Selecting medical students: we need to assess more than academic excellence

To the Editor:

Reading the article on the task of selecting candidates for medical school,1 I recalled my own trajectory into the profession. I was interviewed by a surgeon, who was the sole interviewer, our interaction being one of genteel conversation. My peers at the time had a similar interchange with the university officials. Uniformly, we have all proceeded to remain in medicine. Our careers have lasted.

One has to wonder whether a selection process that is more time consuming is actually better than the above straightforward approach. Considering personality type, there will be a wide spread of introverts and extroverts. Academically adept and generally bright, the hopefuls can perform on the day to leap over any clever tests for entrance. Moreover, the profession has niches for all of them. The introvert can quietly tend towards microbiology, while the extrovert might heartily choose to be a surgeon.

Like politics, the profession needs representatives from different areas of society. We should not aim to standardise too much. There will be nations today where entry into medicine is still standardised with reference to social status. If we recruit only the well-to-do youngsters, we will not have the level of understanding that can be brought into the profession from those of humbler backgrounds. Someone from a lower economic stratum will understand the community to which they wish to return after qualifying as a doctor. I have first-hand experience of observing such a course of career in my peers.

It cannot be forgotten that the aspirants keen to join medicine are very young people whose personalities have yet to ripen through living. If they can pass tough exams, then they have an admirable trait as embryonic personalities. They can focus and work with diligence. They also hold an ambition to become doctors. If they can apply themselves and do not have any overt oddities of personality, they should be given a chance to become doctors. This has been a time-tested method in medical schools — in a world that needs more doctors than ever — and I fail to be convinced that finer filters on the path into medicine will be worthwhile.