Do medical students with A-level mathematics have a better understanding of the principles behind evidence-based medicine?

With the advent of evidence-based medicine, medical students, doctors and other healthcare professionals are required to be more skilled in the interpretation and manipulation of numerical data. The authors observed that undergraduate students without A-level mathematics expressed concern as to their ability to cope with an epidemiology and biostatistics course. It was hypothesized that these anxieties reflected differences in attitudes to numerical manipulation rather than any real lack of competence. Mean exam performance scores were compared for 498 first-year medical students between 2000 and 2002 depending on whether the students did or did not have A-level mathematics. The data revealed no difference in performance. Students without mathematics A-level scored marginally worse (-1.1%, 95% CI -3.1% to 0.8%, p = 0.20) but were no more likely to fail the exam (odds ratio = 0.98, 95% CI 0.40 to 2.6, p = 0.9). It is concluded that some students experience 'numerophobia' - a perceived and, it is thought, disproportionate fear of numbers and simple mathematical manipulation. This may act as a psychological barrier for future evidence-based practitioners.