Only the best: medical student selection in Australia

To the Editor: The implication by Wilson and colleagues that selection processes might at any stage be designed “to identify students ... who are likely to develop physical or mental illness ... that will impair their ability to practise in an empathic and professional manner”1 raises significant ethical and legal issues.

The solution suggested by Wilson et al with reference to “fitness to practise” processes in place in medical schools suggests a link between psychiatric morbidity and unprofessional behaviour.1 The presence of a mental illness should not necessarily equate to an inability to empathise or practise in a professional manner. Such a suggestion undermines the significant efforts of countless clinicians, patients and carers who have worked towards reducing the stigma of mental illness in our society. An ideal situation would be one in which medical students and clinicians alike, should they be struggling with mental illness, just as with a physical disability, could approach their educational or training institution to seek assistance without fear of being categorised as “unfit to practise”.

The Disability Discrimination Act 1992 (Cwlth) states that “it is unlawful for an educational authority to discriminate against a person on the grounds of a person’s disability”, including mental illness, “in the terms or conditions on which it is prepared to admit the person as a student”.2 It is worth considering that these laws have evolved, at least in part, as a response to our views on these matters as a society. If qualities such as compassion, empathy and respect for others are considered to be vital attributes in candidates for the medical profession, we should first ensure that they exist within our own selection processes.