Use of aptitude testing for medical school entry

Madam, - I read with interest your Editorial of August 16th on the introduction of aptitude testing for medical school entry.

Madam, - I read with interest your Editorial of August 16th on the introduction of aptitude testing for medical school entry.

I observed the first airing of this proposal, and the various comments since then, with growing disbelief. Of the many half-baked proposals to emerge from so-called "expert committees" appointed by this Government to study the health service, this must rank as one of the most ridiculous. The growing acceptance of the proposal, as evidenced by your Editorial, brings to mind the tale of the Emperor's new clothes.

In order to apply aptitude testing to medical school entry there are two basic requirements. First, that there is such a thing as an "aptitude" for medicine (there isn't); and second, that even if such an aptitude existed (it doesn't) we could measure it (we can't).

A degree in medicine is a basic level degree and the holders of such degrees go on to a wide diversity of careers. Medical degree holders may indeed go on to treat patients, but many take up executive positions in companies, become pathologists or research scientists in a laboratory, or join the Armed Forces - amid a multitude of other endeavours. To suggest that one aptitude will cover all of these potential career choices is ludicrous.

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It would be difficult enough to make a case that aptitude testing should take place after one is qualified, to see if one has an aptitude for general practice, brain surgery, research, etc; but to suggest that an aptitude test can be taken at 17 or 18 years of age to say whether or not one would make a good doctor is complete nonsense. Come to that, what is a "good" doctor?

Aptitude testing in any case is a form of pseudo-science. It is perhaps marginally superior to hand-writing analysis but is about as useful as Tarot card-reading in predicting what somebody will or will not be able to do 10 years from when the test is taken. The fallacy of believing that aptitude testing is in some way a scientific measure of a person's ability is emphasised by the fact that in Australia the major growth industry in medical education has been the numerous schools that have sprung up which will teach you, for a few dollars, how to pass the aptitude test to get into medical school.

An air of respectability is bestowed on the proposals by constant reference to the "internationally recognised" tests. The only place where they are recognised is Australia and those of us who have worked in that country can testify to the almost universal dissatisfaction with the system - apart, of course, from those with a vested interest in administering the tests or running grind schools that teach you how to pass them.

The new proposal has nothing to do with improving medical education in this country and everything to do with appeasing (temporarily) middle-class mummies and daddies whose Johnny or Mary would make a "brilliant" doctor, if it wasn't for that dreadful points system.

Whatever its faults the points system in Ireland is fair, it is equitable, it gives a target that people need to reach and that they can identify as having been reached or not. To replace this with a system as inexact as aptitude testing with no identifiable end point would create a lot more problems that it would solve.

If it is considered that the points system is leading to too many high achievers entering medicine (which I would dispute), and if one feels that 450 points is a more realistic target, then I would suggest that everybody who gets 450 points and wants to study medicine has their name drawn from a hat. This would be fairer than a half-baked aptitude test of dubious validity.

There may, however, be a case for requiring those proposing to serve on "expert committees" or politicians to undergo aptitude testing - though exactly what aptitude one would test for is open to debate. - Yours, etc.,

Prof CIARAN BOLGER, Consultant Neurosurgeon, Beaumont Hospital, Dublin 9.