Nigel Hawkes, Health Editor
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Doctors do not need top marks at A level to succeed, a project based at King's College London has shown.
It aimed to attract bright students from state schools in inner London who had A-level results that were far too poor to gain entry to medical school and show that, with the right help, they could succeed.
Students would normally require two As and a B at A level, but the scheme, called the Extended Medical Degree Programme, accepted those who had managed no better than three Cs.
The idea was to train doctors who better represented diverse social and economic backgrounds and to prevent medicine from becoming the exclusive preserve of the middle classes.
The programme began in 2001 and now has more than 200 students who are doing well, the academics behind it say in this week's British Medical Journal.
The students get an extra year of studying, with the first two years' studies being spread over three. This enables them to catch up and be given more support, but it is expensive.
Nine out of ten come from ethnic-minority communities and just under a third from middle-class families. To qualify they must have come from one of 100 state schools in the 15 most educationally deprived boroughs in inner London.
A mental agility test is used, with a 30-minute interview, to select the applicants. Most are the first in their family to go to university.
Despite their lower entry grades, those on the scheme gain degree results that are evenly spread throughout the entire year group of 360-400 students. Although they make a slower start, in the clinical years (years 4-6) pass rates are identical for both conventional and EMDP students (93 per cent).
Of those who opted to do the longer BSc degree, 12 per cent got a first, 76per cent an upper second and 12 per cent a lower second, compared with 28 per cent, 65 per cent and 7 per cent among the conventional students.
The authors, Pamela Garlick, from King's, and Gavin Brown, from the University of Leicester, conclude: “A new type of doctor is being created that, among other things, better reflects the social diversity of London's population.”
An editorial in the same issue of the British Medical Journal says that the scheme is politically correct, but costly. The extra cost is £190,000 a year.
Professor Chris McManus, of University College London, and Hugh Ip, of the journal, question whether this is justified. The scheme involves sacrificing equality of opportunity for the quest for social justice, they say.
“Is it worth our while to widen participation, particularly if this risks reducing standards?” they ask. “Political ideology says yes, but the evidence is pending and the costs are rising fast.”
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There is an upper as well as a lower limit in the intelligence required of a good doctor. The results from the 3Cers are perfectly creditable.
The real solution is to reduce doctors' salaries. Then those with a vocation to medicine will be able to find places.
Malcolm McLean, Bradford, UK
Having applied to study Medicine a few times now. It is clear that medical schools favour those canduidates from middle/upper class back grounds. Unfortunately, medical school interviews are aloof to the benefits of accepting candidates into medical school from diverse social back grounds.
Andrew, Worcester, Worcestershire
£190,000 per student per year is a shocking sum. I could get a medical degree from overseas for that. Can I have some of that money so I don't have to borrow it, paying it off out of junior doctor's wages if I return here to work in the NHS?
I wish I was from an ethnic minority. It sounds ace!
Andrew Mooney, Huddersfield, UK
The entry requirements are a reflection of the popularity of the course relative to the places available, not its intellectual rigor, the same is true of every university course. Not to say the course is not academically demanding, it certainly is, but that is not what determines the entry grades.
Sarah, London, UK
The entry requirements are a reflection of the rigour of the courses, or at least that is the clear impression from what I see my friends studying medicine going through.
Whether that leads to better doctors is questionable. What correlation between good A-level grades and good bed-side manner?
Guy, Oxford,
This is dumbing down in the worst way. Yes i think everyone should have a chance in life but the last thing this country needs is something else to undermine the legitimacy of our healthcare. Remember when public schools took kids for free from the east end? 80% dropped out. It is too idealistic.
Alex, London, England
Opening Teaching up to adults with few, if any, formal qualifications has been bad enough. Some of them can't string a coherent sentence together. Are we going to have to suffer the same terrifying drop in standards from the medical profession? It's time to leave Britain I think.
judy, liverpool, england
A new type of doctor is being created that, among other things, better reflects the social diversity of London's population.
In other words, yet another social engineering scheme to excluded higher achievers in favour of dross.
John, London, UK
I think you will find it is 190k per student per year extra. The pass rate for BSc is not the same and so I also doubt the quality of the doctors that are being produced at the other end, many more may be just scraping through.
Pete, Edinburgh,
£190, 000 per year - around £6000 per student? Not much compared to the amount of money spent by the middle classes on their offspring. Also the "3 C-ers" should be higher future earners because of the scheme, so paying more tax.
Diana, derby, UK
High grades can be an indicator of intelligence but can also be an indicator of parental wealth buying the best coaching. As a university teacher, years of experience tell me that a student with Bs or Cs obtained from a tough comp will often easily outshine the straight A fee paying school student.
Graham, Oxford, UK
I don't understand why the Government has picked medical school as their venue of choice for their social engineering programme. The extra cost of training could be used to improve state schools for everyone, instead of helping a few become doctors.
Naveed, West Bridgford, UK
I agree I got into nursing in the late 1970's on 3 O levels only [one being a GCE level 1 equivalent pass]. I was a nurse for 23 yrs - it didn't downgrade my care. The will suceed in ones career comes from the heart, not a pen or computer screen via an exam.
Ian Payne, WALSALL,
But high grades are an indicator of intelligence and/or hard work (one does not need both before university). As such, in most cases, high grades will indicate a characteristic required to succeed. Of course, where the (state) education system has failed individuals this needs to be reconsidered.
John Scott, London,
In contemporary medicine where most medical practitioners just follow instructions C is more than enough. Now they should try D and E
Dave, London,
Too true. Near-perfect results to study medicine (including dentistry), law and other popular courses are more an easy -to-apply culling tool than a reflection of the actual requirements needed.
Angela, Epping, Australia
It must be noted that medicine has never traditionally been seen as an AAA subject.
The strict A-level requirements have only really been used recently because of the massive number of applicants for relatively few places.
James, London,