The previous system has been changed for a number of reasons, which can be seen below:

...because selection methods always need to evolve
New selection methods are constantly being developed and research on their effectiveness is being published all the time. The Department of Health wants to ensure that new doctors starting work in the NHS are selected using the most effective methods. Situational Judgement Tests (SJTs) are an aptitude test which has been proven to predict future performance in GP training in the UK. It is expected to do the same for Foundation trainees as it is closely mapped to the FY1 role through an in-depth job analysis. The Educational Performance Measure (EPM) was deemed by the expert panel reviewing selection methods as the best way to take an applicant’s academic performance into account during the selection process. It provides an excellent way to measure a cognitive and clinical ability over a number of years and assessments, rather than relying on the performance of an applicant on a single exam.

...because there are concerns with the current tool being used to measure aptitude ("white space" questions)
Previously, applicants were asked to answer a series of “white space” questions where they were expected to demonstrate that they met aptitude criteria set out in the person specification through their short-essay answers. The question writers have said that there is a limited number of ways they can ask these questions, which ask applicants to base the majority of their answers on their experience.

A better way of measuring aptitude is to give an applicant a situation they are likely to encounter as an FY1 doctor and ask how they would react in that situation. This is a better indicator of future performance and is the basis of SJTs.

As applicants had quite a long period of time to answer the questions, students had raised the issue that some applicants have had outside help of some sort. Each year, applicants were removed from the process for cheating, collusion and plagiarism. Model answers were easily bought on the internet, as were detailed guides to what makes a good answer.

The SJT addresses these concerns as applicants will sit the test under exam conditions. SJT question writers have said that there are a large number of scenarios that could be used to measure an applicant’s aptitude. A bank of questions has been developed and is continually renewed with new questions.

...because research has shown us a better way
Research evidence suggests that SJTs have good levels of predictive validity (i.e. they are able to predict a person’s performance in the job) as well as demonstrating good reliability. There has not been enough research published about "white space" questions to draw the same conclusions.

The way an applicant responds to a SJT question is a good indicator of how they will behave as an FY1 doctor when encountering a similar situation. This part of the selection process is not meant to measure an applicant’s academic ability, but their ability to be a good FY1 doctor. The majority of the work of a foundation doctor is about prioritisation, organisation, professionalism, team working and having the ability to communicate well with patients and other staff, rather than making a diagnosis. Although academic ability and medical knowledge are very important, these skills have been proven to be crucial to the success of the applicant.

...because the pilots were successful
Situational Judgement Test items were piloted at 17 UK medical schools and two non-UK medical schools during the 2010/2011 academic year involving over 1,000 final year medical students. The analysis and evaluation of the Parallel Recruitment Exercise, which involved 7,000+ applicants to the Foundation Programme 2012, confirm that in this context, the SJT is a reliable, valid and appropriate method for selection. These findings support the considerable published research on Situational Judgement Tests.

...because there were concerns with the previous academic performance measure
Part of the previous measure of academic performance was entangled with the “white space” questions as Question 1 requested applicants list their educational achievements, including additional degrees and posters, prizes and presentations. These did not sit comfortably in here as application questions should all relate specifically to the attributes in the person specification.

Academic quartile scores were a very rough measure which did not allow for much score differentiation between candidates. In addition to this, evidence suggests that not all medical schools calculated their academic scores in a way which was transparent to students.

The Educational Performance Measure (EPM) integrates all three aspects of academic performance – medical school performance (calculated in deciles), additional degrees and other academic achievements. These have been calculated in a clear, consistent and fair way by each medical school using a range of assessments. As types of assessments differ at each medical school, each school consulted with students on which assessments would be used as part of the Parallel Recruitment Exercise for FP 2012, and hence forward. [PRE hyperlink].These have been  published by each medical school in advance so students will know exactly which assessments will be used to rank them. All assessments used in the determination of a student’s performance must:

• Be summative (and therefore subject to more formal controls)
• Cover clinical knowledge, skills and performance
• Cover non-clinical performance
• Cover all aspects of the curriculum assessed up to the end of the penultimate year at medical school
• Represent the average performance of applicants over time
• Include written and practical assessments

Why not just use academic performance as a selection method?
While there is some evidence that academic performance is a good indicator of future performance, there is more evidence to say that it is most closely linked to future academic performance. This means if a student does well at medical school, they are highly likely to pass their royal college exams, but this does not necessarily mean that the most academically gifted make the best doctors. Therefore, academic performance alone cannot be used to choose doctors.