Volume 196 - Issue 11
Only the best: medical student selection in Australia
Authors: Ian G Wilson, Christopher Roberts, Eleanor M Flynn and Barbara N Griffin
Med J Aust 2012; 196 (11): 684. || doi: 10.5694/mja12.10666
Published online: 18 June 2012
Published online: 18 June 2012
In reply: We agree with Rosenfeld that success in medical training means more than graduating with knowledge, technical brilliance and commitment to lifelong learning. Admission interviews are designed
to assess non-academic features, such as empathy, communication, working in teams and professionalism.
We acknowledge that current selection processes are unable
to identify students with major personality disorders or those who are likely to develop physical or mental ...
In reply: We agree with Rosenfeld that success in medical training means more than graduating with knowledge, technical brilliance and commitment to lifelong learning. Admission interviews are designed to assess non-academic features, such as empathy, communication, working in teams and professionalism.
We acknowledge that current selection processes are unable to identify students with major personality disorders or those who are likely to develop physical or mental illness, including alcohol or drug dependency, that will impair their ability to practise in an empathic and professional manner. The significant time lag between developing a psychiatric or substance use disorder and ensuing practice impairment makes a prospective study of potential correlates of later impairment impractical.1 Most medical schools now have robust “fitness to practise” processes to detect and respond to unprofessional behaviour. We contend that this process will have a higher success rate in detecting and managing psychiatric morbidity than would trying to screen the psychological and physical health of all applicants, even if this were considered ethical. Further research is paramount.
Sen Gupta and colleagues rightly emphasise that issues of social accountability are not well served by the largely technical exercises of determining the idealised characteristics of the “best” candidate and employing the most statistically robust methods. They raise the concern that socially accountable selection practices may select people with lower chances of academic success. This is a “deficit” model, which cannot be dealt with by an admission committee working in isolation from the medical school’s policies. Social accountability is demonstrated by a whole-of-school approach and demands integration of selection processes with curricula, student support and assessment, and the complexity of situating clinical placements within the broader community served by the school. An important area of further research is to describe and quantify a school’s success in meeting the health needs of its local community, while maximising the medical educational possibilities of community-based clinical placements, and ensuring that members of the multiple communities served by the school are represented in the intake.
Competing interests
No relevant disclosures.
References
- Dubovsky SL, Gendel M, Dubovsky AN, et al. Do data obtained from admissions interviews and resident evaluations predict later personal and practice problems? Acad Psychiatry 2005; 29: 443-447. 0_FHCBBFIF