MEDICAL MATTERS:Being a good doctor is what counts – not whether you're male or female, writes MUIRIS HOUSTON
FOLLOWING a news report in The Irish Times during the summer outlining how the trend of significantly more women achieving places in medical degree courses had been reversed in this year’s offers from the Central Applications Office, a large correspondence in the letters page ensued.
The introduction of the Health Professionals Admissions Test (HPat) for the first time had benefited males. Some 52 per cent of offers went to girls, while 48 per cent of medical school places had been secured by boys.
This compares with a previous 60-40 ratio in favour of female candidates under an entry system based solely on Leaving Certificate results, with medical schools here reporting 70 per cent of women in some classes.
A number of medical academics commented favourably on this change: “From the profession’s point of view, a 50/50 mix is desirable,” was one comment. Another noted the pendulum had swung too far in favour of females.
The reaction was robust and included a letter from the deans of all medical schools in the Republic, who denied the HPat introduction had anything to do with a gender rebalancing agenda.
Now the editor of the Irish Medical Journal has entered the debate. In an editorial, Dr John Murphy says many in the education and medical professions were taken by surprise by the speed at which the HPat was put in place.
“One of the major concerns is that we don’t know what the HPat is measuring. It is far fetched to believe that a single written examination test at age 17 years will identify the future doctors with creativity, flexibility and initiative.
“Aptitude tests must have reliability. Reliability relates to whether the test consistently produces the same result for candidates of similar ability.”
Dr Murphy labels the change as an “attempt at social engineering”, commenting: “Society needs the best doctors that can be produced and it should be irrelevant whether they are male or female. It is unjust to suggest that girls do well in the Leaving Cert because they learn by rote. They do well because of their application and organised study arrangements.
“Taking 30 or 40 points off the Leaving Cert marks of a clever girl and then subjecting her to a gender-biased aptitude test does nothing for the reputation of the Irish education system or the medical profession.
“Rather than handicapping girls and their academic achievements, the education authorities should be seeking methods of raising the educational standards of boys,” he writes.
The respected editor makes the point that there is no evidence the current group of young doctors emerging from medical school lack personal or social skills. He calls for the new system to be scrapped.
My personal view is that the debate must be widened beyond gender. What we need is a discussion about what sort of doctor we want looking after us in the future.
I sense a loss of vocation among recent graduates. There is a feeling that, for some, being a doctor is simply a job.
And while no one wishes to return to the days when doctors worked dangerously long hours, there is a definite need to redefine the core values of what it means to be a physician.
Professionalism in medicine is crying out for reinvigoration. This is not something that should be left to the profession. We need considered societal input into the question: what sort of doctor?
Surely medicine has to be about more than technical competence or the slavish following of guidelines? What price clinical and empathy?
Colin Bradley, professor of general practice at UCC, has said that being a GP is “about being a doctor to, for and of the people”.
While remaining alert to the dangers of burnout, medicine has to be a life-consuming profession.
When I am unwell, I wish to be looked after by a doctor who is caring, compassionate and committed. Let’s have an entry system that puts a premium on these values.
Forget political correctness: it will never encourage the kind of vocation needed to look after another person.