Assessment for admission to medicine and postgraduate training

Published on 01/06/2015 by admin

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Last modified 01/06/2015

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32 Assessment for admission to medicine and postgraduate training

A range of assessment tools and approaches are available to assist with key selection decisions.

The importance of selection

In recent years the methods adopted to select students for admission to medical studies from the large number of applicants have been the focus of attention. There are good reasons for this:

• Owing to low attrition rates, the admission of students to medical studies is almost equivalent to graduating a student. Once students are selected for admission to medicine they will almost certainly complete their medical studies and graduate as a doctor.

• There are political and other pressures to widen access to medical studies and there is wide recognition that doctors should be matched to the community they serve. Some ethnic and social classes may have been disadvantaged in the selection process and this needs to be taken into consideration in the admissions process.

• Once students graduate they are more likely to practise in the geographical area or type of community in which they originally lived.

• The criteria used for selection were based traditionally on academic qualifications. It was assumed that if a student achieved top grades in their studies at school they would automatically develop the competencies expected of a good doctor. This is not necessarily true, and the personal qualities of the potential doctor are recognised to be important as well as their academic qualifications.

• There may be advantages in choosing students whose career goals match the mission of the medical school, for example in relation to a commitment to rural practice.

Approaches to selection for entry to medicine

Graduate or direct from school entry

In North America, following the Flexner 1910 Report, students were admitted to medical school as graduates following completion of a college course in another subject. In other parts of the world students can enter medical studies direct from school. There has been a move in some medical schools in the UK, Australia and other countries to graduate-only entry. Other schools have maintained a mixed approach accepting both graduates and school leavers. The issue is a controversial one and the arguments for the different approaches are complex. There is no good evidence to indicate that one approach is preferable to the other, but opting to admit students straight from school does have significant financial advantages and there is no evidence that the product is less satisfactory.

A Range of methods

Different approaches have been promoted in the selection of students for admission to medicine. Until recently the emphasis has been on academic ability and intellectual achievement. Attention has been paid to selecting an individual who will do well in the medical school examinations rather than to selecting an individual who will become a competent and good doctor. The ability to perform well in tests may simply predict later test scores and not performance as a doctor. The ability to answer MCQs correctly does not necessarily indicate that a student will be a good doctor. This does not mean that a choice has to be made between someone who has a good academic record and someone who will become a good doctor. They are not mutually exclusive.

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