I’ve blogged in the past about routes to medicine as a profession but have left this one quiet lately.
It’s not that I haven’t done any thinking about it. In fact I’ve drafted a paper which I send to a few people for their thoughts occasionally.
Here goes with a summary of where I’ve got to so far and I would appreciate any comments or thoughts from anyone – I really mean it.
My paper is trying to answer these key questions:
- Does it matter whether or how entry to medical school impacts on A-level (or equivalent) subject choices in the UK?
- If no, is this because a guaranteed supply of highly capable medical professionals is the predominant national priority?
- If yes, are there potentially negative backwash effects on entry to other professions vital to the UK especially within the STEM (science, technology, engineering and mathematics) areas?
Not easy questions to answer I admit and perhaps they are just too big …
My initial analysis has focused on the role of Chemistry A-level or equivalent as the key ‘facilitating subject’ (a term used by the Russell Group of UK universities in their “Informed Choices” guide to HE entry) for entry to UK medical schools. I have tried to hypothesise why chemistry is so important:
- the biochemistry argument – doctors need a sound knowledge of chemicals used in medicine so it is better to get this under their belt as early as possible, though the British Pharmacological Society is devising a separate curriculum/test for prescribing skills at a later stage in the training process. Chemistry and biology complement each other at A-level and beyond, especially when applied to the medical sciences and allied subjects/professions.
- the rigour argument – chemistry is a ‘rigorous’ science subject (like physics and perhaps unlike some of the human sciences such as psychology), so provides proof of the exceptional intellectual capacity that the best undergraduates have OR future doctors will be part a professional elite so they should set the highest levels of aspiration and study post16 chemistry however much they ‘enjoy’ it. On this argument you might expect some correlation between Chemistry A-level results and UKCAT or BMAT additional entry test results for successful candidates.
- the gender equity argument – more girls study chemistry at A-level than physics (which used to be a requirement for medical courses) so more women can become GPs or consultants. Also, since more girls are now studying A-level Mathematics (and Further Mathematics), this is providing them with additional mathematical skills as medical professionals that they would otherwise gain from studying physics.
I stress these are just hypotheses, not tested by any real evidence and I have no special preference for any of them.
If you develop the gender equity argument into a broader social mobility one, as per the Coalition Government approach soon after it came into power, then there are a number of issues around fair access to medical schools in the UK. Examining application data through FOI requests made by one individual last year to all UK medical schools, confirms that interview criteria and processes are important in medicine – and we already know that success within this is relative and may depend on your relatives i.e. if someone in your family is already a doctor then you stand a better chance of getting in to medical school. Admittedly there are more special medical programmes nowadays aimed at students from non-traditional families, but there is still a long way to go on this.
I haven’t even got to the possible backwash effects on STEM careers of the entry system for medicine ….