You want to study Medicine? Let The Voice decide!

It is a miserable weekend and I am on call (no wine!). What else to do on a Saturday night but cosy up in front of the fire and sample terrestrial television. And I am pleasantly surprised ….. isn’t the Voice brilliant? Expecting the usual trashy reality TV shows and related pre Match-Of-The-Day garbage, The Voice is refreshingly energetic, oozing with talent from all walks of life and judged by four “coaches” (Sir Tom Jones, Danny O’Donoghue, Jessie J and Will.i.am) each with the aim of attracting the best voice to their team and then nurturing and coaching them to greater things (http://www.bbc.co.uk/programmes/p00k96j4). As Saturday’s episode came to a close, two things came to mind as I was frantically texting my votes for Jaz Ellington (what a talent that guy is!). Firstly, how cool is will.i.am? I have always been a closet fan every since his days with the Black Eyed Peas, but his career seems to have taken off in so many diverse directions since. In addition to his music (almost 90 million singles and albums sold worldwide), he is creative director for Intel Corp and now runs his own successful fashion design company. (If any of you are considering birthday or Xmas gifts, I would love the fingerless gloves but not sure they would pass infection control). He also seems genuinely committed to putting something back to the community. Raised in a deprived part of Los Angeles his latest venture (iamauto) seeks to re-build “luxury” cars in ghettos in LA and re-cycle these for use in the local community. Add to that his love of cars and his driving skills (see http://www.youtube.com/watch?v=WBWabWHlIPs), and he is for sure an iconic figure.

The second thought process relates to an issue that is topical at present across the Dean’s team here in Birmingham and more broadly across the UK – how do we optimally select students for Medical School? The simple answer is that we haven’t a clue. Historically we have relied heavily (too heavily in my view) on academic performance at School. On the one hand this has some merit – Medicine is a taxing degree course and the data available do show that performance in GCSE’s and A level is a predictor of success, but this has now escalated to such a level that for the 2011 intake most candidates required on average 8.5 A* GCSE’s to gain entry. Having a reputation as one of the hardest Medical Schools to get into is one thing, but trying to reconcile this with much needed widening participation into Medicine from all corners of society and the current public/ professional driven demand for a greater scrutiny of the qualities required to do Medicine, means that our own processes do need to evolve.  The Vice Chancellor continues to remind me that in our era, many students were accepted into Medicine with B’s and C’s at A level and we are certainly not universally dissatisfied with the current medical workforce. Academic performance is one factor, but the not the whole story.

The UK clinical aptitude test is used by many Medical Schools; a publication just last week (http://www.bmj.com/content/344/bmj.e1805) suggests that it may increase intake into Medicine from under-represented socio-economic groups, but many of us remain sceptical of its ability to assess the necessary professional qualities required to do Medicine, notably caring individuals who can communicate. Further outcome data are required.

Although there is limited evidence base, one development we are actively considering is the Multiple Mini Interview (MMI), largely inherited from Canadian Medical Schools and now in use across several Medical Schools in the UK. I can’t help feeling that alongside academic credibility, we must have the opportunity to meet as many of our 3000 applicants as possible for a face-to-face exploration of why students wish to be doctors and a peer group assessment of whether they have the qualities to succeed. I accept this aspiration is over simplistic; even accepting the workload involved in seeing all our applicants, can anyone in a 5 minute interview of a 17-18 year old really assess whether someone will make a good doctor? Maybe not but it must be better than simply looking at one’s ability to store information?  The MMI process involves an interaction between the applicant and many interviewers (including existing students) across several stations each asking a specific issue that may focus on an ethical dilemma, a problem solving exercise, a team scenario in addition to the usual “why do you want to do Medicine” and “interests outside Medicine” type questions. Time will tell whether this will be an improvement on existing practice – but early reports from Dundee and St George’s Medical Schools are encouraging (http://www.ncbi.nlm.nih.gov/pubmed/22455698, http://www.ncbi.nlm.nih.gov/pubmed/21355692). Dr Austen Spruce is in the process of taking over as Head of Medical School admissions from Professor Lote as is charged with developing a strategy across the School – watch this space. Your collective help in any new process will be most welcome.

So finally here is my suggestion to Dr Spruce as he gets his thoughts in order – let The Voice decide! Imagine the scene – 32 Deans of UK Medical School sitting in the Leonard Deacon in comfy black and red leather chairs, Tom Jones hair-cuts and open neck T-shirts with their backs to a student wishing to do Medicine. Each with his/her hand (mine of course to be gloved!) poised over buzzers, waiting to assess the 5 minute vocal plea from the student expounding his/her merits to be a doctor. Irrespective of gender, race, socioeconomic background, I am totally impressed by the first candidate – plunge down on the buzzer and am whizzed around at high speed to come face to face with a student who I hope will now join my team ……  Hmmm dream on dean.i.am …..

PM Stewart

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