Abstract
Secondary school academic achievement is the most predictive measure for successful medical school selection, followed by aptitude tests and, to a lesser extent, interviews. Despite extensive research on medical student selection, little is known about the factors influencing the pathway to medical school prior to the selection process. This study aimed to identify changeable facilitators and barriers along the pathway from secondary school to medical programmes, using data from a New Zealand longitudinal national data repository. Data from the Statistics New Zealand research repository (2016–2020) were used to create four cohorts. An accelerated longitudinal methodology enabled efficient observation of long-term educational trajectories using contemporary data unaffected by COVID-19. The analysis involved multiple forward stepwise logistic regression models to identify predictors of progression towards medicine. Secondary school academic achievement had a lasting impact on university progression, even when not directly used for selection decisions. Subject choice was also significant: higher performance in academic subjects predicted progression towards medicine, whereas higher performance in vocational subjects predicted alternative pathways. Additionally, maternal education level was a significant predictor of progression from secondary school to the pre-medicine stage. The findings suggest that increasing the likelihood of securing a place in a medical programme benefits from strategic academic planning beginning early in secondary school. Consistent with Bourdieu’s Theory of Social Reproduction, early educational experiences have enduring effects on medical school pathways, emphasising the importance of academic achievement, subject choice, and parental education in shaping these trajectories.