Eva Brencicova on admissions to medical school
3 Oct, 08 | by BMJ Group
The procedures of admissions to medical school are extremely varied around the world. Yet they seem to have one thing in common – success is considered a huge deal. At the next family reunion, you are bound to have enchanted relatives patting you on the back, dropping comments about how you make them proud. Are such complements now slightly premature however? What made you stand out amongst the many applicants, allowing you to fish a letter of acceptance out of your mailbox?
My own experiences of the admissions process to medical school in Germany have been far from positive. The first step is an application submitted to a central authority responsible for allocating approximately 80% of university places nationally. This vast majority is assigned depending on rigid criteria, of which the results achieved at A levels are by far the most crucial. The competition is tough these days, and in order to succeed and get hold of one of the sought-after places, the aspirants have to provide exceedingly high marks.
The acceptance test for medical studies, focusing on the candidates´ knowledge in natural sciences, as well as their retentiveness, concentration and spatial imagination, is currently being (re-)introduced at several universities. Achieving a high score and/or fulfilling any of the auxilliary selection criteria, such as having completed an apprenticeship in a medical field (e.g. nursing or elderly care) or a voluntary year of community service, will increase your chances, but remain of minor significance. Even superb achievements in these additional qualifications can hardly compensate for average A level marks.
Roughly 20% of the places available are assigned by the respective universites after they have conducted personal interviews. Unsurprisingly however, only those able to provide immaculate school reports are afforded the chance to convince face-to-face.
I feel disappointed at the narrow approach to distinguishing between candidates in Germany; an intricate issue is being reduced to rigid technicalities. Fundamentally, we need to consider a range of criteria which will allow a more multi-faceted assessment of the applicants, better demonstrating their true “suitability” for medical school. The question is though, how much refinement is feasible considering the mass of applicants universities must process?
Establishing a fair system seems to be a hard nut to crack. Universities in various countries are struggling, as the variety and frequent change in admissions policies clearly demonstrates. Local students are rightly voicing their dissatisfaction (such as in Portugal), but reactions of the responsible authorities still leave a lot to be desired; perhaps this is because they too are at their wits´ end.
Increasingly I find it is those students who pursue a range of interests, whose company I have enjoyed the most. What concerns me is that these are the students who frequently face considerable difficulties in achieving their goal of gaining a place in medical school. The extra-curricular activities in which they eagerly engage have made them open minded and aware of the world beyond the classroom. They are often more mature than their peers, and possess an array of soft skills that cannot be taught. It is true that their academic credentials upon leaving secondary school might not be the most impressive, but should we not consider more than simply exam grades when trying to decide who will become the medical professionals of the future? Are these applicants not a priceless enrichement to the collective? I believe so, but wonder if there is a way to save this increasingly rare species.
Eva Brencicova is medical student, University of Freiburg, Germany.
Competing interests: None declared
It should have nothing to do with pride of one’s family.
Good doctors at one time came from medical families, or those who had no entree pulled them selves up by their bootstraps,because the were determined to become doctors. My father did the latter.I did the former,and became a G.P.; and so did my two sons who worked hard and are both consultants.
C.Helliwell
October 3rd, 2008 at 6:29 pm
Unfortunately this will always continue to be a problem of the admission process of medical schools - too many applicants. You are right in the way that someone who has done many extra-curricular activities is generally better suited to a career in medicine but it has to be more important to be academically able. The introduction of admissions tests is a positive one especially if they can test both academic and non-academic qualities but if I were a patient I would rather my doctor/surgeon was a very high achiever in school and medical school even if it was at the expense of his/her skill on a violin or on a football pitch(!)
D.Lack
October 6th, 2008 at 6:24 am
I thank Eva Brencicova for bringing attention to the important issue of how medical students are selected.
In Sydney one of the universities only recently moved to a new intake system, previously granting admission only on the basis of school marks. If you didn’t live in Sydney with access to the schools and teachers who knew how to propel you into the top 0.2% of the state you stood little chance of making the grade. Even with interview based selection I am aware of people who have paid ‘coaches’ to help them appear more suitable for admission!
Tony Floyd
October 6th, 2008 at 11:36 am
Interesting article, however I am not sure that the people ” whose company I have enjoyed the most” will make the best doctors. Selecting the right students is difficult as there is not one correct formula for creating the best doctors, many different types of doctors are required. I do agree that academic acheivement is not always the most important quality.
H Taylor
October 6th, 2008 at 10:20 pm
I recently had my interview for Sydney Uni Med School which was MMI (multiple mini interview) format, comprised of 8 scenarios running for 7 minutes each. At least we were given the opportunity to prove ourselves. On the other hand the new “lottery” system that many schools are implementing has no basis for selecting people who will be good doctors as it is not solely based on grades, nor is it based on skills, attributes and experiences. It merely selects candidates at random. I don’t think any of these admission strategies can guarantee the candidate will perform well as a doctor, but at least having a consistent selection process empowers us to have SOME control over the results.
Hot topic, Eva.
Lauri H
October 7th, 2008 at 1:19 pm
I am a medical applicant in Scotland. Such requirements are imposed here aswell; however extra curricular activities that are relevant to the course are valued. An aptitude test called UKCAT assesses a persons overall skills and not only their academia. This test is used to varying levels by universities, but these are steps in the right direction.
If you are to demonstrate how good a doctor you can be, you really do need good grades and extra curricular activities. This offers the best chance for acceptance.
A good balance shows that you are a rounded person and not an exam passing machine.
R Hockaday
November 4th, 2008 at 8:10 pm
I disagree strongly. I come from a family of five all of whom are doctors. Medicine is a hard slog with little reward, financial or otherwize. It needs people who are commited to the job and little else. I was a very outgoing person and wanted to have lots of extra-curricular interests. Doing medicine, I neither have the time or money to persue them. I think it’s unfair to recuit outgoing ambitious people to a field in which you have to study hard for the rest of your life with little free time and such little reward.
aj
December 10th, 2008 at 1:33 am