Though flawed, points system still best option

I DISAGREE with the views expressed by Professor Paul Finucane regarding medical school admission (Opinion, September 5).

Education Minister Mary Hanafin’s proposal to introduce an aptitude test, which Prof Finucane welcomes, is based on two false assumptions which owe more to middle-class parental angst than to a rigorous assessment of a perceived problem.

The first is a widely held, though flawed 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 10-15 years later.

The second unsubstantiated opinion is that even were such a definable group of individuals to exist that one can devise an exam to accurately identify them, one almost certainly cannot.

Prof Finucane advocates the dual assessment of Leaving Certificate examination combined with an aptitude test as a means of reducing the stress level on students.

I fail see to the logic in introducing a second examination in order to reduce the psychological stress burden on students. By all means, replace the Leaving Certificate with a separate, structured entrance examination for assessing potential candidates. The highest scoring students will undoubtedly, though not exclusively, be academically gifted students.

However, what will Prof Finucane and the minister say to the well-adjusted, empathetic, intellectually outstanding student who achieves a perfect Leaving Certificate result yet is denied the opportunity to fulfil their dream because don’t have the appropriate ‘aptitudes’?

Prof Finucane states that there are ‘bright and hardworking people who don’t perform well under the intense pressure of the Leaving Certificate’ and who are then denied the opportunity to become doctors.

As someone closely involved in postgraduate medical education, I view the ability to perform at an intellectually high standard while under intense pressure as an essential skill in a trainee doctor.

The Leaving Certificate may be a blunt instrument but it is rigorously fair, and all students regardless of their social background are offered a free full-time education in preparation. 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.

Indeed, 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, offering to maximise their child’s chance of entering medical school. The advantages already enjoyed by more affluent applicants will be reinforced as students from wealthy backgrounds are intensively tutored at great expense to attain high marks in an exam that is supposed to identify the innate potential to be a ‘good doctor’.

The current system is imperfect. However, 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 most difficult lessons to impart to a trainee doctor. It is a discipline that those involved in devising the entry criteria for medical school would do well to acquire.

Dr Michael Clarkson

Consultant Nephrologist

Cork University Hospital

Cork