Getting in to medical school

Sir, – I must take issue with Dr Niall Conroy (August 25th) who seeks “redistribution” of medical school places in favour of…

Sir, – I must take issue with Dr Niall Conroy (August 25th) who seeks “redistribution” of medical school places in favour of Leaving Certificate students, rather than graduate entrants.

His case is that “some of the finest minds in the country” (sic) are being denied their rightful place in Irish medicine and that giving such places to mature graduates (who have already completed a first degree) somehow threatens “the academic calibre of medical school entrants”.

The mind boggles at this idea: surely recent experience suggests that the current process for medical school entrance has left Ireland’s health service profoundly short of non-consultant hospital doctors (NCHDs), with calamitous consequences for our emergency department (ED) and other acute services, where dozens of vacancies remain and there is a reliance on ruinously expensive locum staffing.

The primary cause of the shortfall in emergency department staffing is simple: the decision of so many of our graduates to take a “gap year” (or longer) in their early careers, often in the Antipodes. And the remedies for the crisis are equally simple.

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First, we must recognise that the need for “time out” is felt, apparently irresistibly, by many young Irish (and British) adults, and is probably here to stay for the foreseeable future, so we must “deal” with it.

Second, we should “reward” those graduates who commit to work (for, say, a year) at our medical “frontline”, with “bonus points” in the processes of application for medical school, general practice and hospital medicine in Ireland, and perhaps with a “premium” in terms of remuneration.

Third, and perhaps most importantly, we need to appreciate that mature graduates – who have usually “done” their gap year – are often delighted to work at the frontline; they bring invaluable real-life experience to the practice of medicine, and their previous backgrounds in pharmacy, nursing and psychology etc, are often a wonderful advantage.

Moreover, their dedication to patients, in my (thankfully growing) experience is second-to-none, in a delightedly “old-fashioned” way. So I say, why not make mature entrants the “norm” or at least the majority? After all, from where I stand, the academic calibre of medical school entrants matters little compared with the calibre of care we provide to our citizens. – Yours, etc,

Dr CHRIS LUKE,

Consultant in Emergency Medicine,

Mercy University Hospital,

Cork.