysis of score weighting and ranking formats is necessary to ensure objectivity and minimize potential biases. Exploring alternative assessment methods that complement both the SJT and EPM, such as portfolio-based evaluations or structured interviews, could also provide a more holistic view of a candidate's suitability for the Foundation Programme. Continuous monitoring and evaluation of the effectiveness of these measures are crucial to ensure a fair and comprehensive evaluation process.