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EDITORIALS: Kamran Abbasi Is medical school selection discriminatory? BMJ 1998; 317: 1097-1098 [Full text]

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Disabled people are also disadvantaged in medicine

Kadaba Vasudev   (11 November 1998)

Medical School Admission Policies

J D M Douglas   (12 November 1998)

Disabled people are also disadvantaged in medicine 11 November 1998
Kadaba Vasudev Send response to journal: Re: Disabled people are also disadvantaged in medicine	Editor-Dr Kamran Abbasi's editorial on the alleged disadvantage faced by ethnic minority applicants to medical schools makes disturbing reading.(1) One should not forget that another group of people who constitute the world's largest minority, the disabled, are much more disadvantaged in every walk of life. A working party set up by the British Medical Association, as part of its remit, tried to establish without success whether or not disabled applicants to medical schools faced inequalities of opportunities.(2) It suggested in its report a detailed controlled study in this matter. Other recommendations of the working party include : practice of equal opportunities in the selection and admission of disabled medical students with continued equal opportunities during medical training (if they wish) for those students who become disabled during their undergraduate training ; production of a pre-medical school advice leaflet about disability issues for those with disabilities who are considering training in medicine and who need guidance on the opportunities. It is only right and and proper that the rights and interests of the disabled are equally safeguarded as those of women and ethnic minorities. 1 Abbasi K. Is medical school selection discriminatory? BMJ 1998;317:1097-1098(24October) 2 Meeting the needs of doctors with disabilities. British Medical Association,1997
Medical School Admission Policies 12 November 1998
J D M Douglas Send response to journal: Re: Medical School Admission Policies	Dear Editor The difficulties of selecting potential Doctors have been highlighted by Kamran Abbasi (Reference 1). The requirement for medical school admission committees to select people who reflect current society in cultural background and have the intelligence, team working and communication skills set out by G.M.C (Reference 2) is almost an impossible task which the profession and society sets them. The range of medical careers from clinical through laboratory to administration can accommodate a range of personal qualities and potential. The Australians (Reference 3) advocate a psychometric template for selection but this begs the question that we know what makes good Doctors and what predicts lifelong professional contentment and vigour. Can a dubious interview with poorly trained assessors screen teenage candidates any better in 20 minutes? What is the wider professional responsibility to help people interested in a medical career make the correct choice? The Scottish Medical Schools advise potential candidates to demonstrate evidence of "work experience" in their personal statements on the UCAS form. Unfortunately, this requirement causes a problem for school children in rural areas and will eventually exacerbate the current problems of rural recruitment detailed by Gillies (Reference 4). Society needs Doctors from rural areas, as well as ethnic minorities to understand the communities they come from. The work experience hurdle unwittingly discriminates in favour of private schools rather than state schools. Private schools are more likely to have well organised contacts to set up work experience programmes with local hospital and very active programmes to frog march marginal pupils through Duke of Edinburgh Award Schemes, which look well on the Cirriculum Vitae. In contrast, the bright children from concrete jungles have to show extra dedication to achieve their grades and may not have the medical role models or supportive guidance staff to set up work experience which looks impressive in the personal statement. Work experience is a good idea but the definition needs challenging. It often means an embarrassed teenager tagging along behind an embarrassed hospital consultant in front of an embarrassed patient. The confidentiality problems are practically insoluble and particularly pertinent in small rural communities. Why bother with observing patient contact? Why bother glimpsing at high tech hospital medicine when it is all detailed in television dramas and documentaries? The best work experience for potential medical students is participating in the care of the elderly in a nursing home or a Saturday job in a busy shop providing a service to the public and dealing with their demands or complaints. However, the next crucial step for the potential Doctor is skilled reflection on such work experience and learning styles in order to help them decide if they should even apply for medicine. Modern teenagers are perfectly capable of discussing the range of medical careers and personal qualities needed in addition to the intellect for a lifelong medical career. The profession has a duty to help them make an informed choice for the benefit of future patients, themselves, colleagues and the state investment. Who should fulfil this role of medical mentoring prior to medical school application and how should it be organised? It needs skilled medical volunteers who are willing to talk with teenagers on an individual basis when they are at the stage of applying for medical places. It needs to be available to all potential medical students and not just rely on "old boy" contacts. General Practice trainers have the educational skills for such medical volunteers. In order to address the problems of work experience and rural recruitment, the North of Scotland Faculty of the Royal College of General Practitioners has recently set up the Highland Schools Medical Mentor Scheme (Ref 4). The Faculty office maintains a list of G.P's in which is available to school guidance teachers to set up a series of meetings between the Doctor and the potential Doctor Resources probably have to limit schemes to candidates with the necessary grades in Scotland or potential grades in England. The medical mentor and potential Doctor reflect up medical careers, work experience, life experience and differing undergraduate courses between medical schools. Choosing between traditional, integrated and problem based undergraduate courses, needs discussion. Observing patient contact is not on the offer to the school or pupil within the Highland Scheme and indeed should not be required by admission committees. Yours sincerely Dr J D M Douglas MD, FRCGP, DoccMed Tweeddale Medical Practice Fort William References 1. Is medical school selection discriminatory? Abbasi,K. BMJ1998;317:1097-98. 2. Duties of a Doctor, G.M.C, London 3. How to do it: Select medical students. Powis,D. BMJ 1998;317:1149-50 4. Remote and rural General Practice. Gillies,J C M. BMJ 1998; 24 October General Practice Classified: 2-3