To the outsider, university training in medicine and, by hopeful consequence, a career as a doctor, comes across as a fascinating, if bewildering myriad of high-speed, non-stop days, doors crashing open revealing a new tragedy sound-tracked by confident professionals conversing in a language all of their own and an unending supply of interesting victims, which usually form the basis of the growing number of medical dramas currently on our TV screens.

I'm due to take my final medical exams in May and hope to begin my internship in July. And, so while my qualification as an insider may be debatable, I can still say that to me a medical career remains fascinating but bewildering, nonetheless. Without wishing to put off prospective applicants to medicine courses, I feel a few myths about the course need to be addressed.

There has been a long-running debate in recent years concerning the merits or otherwise of the current Points system for entry into third-level courses. A persistent argument arises that high points is not a sufficient screening mechanism, while others argue that the academic standard required of this course necessitates such a process.

First, it should be said that in terms of academic requirements, the Points system unwittingly provides the perfect mechanism for screening. The subject material in medicine is no more difficult than any other university degree - there's just a lot more of it! The key to success in achieving over 500 points in the Leaving Cert is the ability to remember an enormous volume of facts and, yes, this IS good preparation for a course in medicine.

At this point, one is reminded of the almost annual morning radio debate about doctor's inability to communicate properly with patients during which the entry system into medical courses and the subsequent training is questioned. Interviews are inevitably suggested. It's worth remembering on this point, the increasing number of grind schools catering for the current Points system requirements. Interviews for medicine would doubtless lead to similar private interviews for training schools.

The criticism that medics are often guilty of poor communication skills is deserving of more attention. During my own training, some effort has been made with regard to inclusion of a number of initiatives in the curriculum but invariably they suffer in priority to the larger more daunting subjects and thus tend to be disregarded as a mere exam, which must be gotten and forgotten, often in the same day.

In truth, it's probably impossible to either screen students for inter-personal suitability or to train them in university, given the prioritisation of academic requirements at school and the enormous workload in college.

It was pointed out to me recently that development of a poor bedside manner may unconsciously begin during the final three years of medical school, the clinical years. This is the period where a significant proportion of teaching is conducted at the bedside, where a consultant, anything up to 15 medical students, and the unfortunate patient are enclosed within a curtained bed-space. The student, initially mortified at the exposure to "education by humiliation", gradually becomes desensitised to the process and often displays this to the patient. Thus begins the inevitable slide into coldness with which we are often criticised.

Medical training will no doubt continue to be criticised on the grounds that it is unable to produce doctors who can communicate to patients. While by no means attempting to offer such a naive theory as an excuse or a future defence, desensitisation to many experiences is necessary to remain sane but often can descend into dehumanisation.

Gavin Jennings

A final-year medical student at NUI Galway