Testing the gender balance
The new system of entry into medical school aims to help achieve a 50/50 gender balance, writes BRIAN MOONEY
WRITING IN my education column in The Irish Timeslast September, when the details of the new HPat assessment was announced, I speculated that an attempt was being made to reduce the 60:40 advantage that females enjoyed in securing places in undergraduate medical degree programmes, based on the high scores achieved by them in the Leaving Certificate.
In light of my observation it is interesting to note that the professor of academic medicine and director of undergraduate teaching and learning at Trinity College Dublin, Seán McCann, said following the announcement of the first set of medical place allocations under the new system, that one of the original aims in amending the entry system to medical school was to change the gender balance and that “from the profession’s point of view, a 50/50 mix is desirable”.
Following the allocation of places, we have heard a number of females who secured 590-600 CAO points complaining on radio talk shows about the unfairness of the HPat admissions system. One is forced to ask the question, does the HPat test identify the best doctors?
The HPat test was developed by the Australian Council for Educational Research (ACER). ACER is a provider of support to education policy-makers and professional practitioners.
It is a private, not-for-profit company, which generates its entire income through contracted research and development projects and through products and services that it develops and distributes. ACER supports the introduction of its HPat test as a method for selecting Irish medical students on the following grounds:
1. It measures a prospective medical student’s logical reasoning and problem-solving skills as well as their non-verbal reasoning and their ability to understand the thoughts, behaviour and/or intentions of people.
2. It does not test academic knowledge, and candidates do not require special understanding of any academic discipline.
3. Intensive preparation is not advisable nor necessary, although wide and critical reading may provide helpful preparation for sections one and two. However, as with any test, some practice in answering questions of a similar type, and under similar time constraints as those found in the real test, is helpful and reassuring to most candidates.
4. It tests a prospective medical student’s response to stimulus that will not necessarily be familiar.
5. The purpose of the test is to assess the general skills and abilities developed over the course of your education and life experience that are considered by universities to be important to the study and practice of medicine.
In light of Prof Seán McCann’s statement that one of the original aims was to change the gender balance away from the previous 60:40 ratio in favour of females, it is ironic that ACER was recently awarded the 2009 Employer of Choice for Women status by the Equal Opportunity for Women in the Workplace Agency on the basis of its policies and practices that support women across the organisation and have a positive outcome for both women and their business.
In supporting the introduction of the HPat test alongside the discounting of Leaving Certificate points from 550-600, to reduce the success rate of females in securing medical places, the university medical faculties stated that to operate most effectively in medicine, graduates need to:
- be flexible
- have good thinking skills (critical and analytical)
- be able to respond quickly to new situations and problems
- have a well-developed ability to understand and respond to patients’ needs and individual situations.
While attending a conference on medical education in Cambridge recently, I was struck by the wide variety of career opportunities available to medical graduates. On a visit to Adenbrooks Hospital during the conference, I spoke to some brilliant doctors who spend their lives in the laboratory developing new treatments and medications for life-threatening diseases. These doctors will never interact with patients, and do not require good bedside manners.
Likewise, consider the brilliant surgeon, whose skills relate in no way to their interpersonal skills. In devising a test to determine who will make the best doctor, how do you factor in the wide range of roles that are open to medical graduates?
Are we being fair to young 17-19 year-old Leaving Certificate students, who have yet to develop many of the skills tested in the HPat assessment, by moving away from their examination performance as the method of determining who gets to go to undergraduate medical school, because the CAO points system does not give the medical establishment the correct gender balance?
Are we comfortable with a system that actively discriminates against females attaining medical places?
Is the medical establishment supporting the change in the admissions system because it fears the feminisation of the medical profession will somehow reduce its status, and thus its financial rewards as it is reputed to have done in teaching and other professions?
Are there those within the medical establishment who consider it a waste investing huge resources in training females as doctors if, after a number of years in practice, they decide to leave the active labour force or decide to work on a part-time basis to give time to care for their children?
Where are the voices of those who would normally speak out in protection of equality of opportunity for women in the workplace?
Given that commercial interests are now offering HPat training workshops, at very high costs, which they claim increase success rates among applicants, are we moving to a situation where only the wealthy can consider an application to medical college?
I believe that before we accept the system used to select this year’s students, we need to address some of the above questions.