Volume 196 - Issue 11
Only the best: medical student selection in Australia
Authors: Tarun K Sen Gupta, Richard B Murray and Robin A Ray
Med J Aust 2012; 196 (11): 683-684. || doi: 10.5694/mja12.10665
Published online: 18 June 2012
Published online: 18 June 2012
To the Editor: Wilson and colleagues thoughtfully summarise medical school selection procedures, highlighting the need for greater social accountability.1 We would strengthen the aim of choosing applicants with “the characteristics required to be competent medical practitioners”1 by arguing they should also be responsive to community needs.
What are the “outcomes” of interest in selecting medical students? Methodological problems abound, and studies mostly consider outcomes that are ...
To the Editor: Wilson and colleagues thoughtfully summarise medical school selection procedures, highlighting the need for greater social accountability.1 We would strengthen the aim of choosing applicants with “the characteristics required to be competent medical practitioners”1 by arguing they should also be responsive to community needs.
What are the “outcomes” of interest in selecting medical students? Methodological problems abound, and studies mostly consider outcomes that are readily counted: academic achievement and intern performance rating.2 Granted, selection should identify students with good prospects of graduating as competent doctors, yet what is counted does not always count. The paying public is interested in the likelihood of a doctor applying the considerable privilege of a medical education towards social good rather than individual enrichment.
The selection focus should shift to how best to meet the needs of the communities being served. Schools should define desired candidate profiles that reflect socially accountable graduate outcomes — with selection harnessing the best available evidence to achieve this, using academic and non-academic measures. This approach could counter claims that “beyond marks, many of our schools are engaged in ... a very elaborate, labour-intensive, and expensive lottery”.3
There are paradoxes here. Socially accountable selection practices (say, considering disadvantaged, rural or Indigenous background) may select people with lower chances of academic “success”. Such students should be supported to attain the standard — and success celebrated, rather than failures rued. If schools are judged merely on academic criteria, they may trade off social accountability for academic excellence. Selection processes should explicitly manage such tensions to avoid perverse outcomes — and count what actually counts.
Competing interests
No relevant disclosures.
References
- Wilson IG, Roberts C, Flynn EM, Griffin B. Only the best: medical student selection in Australia. Med J Aust 2012; 196: 357. 0_CHDCGBDC
- Ferguson E, James D, Madeley L. Factors associated with success in medical school: systematic review of the literature. BMJ 2002; 324: 952-957. 0_i1142866
- Norman G. The morality of medical school admissions [editorial]. Adv Health Sci Educ Theory Pract 2004; 9: 79-82. 0_i1142869