Removing the interview for medical school selection is associated with gender bias among enrolled students

To the Editor: Wilkinson and colleagues report sex bias in two components of widely used methods of selection of students for graduate entry to Australian medical schools.1 They argue for more equitable methods to ensure that selected “cohorts  . . . should be representative of the communities from which they are drawn”. In focusing on sex equity in particular, they neglect the prime responsibility of medical schools to produce graduates to meet national workforce needs.

Australia has obvious workforce problems. Among these are the shortage of doctors in rural and remote areas, the paucity of Indigenous doctors, the rise in specialisation at the expense of generalists, the increased reliance on overseas-trained doctors to staff the public sector and, most cogently for this discussion, the significantly diminished workforce contribution of women doctors (who work, on average, 40% less throughout their careers than do men).2

Where is the evidence that equitable selection based on population demographics produces desirable workforce outcomes? The range of attributes needed to practise the diversity of modern medicine is broad. In the absence of an obvious single panacea for “optimal” selection of “a good doctor”, perhaps we need more diversification in admission policies?

Of course, some will argue that selection based on particular workforce issues smacks of social engineering; others will ask whether or not there is any evidence that selection, by any method, improves workforce outcomes. Perhaps, to them, a lottery commends itself.3 What could be more equitable? At least, it would enrich the mix of those admitted under current selection policies.

Expensive medical education is largely subsidised by the public purse. Surely aiming to address the abovementioned workforce issues with cost-effective solutions should be a major consideration in selection policy rather than a focus on equity between the sexes.