Intended for healthcare professionals


Ethnic and sex differences in selection for admission to medical school

BMJ 1999; 319 doi: (Published 04 December 1999) Cite this as: BMJ 1999;319:1500

Don't let's discriminate against academic brilliance

  1. Derek Roskell, clinical tutor in pathology (
  1. John Radcliffe Hospital, Oxford OX3 9DU
  2. Manchester University Medical School, Manchester M13 9PL
  3. School of Public Health, 140 Warren Hall, University of California, Berkeley, CA 94720, USA
  4. South and West Devon Health Authority, The Lescaze Offices, Dartington TQ9 6JE
  5. Faculty of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH

    EDITOR—It seems naive to suggest that Nottingham Medical School's selection process avoids discrimination.1 Academic ability is scored as pass or fail, whereas a questionnaire about work experience, extracurricular activities, and positions of responsibility is scored quantitatively, as are the applicant's and referee's statements and interview. This process is presumably based on the idea that doctors need only a minimum academic ability It would be equally true that potential doctors need only an acceptable level of achievement in extracurricular activities, positions of responsibility, and the other factors that are highly rated.

    A questionnaire on work experience, extracurricular activities, etc might measure some objective markers of suitability, but the required answers could probably be inferred from the questions and suitable experience could be arranged if it seemed necessary. Students from less privileged backgrounds have less opportunity to develop skills in sport or music or to gain voluntary work experience. Equally, while candidates who have been given awards and positions of responsibility would be ranked highly, putting great weight on this may only perpetuate unfair discrimination that has been made by others.

    Medicine encompasses a huge range of careers; our numbers include leaders and followers, workhorses and creative thinkers, the quietly compliant and the revolutionary. We need to recruit a similarly wide range of students, including the academically excellent.

    Of course potential medical students need communication skills; extracurricular interests probably reflect a balanced personality; and it is useful to have some knowledge of the health service before applying to study medicine. But to attempt to quantify these things and discount academic achievement ignores one of the few objective criteria we have. Academic ability must, like everything else, be interpreted in the context of the applicant's background, and it will rarely be the overwhelming factor in selection.

    The Nottingham approach risks two things. …

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