Can you really be ‘coached’ to pass aptitude tests for entry to medical school?

The deans of medical schools want to change entry requirements for studying medicine in Irish universities following concern that many applicants are being coached for tests aimed at determining their aptitude for working in the sector. Tell me more about these tests

Applicants for undergraduate medicine are required to combine their Leaving Certificate results with the Hpat (Health Professions Admission Test), which was introduced in 2009 to assess skills deemed important for medicine, such as reasoning, problem-solving and interpersonal skills.

While the 2½-hour test was initially envisaged as one that candidates could not study for, there is now an extensive private tuition industry where students can prepare for the assessment.

How much are candidates paying for private tuition?

There are lots of “preparatory courses” available for students, who can spend up to €800 for a 15-week series of classes and mock exams.

Typically, they are operated by so-called grind schools such as the Institute of Education in Dublin, Hewitt College in Cork and many others; in addition, there is something of a cottage industry among medical students who have done well in the test offering their services.

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How widely used is the Hpat?

About 3,000 students take the test each year, which is required to study undergraduate medicine at University of Galway, the Royal College of Surgeons in Ireland, Trinity College Dublin, UCC and UCD. University of Limerick also requires the Hpat for entry to its master’s courses in occupational therapy and speech and language therapy.

Can you really be coached to do better in the Hpat?

When it was introduced in 2009, the Australian Council for Educational Research (Acer), which devised the Hpat, said it did “not endorse any training college and actively discourages candidates attending them. They are a waste of the candidates’ (or their parents’) money.”

However, there is evidence that suggests they can pay off. A review by five medical faculties three years after its introduction found 40 per cent of successful applicants each year had improved their Hpat score after resitting it and so got a place in an undergraduate medical school. The report found the greatest improvement was in the non-verbal reasoning section.

There have been adjustments to the weighting of components of the test and changes to rules around when candidates can sit the test over the years. Nonetheless, critics say those who can afford expensive preparatory and repeat courses retain a significant advantage.

Is the issue of “coaching” candidates a concern outside Ireland?

Yes, it is an issue elsewhere. Studies highlight that in countries such as Germany and the UK, private companies offer expensive preparatory courses for similar medical aptitude tests. They, too, are grappling with ethical questions about equal access, as these courses may improve test results and thus increase the likelihood of admission for wealthier candidates.

Interestingly, Australia combines the test with a structured interview process to help identify those suited to the profession.

So, what changes are being planned to the Hpat?

The Hpat is marked out of a total of 300 points, which is added to a candidate’s Leaving Cert score. For example, a student who gets 500 points in the Leaving Cert and 200 points in the Hpat gets a combined score of 700 points.

Under revised plans, the Hpat would be reduced to 150 points. This, say sources, means the test would carry the equivalent weight of about one extra subject for entry purposes.

When will changes come into effect?

The planned changes will require sign-off by the academic councils of universities. In theory, this should be simple, say sources. If implemented, they would probably have a two-year lead-in time from when the changes are announced.

Why was the Hpat introduced in the first place?

It was introduced following concerns that medical applicants needed to achieve “a perfect Leaving Cert”, while those with an aptitude for medicine were falling through the cracks.

The system that came in – which is still in place – says that for school leavers to be eligible to compete for entry to undergraduate medicine they must achieve a minimum of 480 points, meet minimum subject entry requirement and complete the Hpat. Hpat scores are added to Leaving Cert points, although Leaving Cert points above 550 are moderated, with one point awarded for every five scored above that level.