Madam, - As a hospital consultant who entered medical school without the having enjoyed the "benefit" of a private primary or second-level education, I am concerned at Mary Hanafin's proposals to change medical school admission. The proposal as outlined is based on two false assumptions that owe more to middle-class dinner party angst than to a rigorous assessment of a perceived problem.
The first of these is a widely held, though erroneous, belief that a select group of teenagers exhibit a range of aptitudes undiscovered by the Leaving Certificate that will result in them becoming "good doctors" some 10 to 15 years later.
The second is that, even were such a definable group of individuals to exist, one can devise an exam to accurately identify them. Almost certainly one cannot.
The Leaving Certificate may be a blunt instrument, but it is rigorously fair and all students, regardless of background, are offered a largely free full-time education in preparation for it. There is no evidence that other testing systems will improve either the fairness of the selection procedure or the quality of the doctors so selected.
The question is not one of "dumbing down", but one of ensuring equity of access to all students regardless of their social background. Private educators will be rubbing their hands in glee at the thought of a new entrance examination for a coveted place in medicine. As in the United States, preparation courses for the "aptitude" test will be relentlessly marketed to parents hoping to maximise their child's chance of entering medical school. The advantages already enjoyed by more affluent applicants will be reinforced as students from wealthier backgrounds are intensively tutored at great expense to attain high marks in an exam that is supposed to identify the qualities inherent in a good doctor.
Overcoming the urge to "do something" when faced with a difficult problem for which there is no proven intervention of benefit is one of the hardest lessons to learn as a trainee doctor. It is a discipline that the Minister and the Higher Education Authority would do well to acquire. - Yours, etc,
Dr MICHAEL CLARKSON,
Consultant Nephrologist,
Cork University Hospital.
Madam, - The Minister for Health's proposals on medical faculty admission are welcome and overdue.
The pattern of high points in the Leaving Certificate shows that, of those receiving 550 or more points, 63 per cent are female and 37 per cent male. This indicates that points are a poor measure of innate high ability and distort the gender mix of future doctors.
Other college entrance tests, such as SAT and ACT in the US, have quite different gender patterns to the Leaving Certificate. This shows that that the nature of the test can strongly affect the male/female pattern of results.
The mix of tests proposed by the Minister is therefore a good thing. - Yours, etc,
SEAN McDONAGH,
Bettyglen,
Dublin 5.
Madam, - The Minister for Education plans to lower the points requirements for entry into medicine on the basis that "you do not need to have a perfect Leaving Cert score to be a good doctor." (The Irish Times, September 3rd). The Minister is quite right: the minimum subject entry requirements for each course, including medicine, are set by the universities and are quite low.
The points system however, was never designed as a mechanism for setting minimum criteria for entry to university. It was designed to allocate places equitably in situations where demand exceeded supply. It's not a perfect system, but at least it's fair.
The same cannot be said for the system the Minister proposes. It is quite likely that poorer students with excellent Leaving Certificate results and with an aptitude and vocation for medicine will be squeezed out by those from more privileged backgrounds. What the Minister proposes brings wealth into the equation. Post-graduate entry into medicine requires that students have the necessary €12,000 required to pay for each year of the course. Undergraduate entry, although less expensive, will require success in an aptitude test, in competition with those who can afford to pay fees for the grind schools which will inevitable emerge to service the tests.
There is a shortage of places in medicine. The problem should be fixed by increasing the number of places available, not by tinkering with the points system. - Yours, etc,
JOHN DUNNE,
Beaufort Downs,
Dublin 14.