Requirements for admission to medical school: how many years of university study are necessary?

OBJECTIVE: To assess whether students admitted to medical school after completing 2 years of undergraduate study performed as well as those admitted after longer periods of undergraduate study in terms of broad patient-care skills measured at the time of graduation. DESIGN: Retrospective study. SETTING: University of Alberta, Edmonton. PARTICIPANTS: Graduates of the classes of 1990 and 1991, of the 226 graduates 133 had entered medical school after 2 years of undergraduate training, 39 after 3 years and 54 after 4 or more years. Eight students had been excluded because they were either transfer students or international students. OUTCOME MEASURES: Objective and subjective assessments of the main clinical rotations (internal medicine, obstetrics and gynecology, pediatrics, psychiatry, radiology and surgery), results of the faculty''s final comprehensive examination and of the Medical Council of Canada''s Qualifying Examination. RESULTS: The students who had completed 2 years of undergraduate study before medical school were significantly younger than those who had completed 3 years and those who had completed 4 or more years (mean age [and standard deviation (SD)] 20.5 [2.1], 21.5 [2.4] and 25.1 [4.4] years respectively, p < 0.001). They also had a significantly higher mean grade point average (GPA) for the prerequisite courses for admission to medical school than those with 3 years and those with 4 or more years of undergraduate study (8.26 [SD 0.3], 7.95 [SD 0.3] and 7.80 [SD 0.5] respectively, p < 0.001). The overall mean GPA for the best 2 years of undergraduate study did not differ significantly between the three groups. The students with 2 years of undergraduate study had a significantly lower mean score for the pre-entry interview than those who had 4 or more years of undergraduate study (32.1 [SD 7.6] v. 38.3 [SD 8.5], p < 0.001). There were no significant differences between the three groups in the results of any of the subjective or objective outcome measures. CONCLUSION: Students who completed 2 years of undergraduate study before admission to medical school were able to achieve a satisfactory level of competency and maturity by the end of medical school. The 2-year option for entrance into medical school should be reconsidered.     

Characteristics of medical students who choose primary care as a career: the McMaster experience.

We examined the relation between demographic characteristics and the career choices of medical students who entered McMaster University medical school between 1969 and 1975. In contrast to earlier work, this study found no significant differences in sex, age, marital status at the time of entry into medical school, undergraduate major, whether prerequisite premedical courses had been taken, undergraduate grade point average and academic performance between the graduates who chose primary care and those who chose a specialty. This suggests that many medical school graduates in the 1970s entered primary care by choice rather than by default.     

Unprofessional Physicians—Some Correlative Data

In the background of those physicians who have problems in medical practice serious enough to attract attention by the licensing body, there are factors that apparently can help predict such behavior. As a candidate for medical school the applicant more likely to have future problems has the following profile: (1) older than the average applicant with a lower grade point average; (2) more likely to have used tobacco; (3) did not receive a baccalaureate degree; (4) no military service; (5) turned in a sloppy handwritten application form, and (6) received a less than ideal character reference by the college from which applying. Furthermore, after admission to medical school the person more prone to future problems tends to be a poorer student than his peers and to receive a poorer rating in his first postgraduate year. The Loma Linda University graduate who has had such problems is also more likely to have settled in Southern California and to be in general practice.     

Fighting the odds in the UK.

Caroline Richmond reports on miscellaneous winners and losers from the health care scene in the United Kingdom. The winners include a young patient who is holding her own against formidable medical odds after receiving heroic treatment for leukemia, and the country''s osteopaths, who have won the right to compile a statutory register. The losers are the venerable St. Bartholomew''s Hospital, which appears to have lost its battle to stay open, and a 32-year-old man who almost made it to medical school by posing as a teenager.     

Prospective survey of performance of medical students during preclinical years.

The performance during the preclinical course of 517 students who had applied to this medical school for admission in 1981 and who had been accepted by the school or by another British medical school was analysed in relation to variables measured at the time of application to find factors that predicted success in the preclinical course, whether students chose to take an intercalated degree, and the class achieved in the intercalated degree. Thirty one of the 507 students who entered medical school withdrew from the course or failed their examinations; these students were particularly likely not to have an A level in a biological science. O level grades were of minimal predictive value for performance during the preclinical course. A level grades discriminated between successful and unsuccessful students but had too low a specificity or sensitivity to be of use in individual prediction. Mature entrants performed better overall than school leavers. Background variables accounted for only 14.2% of the variance in performance, implying that motivation and personality may be more important in determining performance. The 80 students who chose to take an intercalated degree were more likely to be men and not to be mature entrants; for a further 50 students intercalated degrees were obligatory. Performance in the intercalated degree related to performance during the preclinical course and to assessments made at the selection interview but not to achievement at O or A level.     

Medical school applicants from ethnic minority groups: identifying if and when they are disadvantaged.

OBJECTIVE--To assess whether people from ethnic minority groups are less likely to be accepted at British medical schools, and to explore the mechanisms of disadvantage. DESIGN--Prospective study of a national cohort of medical school applicants. SETTING--All 28 medical schools in the United Kingdom. SUBJECTS--6901 subjects who had applied through the Universities'' Central Council on Admissions in 1990 to study medicine. MAIN OUTCOME MEASURES--Offers and acceptance at medical school by ethnic group. RESULTS--Applicants from ethnic minority groups constituted 26.3% of those applying to medical school. They were less likely to be accepted, partly because they were less well qualified and applied later. Nevertheless, taking educational and some other predictors into account, applicants from ethnic minority groups were 1.46 times (95% confidence interval 1.19 to 1.74) less likely to be accepted. Having a European surname predicted acceptance better than ethnic origin itself, implying direct discrimination rather than disadvantage secondary to other possible differences between white and non-white applicants. Applicants from ethnic minority groups fared significantly less well in 12 of the 28 British medical schools. Analysis of the selection process suggests that medical schools make fewer offers to such applicants than to others with equivalent estimated A level grades. CONCLUSIONS--People from ethnic minority groups applying to medical school are disadvantaged, principally because ethnic origin is assessed from a candidate''s surname; the disadvantage has diminished since 1986. For subjects applying before A level the mechanism is that less credit is given to referees'' estimates of A level grades. Selection would be fairer if (a) application forms were anonymous; (b) forms did not include estimates of A level grades; and (c) selection took place after A level results are known.     

Students’ Perceptions of Peer-Organized Extra-Curricular Research Course during Medical School: A Qualitative Study

Early integration of research education into medical curricula is crucial for evidence-based practice. Yet, many medical students are graduating with no research experience due to the lack of such integration in their medical school programs. The purpose of this study was to explore the impact of a peer-organized, extra-curricular research methodology course on the attitudes of medical students towards research and future academic careers. Twenty one medical students who participated in a peer-organized research course were enrolled in three focus group discussions to explore their experiences, perceptions and attitudes towards research after the course. Discussions were conducted using a semi-structured interview guide, and were transcribed and thematically analyzed for major and minor themes identification. Our findings indicate that students’ perceptions of research changed after the course from being difficult initially to becoming possible. Participants felt that their research skills and critical thinking were enhanced and that they would develop research proposals and abstracts successfully. Students praised the peer-assisted teaching approach as being successful in enhancing the learning environment and filling the curricular gap. In conclusion, peer-organized extra-curricular research courses may be a useful option to promote research interest and skills of medical students when gaps in research education in medical curricula exist.     

医学研究生灾难医学知识的初步调查及对策

目的了解医学研究生对灾难医学相关知识的认知情况。方法通过发放调查问卷,对我校2008-2011年入学的458名医学研究生进行灾难医学相关知识调查分析。结果医学研究生对灾难医学的基本概念、基本急救技术、灾后心理援助以及传染病的预防及处理相关知识掌握较好,但对灾难伤员的检伤分类、灾难医学管理相关知识掌握明显不足。结论医学研究生掌握灾难医学相关知识已明显提高,但仍存在不足,应加强医学研究生急救技能培训、开设灾难医学选修课,以提高我国灾难医学救援整体水平。     

Medical women of the West.

The presence in the West of women physicians with degrees from regular medical schools spans a period of approximately 130 years. Women''s Medical College of Pennsylvania graduated many of these early women physicians. The first woman medical graduate of a western school was Lucy M. Field Wanzer, who finished in 1876 at the Department of Medicine, University of California in San Francisco. Soon thereafter, schools that would become Stanford University and the Oregon Health Sciences University schools of medicine, as well as the newly founded University of Southern California, were contributing to the pool of women physicians. The University of Michigan Medical School, the first coeducational state medical school, also educated some of the western women physicians, who by 1910 numbered about 155. This regional account of the progress of women physicians as they strove to become an integral part of the profession emphasizes the familiar themes of altruism, ingenuity, and perseverance that characterized their efforts.     

Some Observations on Attrition of Students from Canadian Medical Schools

Students who entered their freshman year for the first time in 1958 and in 1959, from all medical schools in Canada, and those entering the four Western schools in 1960 were studied from the time they matriculated until they either graduated or withdrew from medical school. The rate of attrition is about 15% of matriculants each year, with the lowest rate at the University of Western Ontario (1.7%) and the highest at the University of Ottawa (33.6%) over the time period studied. Attrition was classified as academic and non-academic. Significantly higher rates were found in the case of non-academic attrition for women and in the case of academic attrition for Commonwealth students. Significantly higher rates for both types of attrition were found for older students and students who had attended undergraduate colleges different from their medical school colleges. It would appear from available statistics that the factors which combine to produce attrition are the intellectual and personality characteristics of the student, school promotional policies and evaluation methods.     

Career development of McMaster University medical graduates and its implications for Canadian medical manpower.

A study was undertaken of the career paths and decisions, and the factors influencing the decisions, of the first six graduating classes of McMaster University''s medical school. Climate and geography, preference for urban or rural living and influence of spouse were the factors that most influenced the location of practice, although the graduates who moved to the United States considered economic factors important too. Nearly one third of the specialists were practising in the United States. Personal challenge and positive clinical experience in the field were the major influences on choice of medical field. Graduates entering a specialty were more likely than those entering primary care to consider encouragement of others, a positive example set by medical school faculty members, working hours and research experience in the field as important influences on their choice of medical field. Data are needed on the career decisions, and the factors affecting them, of the graduates of all Canadian medical schools if Canadian medical manpower planning is to be realistic.     

Can the academic background of medical graduates be detected during internship?

Performance ratings were obtained by the clinical supervisors of four graduated classes of McMaster University medical students during internship. The supervisors detected no difference in performance between the graduates who met the "traditional" admissions criteria (both an undergraduate grade point average of 3.1 or greater on a 4-point scale and previous training in biology, general and organic chemistry, and physics) and those who lacked one or both of these prerequisites. These data suggest that medical schools can expand their admissions criteria without fearing that their graduates will perform less well as interns because of a lack of traditional academic preparation for medical school.     

Bullying among medical students in a Saudi medical school

ABSTRACT: BACKGROUND: Bullying and sexual harassment of medical students by their teachers appears to be widespread phenomenon. However, nothing is published about its prevalence in conservative countries such as Saudi Arabia. This survey aims to ascertain the extent of these mistreatments among students in a Saudi medical school. FINDINGS: A cross-sectional questionnaire survey was conducted on a group of 542 clinical years' medical students in a Saudi medical school to explore students' perceptions of their educational environment including exposure to different kinds of bullying. Bullying was defined as "a "persistent behaviour against a medical student that is intimidating, degrading, offensive or malicious and undermines the confidence and self- esteem of the recipient". Results revealed that more than one quarter (28.0 %) of the surveyed students reported exposure to some sort of bullying during their clinical . Ninety percent of the reported insults were verbal, 6 % sexual and 4 % physical. Males were more exposed but difference was not statistically significant. CONCLUSIONS: Bullying among Saudi medical students is an existing problem. A policy against bullying and harassment should be adopted in all of medical colleges to monitor this phenomenon and support students who have been bullied.     

Curriculum change needed at Yale

The United States Congress has recently passed an important bill entitled, The Health Professionals Assistance Act of 1976. It seeks to right physician maldistribution in the country and curtail the over specialization of medical practitioners. Quotas have been set in terms of the number of medical school graduates who must enter primary care training programs over the next few years. Failure to comply risks loss of the federal capitation grant of twenty-one hundred dollars per student or about one million dollars a year in Yale''s case.The causes of physician maldistribution are discussed. Partial blame is ascribed to the medical schools themselves and recommendations are made for curriculum changes which if adopted may achieve better physician distribution without further government inroads into medical school affairs.     

Career changes among Saskatchewan physicians.

OBJECTIVE: To determine how often Saskatchewan physicians changed career paths during medical training and practice. DESIGN: Population survey (mailed questionnaire). SETTING: Saskatchewan. PARTICIPANTS: All 1077 active members of the Saskatchewan Medical Association were sent a questionnaire; 493 (45.8%) responded. OUTCOME MEASURES: Long-term career goal or plan in next-to-last year of undergraduate medical school, probable choice of career if forced to choose at that time, and number of physicians who changed their field of training or practice at any time since graduation. RESULTS: In all, 57.8% (237/410) of the respondents were currently practising in a field different from that planned in their next-to-last year of medical school, 63.5% (275/436) were not practising in the field they would have chosen if forced to at that time, and 42.9% (211/492) had changed their field of training or practice at some time since graduation. Older physicians, those who graduated outside of Canada and specialists were the most likely to have changed career paths, family physicians, and those who graduated in Saskatchewan were the least likely to have changed. CONCLUSION: The current system of postgraduate training in Canada does not permit career changes of the sort made by most of the practising Saskatchewan physicians in the survey sample. The implications of this new system are as yet unknown but require careful monitoring.     

Further Careers of Young British Doctors

After surveys in 1961 and 1966, further questionnaires were sent in 1969 to those who had responded in 1966. These showed that wastage due to emigration and unemployment of married women doctors was nearly 20%. Compared with 49% of all qualified for three to four years in 1966, 73% had definitely decided on their future career seven to eight years after qualifying in the 1969 survey, the choice tending to be for specialties less popular among more junior doctors. Responsibility for patient care seemed not to be related directly to seniority or to performance in medical school examinations.     

The Educationally Handicapped Child—The Physician's Place in a Program to Overcome Learning Disability

Under California Assembly Bill 464, special classes may be provided by school districts for children designated as educationally handicapped. An educationally handicapped child is not mentally retarded or physically disabled. He may have neurological handicap or emotional disorder, but he must show impaired achievement in relation to his tested abilities.A physician may be asked to participate in the program, either as a specified member of the admissions committee of the school district or to provide a medical clearance for entrance of one of his own patients into the program.He does a thorough history and physical examination but adds special examination of attention, activity, coordination and attitudes.The educationally handicapped child is helped most by the physician who does not reject the idea of educational handicap even if the medical examination is negative; who treats his minor ills; who medicates, when it is indicated, for hyperactivity, distractibility or extreme anxiety; who cooperates with parents and school personnel.     

Differences in abuse reported by female and male Canadian medical students.

OBJECTIVE: To assess differences between male and female medical students concerning their experiences of abuse during training in a large Canadian medical school. DESIGN: Voluntary, anonymous cross-sectional survey of first- and fourth-year medical students during February 1991. SETTING: University of Toronto School of Medicine. PARTICIPANTS: Of 396 first- and fourth-year students surveyed after one of their regular classes, 347 (117 women, 230 men) completed the questionnaire. INTERVENTION: A 165-item, multiple-choice questionnaire concerning experiences of verbal or emotional abuse, sexual harassment and physical abuse, completed within 30 minutes. MAIN OUTCOME MEASURES: Differences between male and female respondents in abuse experiences before and during medical training, the relation between abuse before and during training, and the psychologic and behavioural effects of abuse during training. RESULTS: The experiences of the male and female respondents differed mainly in regard to sexual harassment: 42% (49/117) of the women and 11% (25/230) of the men reported sexual harassment before entering medical school (p < 0.0001); 46% (54/117) and 19% (43/230) respectively reported sexual harassment during medical training (p < 0.0001); and women who reported sexual harassment were the only respondents for whom a significant relation was found between abuse before and during training (p < 0.043). The women were more distressed than the men by all forms of abuse. A significant relation was shown between male students who reported experiencing abuse during medical training and mistreating patients (p < 0.0001). CONCLUSION: Female students'' experiences of sexual harassment differed from those of their male counterparts. As well, the female students'' reactions to and ways of coping with all types of abuse differed from those of the male students.     

The Selection of Medical Students in Western Canada

The methods employed in the selection of medical students for the 1964-65 class of freshmen at the four Western medical schools are described and recommendations are made for improving the procedure. The structure and functions of the various selection committees varied from school to school but their prime purpose was the same—the selection of “good students” who would later become “good physicians”. Not surprisingly, academic achievement and confidence in estimating this ranked highest in importance, and while non-intellectual characteristics ranked almost as high, committee members had no confidence that they could evaluate these qualities.It is suggested that the ideal selection committee would be a “high-priority” committee consisting of six to eight members who would meet at least twice a year, have tenure of at least four years, be trained in interviewing applicants, consider Medical College Admission Test scores, review applications before each meeting, and establish research committees to investigate the students they choose.     

Applicants to Canadian Medical Schools for 1966-67

An examination of applicants to Canadian medical schools for 1966-67 revealed that 4534 applications were received for the approximately 974 available places. The number of Canadian applications was 2866 and these were made by 1815 individual applicants, an increase of 48 over 1965-66. United States applicants declined from 1143 to 1013.Evaluations made by the schools concerning the acceptability of the Canadian applicants disclosed that 55 applicants who rated as “acceptable” by one or more schools failed to gain admission to any medical school in 1966-67 (as compared to 36 in 1965-66). However, of those applicants who did find a place 76 were evaluated as “marginal” or “unacceptable”, while another 126 were rated as “acceptable” by one school but “marginal” and/or “acceptable” by one or more other schools.These results were interpreted to imply that the Canadian medical schools were still experiencing difficulty in attracting well-qualified applicants for study in medicine.