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Medical student selection - we have to find another way

Martin B Van Der Weyden
Med J Aust 2007; 186 (7): 329.
Published online: 2 April 2007

* Ribeiro B (President, the Royal College of Surgeons of England). Thoughts of the New Year. Ann R Coll Surg Engl (Suppl) 2006; 88: 42-43.

Some may suggest it is time to ask some hard questions of our medical school selection policies. Is the requirement for equality, diversity and political correctness getting in the way of selecting the best and most motivated?*

Few issues arouse more passionate debate than the admission policies of our medical schools and their ever-changing educational philosophies and course content.

When it comes to student selection, most schools rely upon combinations of academic scores and cognitive aptitude assessment, followed by the elaborate and expensive lottery — the interview. But whether these prove to be reliable barometers, predictive of good doctors or good practice, remains dubious.

The pragmatic Dutch have long recognised the nebulous nature of these exercises and instead use a state-run lottery for student selection: the higher your academic achievement, the more lottery tickets you receive! Yet in this era of best evidence, Australian medical schools continue with their evidence-poor selection rituals.

Is it not time to move to a uniform, Australia-wide system to allow for, at the very least, prospective and national data and best evidence?

But there is another concern.

Geoff Norman, a prominent Canadian medical educationalist, argues that our current medical school selection processes are “evil”, claiming that in “selecting the 10% who are worthy of admission (and hence guaranteed an esteemed and well paid place in society), we are telling the other 90% that they are unworthy ... Yet the evidence we have [for selection] is likely little better than a horoscope.”

Instead of continuing with this “professional crap shoot”, we have to find another way.

  • Martin B Van Der Weyden


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