Rapid Responses to:
|
|
Rapid Responses: Rapid Responses published:
-
![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Graduate medical courses disadvantage state school applicants
- Andrew D Beggs (25 November 2007)
-
Students entry to Medical School
- Moyra F Guthrie (28 November 2007)
-
Re: Students entry to Medical School
- David R Warriner (29 November 2007)
-
Flexibility
- Robert WATSON (29 November 2007)
-
Working class background
- Judith A Langfield (30 November 2007)
-
similarities between medicine and law
- oscar,m jolobe, c/o john rylands university library, oxford road, manchester M13 9PP (7 December 2007)
-
Graduate entry into medical school
- Harish P Janardhan (15 December 2007)
-
Priming Period
- Minnie Faith (17 December 2007)
|
|
|||
|
Andrew D Beggs, Research Registrar Surgery London, UK
Send response to journal:
|
Sir, Professor Peile's article on graduate medical school entry raises several points. The part of the article I must take issue with is the assertion that candidates are somehow "stronger" for a previous degree and "life experience". Candidates from poorer backgrounds are totally disadvantaged since the changes in maintenance grants and the introduction of tuition fees. It is simply not economically viable for these kind of entrants to medical school to have done a prior degree as their medical degree would be unaffordable due to the levels of debt sustained during their first degree and the fact they must pay for at least a portion of their medical degree. As both articles have shown there is no real evidence for a graduate medical course either way, and as so many initiatives in the last 10 years, has been introduced without any trialling or room for debate. Andrew Beggs Competing interests: None declared |
|||
|
|
|||
|
Moyra F Guthrie, Consultant psychiatrist Murray Royal Hospital Perth PH7 2BH
Send response to journal:
|
I agree completely with your article in which you describe some of the disadvantages of the current system which seem to me to discriminate for middle class, parentally coached, highly competitive individuals who either are fortunate enough to know what they want to do with their lives at 14 when they choose their first exam set or are fortunate that other people make their exam choices for them. Some of the best doctors I know now would never have got into medical school with the current system! Competing interests: I am a member of a University Admissions committee |
|||
|
|
|||
|
David R Warriner, F2 Doctor in Paediatrics Scarborough YO12 6QL
Send response to journal:
|
Dear Sir, I welcome current graduate entry programmes, due to the diversity and wealth of experience they bring to the student and professional body. But, as a working class, B'grade, state schooled doctor, I feel I must stick up for the current system. Along with 4 other peers, I went straight to university from school. We gained our life experience from voluntary and paid work during school and university, not simply stacking shelves or taking aimless gap years. If medicine had been graduate only entry, then we could not have afforded to pursue my career and thus would have chosen an alternative. Commitment and aptitude to medicine can not be measured by a Degree, any more than it can by A-levels, it simply creates more barriers and revenue. Similarly, "maturity" is not simply a function of age, indeed with so many graduates in so called Mcjobs is it fair to advocate such a pre-requisite. David Warriner Competing interests: See first sentence. |
|||
|
|
|||
|
Robert WATSON, surgeon UNC
Send response to journal:
|
I am not opposed to graduate entry (the more flexibility the better) but to mandate it and reduce flexibility with the additional cost to both society and the individual would seem most odd. (Strangely during my 13yrs of postgraduate medical education I have never wished that I was older, had more dept or possessed a degree other than MBChB) I personally find one of the most beautiful aspects of medicine is that it is such a broad church with the ability to embrace a wide variety of differing individuals with differing strengths and weaknesses. The 'STRUCTURED'- one size fits all approach to education/medicine/life to me takes away some of its most interesting facets. Kind Regards Competing interests: I entered med school as a school leaver from a comprehensive school (with less than 5% of my year going on to university) |
|||
|
|
|||
|
Judith A Langfield, Retired GP 18 Glenside Close, Bristol, but no longer working
Send response to journal:
|
I came from a working-class background, and was able to attend University because of the grant system. The medical degree course taking five years was bad enough, but to have to have read for a prior degree would have added another three years of not earning, and would have been completely out of the question. I would hope that my upbringing enabled me to relate to many types of patients more easily than others might have done. Competing interests: None declared |
|||
|
|
|||
|
oscar,m jolobe, retired geriatrician manchester medicalm society, c/o john rylands university library, oxford road, manchester M13 9PP
Send response to journal:
|
Having obtained a diploma in law (G.Dip.L) subsequent to my medical qualification, I was in the fortunate position of being able to recognise similarities between medicine and law which prompted the character in the cartoon to say "I also have a degree in law, so, if you want to sue me, I can do that too!". Both medicine and law rely on good advocacy, because, no matter how sound the evidence might be, without good advocacy even the best case might founder. That is why, despite good evidence that diabetics do badly after myocardial infarction, and, accordingly, are the ones in greatest need of reperfusion therapy, whether by thrombolysis(2) or by primary coronary angioplasty(2), even the most authoritative guidelines(3) do not take recognition of the clinical presentation of myocardial infarction highly relevant to diabetics, namely, the pain-free presentation(4), so as to recommend reperfusion therapy, where indicated by electrocardiographic criteria, within 12 hours of symptoms such as sudden onset left ventricular failure or "collapse" which might replace chest pain as markers of the onset of myocardial infarction(5). This is a case badly in need of the quality of advocacy which can only emerge from Queen's Consel chambers. So, perhaps, rather than recommending that Specialist Registrars should also possess a law degree, we should, instead, recommend that they should "shadow" a QC for a year or two as part of their training. References (1) Peile E Should all medical students be graduates first? British Medical Journal 2007:335:1072 (2) Timmer JR., Ottervanger PJ., de Boer M-J et al Primary percutaneous coronary intervention compared with fibrinolysis for myocardial infarction in diabetes mellitus Archives of Internal Medicine 2007:167:1353-9 (3)American College of Cardiology/American Heart Association Task Force on Practice Guidelines ACC/AHA Guidelines for the management of patients with ST-Elevation Myocardial Infarction-Executove summary Circulation 2004:110:588-636 (4)Culic V., Eterovic D., Miric D., Silic N Symptom presentation of acute myocardial infarction: influence of sex, age, and risk factors American Heart Journal 2002:144:1012-7 (5) Jolobe OMP Delivering the National Service Framework for coronary heart disease(letter) Journal of the Royal, College of Physicians of Edinburgh 2004:34:162 Competing interests: None declared |
|||
|
|
|||
|
Harish P Janardhan, Graduate student - MD Biochemistry CHRISTIAN MEDICAL COLLEGE,VELLORE 632002- INDIA
Send response to journal:
|
I strongly advocate that the entry into medical school should be allowed only for graduates in the biological sciences as this would enable the student to appreciate important biological concepts,which are generally fathomed with less maturity in the secondary school going years,and underscore its relevance for the medical profession. This would ensure that the student understands the workings of the human system through a more holistic perspective including concepts of evolution. This approach also equips the medical student with skills required to start biomedical research at the medical school level with more confidence and adds to the scientific perspective in the practice of medicine. Competing interests: None declared |
|||
|
|
|||
|
Minnie Faith, MBBS,MD Senior Lecturer, Department of Biochemistry Christian Medical College, Bagayam, Vellore. Postcode- 632002
Send response to journal:
|
Sir, Apart from the financial liability that can be incurred on entering medical school following completion of a graduate course, I firmly agree with the views expressed in Ed Peile’s article “Should all medical students be graduates first?” As a faculty member interacting with first year medical students on a regular basis, I definitely feel that the current system of admission into medical colleges needs some revision in the criteria. In a Southeast asian country like India, the race for entry into courses like medicine is a full-fledged preparative rat race, with much emphasis on rote learning. How well are these youngsters who are seventeen or eighteen years old prepared for the rigor and discipline of the medical course that needs to be independent of parental guidance or schoolteacher supervised learning? How well is the psychology of an adolescent equipped to independently juggle the rigorous academic and social, recreational activities of a college or university environment that are equally important for development into a well trained doctor? Also in medicine, the importance of training the mental faculties towards factual evidence is of paramount importance. This becomes difficult when adolescents come armed with preconceived notions and myths about the medical course, which would benefit from a prior priming period. It is definitely a look in the right direction, when individuals after going through a graduate course turn to medicine which requires a high level of commitment evident in the long time period that it takes to complete the course and a post graduate specialization. Apart from the high grades that a student acquires at the A level or 12th grade, other factors such as overall psychological maturity, age and commitment levels need to be taken into account in one form of assessment or another. A prior graduate education may provide the prerequisite, preliminary priming period in this direction. Competing interests: None declared |
|||