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Should all medical students be graduates first?

BMJ 2007; 335 doi: (Published 01 December 2007) Cite this as: BMJ 2007;335:0712434
  1. Ed Peile, professor of medical education1,
  2. Charles George, chair2
  1. 1Institute of Clinical Education, Medical School, University of Warwick, Coventry CV4 7AL
  2. 2Board of Science and Education, BMA, London WC1H 9JP

Most people enter medical college straight from school. Ed Peile argues that a single system of graduate entry medical schools would provide the workforce needed for the future, but Charles George thinks that there is insufficient evidence to make this a criterion of entry

YES We must stop the headlong rush of pupils going straight from school into five year long medical courses. Bright teenagers are encouraged by teachers and parents to maximise their potential by aiming for the kudos and earning power of medicine. As consultants in their 20s, they will have little more breadth to their life experience than when they were studying during the week and spending their weekends meeting the unwritten requirements for school leavers to get into medical school-by working in care homes, hiking for the Duke of Edinburgh Gold Awards, and practising for grade 8 cello.

If we do what we have always done, we will always get a niche medical workforce. Selection is a different matter when students have had a chance to prove themselves independently, meeting the challenges of a university setting, and perhaps those of the workplace.

Diversity of the medical workforce has been hampered for too long by the “rhubarb forcing” techniques of secondary schools. Better grades at A levels are a predictor for medical student success, but our failure to nurture talent in deprived schools, coupled with the coaching power of private schools, has ensured that by restricting entry to medical school to those with better grades at A levels we are further disadvantaging some school leavers.1

Graduate entry medicine can widen diversity

Graduate entry medicine in the United Kingdom was predicated on faster production of doctors and on broadening the field from which they are recruited.2 Such courses should make efficient use of existing educational and healthcare capacity to produce more medical …

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