In the first of a two-part series, HEALTHplus looks at whether the new assessment system is producing the the best candidates for medical courses, writes BRIAN MOONEY
THE CURRENT CAO season has seen a further increase in applicant interest in all undergraduate medical and para medical courses. The points required to secure a medical place have increased again this year, which has left many aspiring doctors disappointed.
The introduction of the HPat assessment test in 2009 was designed to identify the most suitable candidates to pursue a career in medicine.
Its introduction, alongside a modified version of the current CAO points system – in which the points achieved by students between 550-600 were discounted to 20 per cent of their face value – was intended to break the link between achieving a perfect score in the Leaving Certificate and pursuing a career in medicine.
The intensity with which applicants have engaged in preparation courses for the HPat which, according to its publishers in Australia, cannot improve performance, gives the lie to the argument that interest in medicine would diminish under the new application system.
If it can be shown that students, who attended prep courses in 2010, having taken the HPat assessment in 2009, achieved significantly higher scores this year, then the whole HPat process will be fatally undermined and should be abandoned.
Why is there such a huge demand for medical and para medical places from Irish students today? When I attended UCD in the early 1970s, I could have registered for any degree programme I wished, so long as I had matriculated, which entailed securing two higher level C grades in the Leaving Certificate, and met the minimum entry requirements for the course in question. I chose an arts degree in politics, economics and philosophy, because they were the subjects that interested me. In those days nobody had ever heard of the points system.
At a Literary Historical Society reunion event in Earlsfort Terrace to mark UCD’s departure from the building, a speaker recounted arriving in the main entrance hall of the terrace on registration day in the 1960s to find lines of students in front of five wooden tables.
His friends had already retired to one of the public houses on Leeson Street and he was impatient to join them, so he chose the shortest queue and found himself registering for medicine.
The points system was introduced in the mid-1970s to ration college places because demand was beginning to outstrip supply. Free second-level education had massively increased the number of students taking the Leaving Certificate who, quite naturally, wanted to continue their education on to university.
The points system became the new queue to replace the five tables in Earlsfort Terrace. Because of the costs associated with training doctors and the requirement to secure hospital placements, it was not possible to increase the number of places on offer, which remained at 308 for more than 30 years, until the increases sanctioned by Mary Hanafin during her term as Minister for Education.
Inevitably through the 1980s and 1990s, it became progressively more difficult to secure an undergraduate place in one of the five medical schools, and the points requirements increased yearly.
It very quickly became apparent that the points acquired by a student were beginning to be regarded as a commodity in themselves. Their intrinsic value had to be maximised in the eyes of many parents and students.
Highly academic students who were achieving more than 550 points were therefore being encouraged to cash in their points for the highest value courses they could which, in most cases, were the medical and para medical ones.
In the minds of the applicants and their parents, applying for a course with an entry point requirement lower than the one you achieved was seen as wasting a very valuable resource.
The idea behind introducing the HPat test and reducing the points achieved above 550 to 20 per cent of their value was to break the link between very high academic achievement and deciding on a career in medicine.
It may seem self-evident to say the job of a doctor, across the whole range of careers open to medical graduates, involves dealing with sick people.
Sick people can often be at their lowest ebb, and at their most cantankerous when they are feeling unwell.
Doctors need huge reserves of emotional energy, as well as the physical variety, resulting from the nature of their work, and the long hours they often have to work.
They have on a weekly basis, the very painful task of informing patients that they or members of their family have life-threatening conditions.
The aptitudes and skills associated with such a role are not necessarily those that will secure a person six As in their Leaving Certificate, though they are not necessarily mutually exclusive.
Parents, who play a hugely important role in advising their children on their career options, need to be mindful that securing a place in medicine will only be of long-term value if the child who secures the place has the personality and vocational interest to blossom working within the health services.
Next week: How can those without perfect Leaving Certificate scores gain entry to medical school?