Moral reasoning as a criterion for admission to medical school.

To determine whether admission interviews could differentiate applicants on their personal qualities (such as integrity, empathy and commitment) 456 applicants from two medical schools were tested on the Defining Issues Test (DIT), which measures the amount of principled or post-conventional moral reasoning. No difference was found between the DIT scores of the accepted and the rejected applicants of the school in which the admission criteria are the traditional scholastic ones. On the other hand, a great difference was shown in the school which admits students for their personal characteristics as assessed by interviews. Yet only moderate correlation was shown between the DIT and the interview scores. Since moral reasoning is a key concept in medical professional behaviour and is correlated with clinical performance, the findings deserve special attention. A possible use of the DIT in the student selection process is discussed.