Equal opportunities must recognise ability
Editor - I want to be an Olympic sprinter, but I am unfit. However, the standard ought not be adjusted for unfit people, instead I should train harder. But in the end if I cannot run fast enough then I cannot meet the criteria for selection so I cannot compete in the Olympics. I will have to accept that I will never be a sprinter. But I will be a doctor, hopefully.
Carruthers states that selection for medical school reflects society's attitudes,1 and I agree. Society demands of its doctors that they are intelligent and confident and present themselves well. Selection for medical school is designed to find those who will be able to fulfil these expectations and presumably go on to be good doctors. At present medical schools use the criteria of A level grades and interview. However, Carruthers is wrong to draw a distinction between those who present themselves well at interview and better candidates: according to the criteria for entry they are the same.
Making entry easier for certain groups is like making Linford Christie carry extra weight so that he runs as slowly as I do. This situation would be undesirable in athletics-and much more so in medicine. Doctors are expected to reach the highest standards. Likewise, applicants should all be brought up to the highest standard, rather than the standard being lowered so that more people can achieve it. There should be only one set of criteria for entry to medical school, as there is only one for becoming a doctor.
You state in your editorial that it is time to rethink the criteria for entry.2 This is the real debate, not what school you've been to, but whether or not the current criteria result in the selection of future good doctors. Let's debate what the criteria ought to be, not come up with a "simpler method," such as offering the universities incentives to accept whichever is the politically fashionable group of the day.
Why do we want to select a broad spectrum of students? The implicit assumption is that having equal numbers from all groups in medical school is equivalent to equal opportunity. But this only holds true if all the applicants are equally able. If some groups are allowed to meet a lower standard for entry then equal access is unequal opportunity, and discriminates against the high achieving group. The way to achieve representative numbers is not to use positive discrimination but to fund the state school system properly so that its students attain the same high results. This would be a better use for any extra funding and might help to achieve my and Carruthers' goal of reducing the basic inequalities in society.
Duncan McPherson, fourth year medical student, Royal Free and University College Medical School
Email: d.mcpherson@ucl.ac.uk
studentBMJ 2000;08:303-346 September ISSN 0966-6494
- Carruthers R. Class bias of medical schools is a reflection of society, not of application procedures [letter]. studentBMJ 2000;8:252. (July.)
- Roach JO, Dorling D. Recruiting the wrong students. studentBMJ 2000;8:178-9. (June.)
