Medical housing "lines".

General practitioners are often asked for medical certificates (housing "lines") by applicants for council housing who claim to have medical problems requiring housing priority. The results of a survey by questionnaire showed that general practitioners in Edinburgh do not know how the housing system works and that they seem to overestimate their patients'' chances of obtaining suitable council housing. General practitioners need to know how the housing system works, and communication between general practitioners and housing departments should be improved. A comparison was also made between the number of medical points awarded by a community medicine specialist and a group of general practitioners who had written housing "lines" for their patients. The general practitioners tended to award more points than the specialist. Social priority for housing should be recognised as an independent factor and a new category of top social priority added.     

Prospective study of the disadvantage of people from ethnic minority groups applying to medical schools in the United Kingdom.

To assess whether the ethnic origin of applicants affects their likelihood of being accepted into medical school in the United Kingdom the outcome for the 2399 applicants who applied to read medicine at university in 1986 and included St Mary''s Hospital Medical School as one of their five choices was studied prospectively. Altogether 2040 of the 2399 applicants were British (United Kingdom) nationals, constituting 24.7% (n = 8249) of all home applicants for medicine in 1986, and 1971 of them with postal addresses in the United Kingdom were sent questionnaires asking about their ethnic origin, whether English was their first language, and about their attitudes to ethnic monitoring. A total of 1817 (92.2%) applicants returned the questionnaire, 401 (22.6%) saying that they were from an ethnic minority group and 393 (21.6%) having non-European surnames. Multiple logistic regression identified 11 significant predictors of successful application, of which grades at O and A level, application after A levels, and date of application were the most important. After taking these four variables into account the predicted acceptance rates for home students on the basis of their application forms alone were 47.8% for white applicants and 35.6% for applicants from ethnic minority groups compared with actual acceptance rates of 49.6% and 27.3%, respectively. The difference in success of white and non-white applicants could partly but not entirely be explained by differences in the characteristics considered to be important in a professional context by selectors during shortlisting of candidates: academic ability, interests, and contribution to the community. No differences in the success rate of applicants from ethnic minority groups to individual medical schools could be identified. More research is needed to discover how perceptions of professional suitability are assessed from application forms and interviews.     

Applications and Enrolments at the Western Medical Schools: A Study of Medical Matriculants for 1964

All applicants and those who subsequently enrolled for the 1964-65 session in the Western medical schools were studied with the hope that it would encourage a national registration of applicants. Seven hundred and sixty-four applicants completed 865 applications for 288 places in four schools. Although the principal factor in selecting medical students in all Western schools is pre-medical performance, 49 “good-quality” (academically of good standing and under 30 years of age) resident applicants were not accepted in their own provincial school, and 49 places were filled with “poor-quality” students.The loss of good applicants to the Western medical schools and the 20% overlap of each school''s applicant pool with that of other schools suggests that objective standards of quality must be developed, and that a regular annual national assessment of applicants should be conducted by the Association of Canadian Medical Colleges.     

Canadian and Landed Immigrant Applicants to Canadian Medical Schools for 1968-69

There were 2337 Canadian and Landed Immigrant applicants for the fall 1968 entering classes at Canadian medical schools. These applicants filed a total of 4579 applications.The results of this study show that there are regional differences in the quantity and quality of the applicant pool for Canadian medical schools. The study also shows that despite the fact that Canadian and landed immigrant applicants are filing more applications than they have in the past two years, there has been no appreciable change in the ratio of applicants to available places. A further point to be noted is that the participation of women both as applicants to and as medical students in the entering class of 1968-69 at Canadian medical schools was higher than in previous years.     

Audit of admission to medical school: II--Shortlisting and interviews.

Analysis of shortlisting of applicants for interview at St Mary''s Hospital Medical School showed that factor analysis could reduce the selection criteria to three independent scales--"academic ability," "interests," and "community service"--all of which contributed to the interview decision. Early applicants scored more highly on all three factors but were still at a greater advantage in selection for interview than would have been predicted. The dean''s judgment of priority for interview from the UCCA form was found to predict a candidate''s chance of acceptance at other medical schools besides St Mary''s. Analysis of interviewing showed high correlations among interviewers in their assessments, although there was evidence of influence by the chairmen. Factor analysis showed three major factors--academic suitability, non-academic suitability, and health--of which non academic suitability was the major determinant of interview success. Non academic suitability was related to personality (high extraversion and low psychoticism) and to the choices made on the UCCA form. The system of admission interviews enabled greater emphasis to be put on broader interests and achievements than if selection had been on the basis of UCCA application form alone.     

A Pilot Study of Applications to the Four Ontario Medical Schools for Admission to the First Professional Year

In the fall of 1964, newspaper accounts of the medical school applicant situation in Canada reported that hundreds of fully qualified applicants were being turned away because of shortage of places. Such reports precipitated a pilot study of the applications received by the four Ontario medical schools for the first professional year of medicine and it was found, first of all, that the total of 1352 applications represented only 880 individuals. Nearly 32% of these applicants were American and 18% were citizens of Commonwealth or other countries. While a majority of the applicants met the minimal requirements of the schools, very few of the rejected applicants had academic records that justified admission when the informal standards of the schools were applied. It was concluded that it is erroneous to speak of a surplus of well-qualified applicants at the present time and that the need for recruiting programs still remains.     

A survey of medical directors of life insurance companies concerning use of genetic information.

Rapid advances in our ability to test persons presymptomatically for genetic diseases have generated increasing concern that genetic information will be abused by insurance companies. Reasoning that the insurance companies may have the strongest interest in using genetic data and that the medical directors of those companies with responsibility for rating applicants would be a good source of information on the use of such data, we conducted a large survey of medical directors of North American life insurance companies. We received responses from 27 medical directors. Our results suggest that (1) few insurers perform genetic tests on applicants, but most are interested in accessing genetic test information about applicants that already exists; (2) the degree of insurers' interest in using genetic test results may depend on the face amount of the policy applied for and on the specificity and sensitivity of the test; (3) many companies employ underwriting guidelines with respect to certain genetic conditions but may not always have specific actuarial data in house to support their rating decisions; (4) a considerable degree of subjectivity is involved in most insurers' rating decisions; and (5) some of the medical directors who responded to our survey are not fully informed about certain basic principles of medical genetics.     

Commissioning a national programme of research and development on the interface between primary and secondary care.

The first call for applications to the NHS research and development programme on the interface between primary and secondary care was advertised in February 1994. A total of 674 outline proposals were submitted and 54 (8%) secured funding. Projects have been commissioned in 16 of the 21 priority areas and around 6m pounds has been committed. Analysis shows that multidisciplinary applications are more likely to be funded and that the odds for a successful application are on average nearly doubled for each discipline represented up to five. A survey of applicants and peer reviewers found satisfaction with much of the commissioning process, but peer review and feedback were subject to criticism, particularly by unsuccessful applicants. The programme shows that it is possible to commission a large number of projects in an innovative area of research and development and has identified refinements that will further increase the efficiency and acceptability of the process.     

Factors influencing the response to advertisements for general practice vacancies.

OBJECTIVES: To investigate the extent of problems in recruiting general practitioners and to determine which practice characteristics affect recruitment--in particular, to see if practices with deprived patients have more recruitment problems. DESIGN: Postal questionnaire survey in August 1995. SUBJECTS: 489 consecutive practices that had advertised for a partner in the BMJ from January to April 1995. MAIN OUTCOME MEASURES: The number of applicants, the practices, satisfaction with their quantity and quality, and whether a successful appointment was made. RESULTS: 442 (90%) practices replied. 262 practices (60%) were not very satisfied or very dissatisfied with the number of applications they received; 15 (3%) received no applications. There was a significant difference in the number of applications received by practices in different NHS regions. The 32 practices with the highest proportions of patients eligible for deprivation payments received a median of five applicants compared with 10 for practices without deprivation. CONCLUSION: There is a widespread problem in recruiting general practitioners. Recruitment is hardest in areas with the greatest health needs.     

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.     

Why Alcoholics Ought to Compete Equally for Liver Transplants

Some philosophers and physicians have argued that alcoholic patients, who are responsible for their liver failure by virtue of alcoholism, ought to be given lower priority for a transplant when donated livers are being allocated to patients in need of a liver transplant. The primary argument for this proposal, known as the Responsibility Argument, is based on the more general idea that patients who require scarce medical resources should be given lower priority for those resources when they are responsible for needing them and when they are competing with patients who need the same resources through no fault of their own. Since alcoholic patients are responsible for needing a new liver and are in direct competition with other patients who need a new liver through no fault of their own, it follows that alcoholic patients ought to be given lower priority for a transplant. In this article, I argue against the Responsibility Argument by suggesting that in order for it to avoid the force of plausible counter examples, it must be revised to say that patients who are responsible for needing a scarce medical resource due to engaging in behavior that is not socially valuable ought to be given lower priority. I'll then argue that allocating organs according to social value is inconsistent or in tension with liberal neutrality on the good life. Thus, if one is committed to liberal neutrality, one ought to reject the Responsibility Argument.     

Canadian Applicants to Medical Schools in Canada for 1965-66

An examination of applicants to Canadian medical schools for 1965-66 revealed that 4660 applications were received by the 12 schools for approximately 900 places available; 2852 of these were from Canadians, but because many applicants applied to more than one school, these 2852 applications represented only 1767 individuals. Evaluations made by the schools concerning the acceptability of these applicants showed that only 36 persons rated as “acceptable” by one or more schools failed to gain admission to any Canadian school for 1965-66. Furthermore, 66 “marginal” applicants were accepted, as were 130 multiple applicants who were rated as “acceptable” by one school but “marginal” and/or “unacceptable” by one or more other schools. Of the 464 multiple applicants, only 40% received the same evaluation from all schools to which they applied. If those multiple applicants who were rated as acceptable by all schools to which they applied are added to single applicants rated as acceptable, the pool of these clearly acceptable candidates (40% of all Canadian applicants) is sufficient only to fill 78% of places available. It was thus concluded that it is erroneous to speak of a surplus of well-qualified Canadian applicants at the present time.     

Factors affecting likelihood of applicants being offered a place in medical schools in the United Kingdom in 1996 and 1997: retrospective study

Objective To assess the relation between a range of measures and the likelihood of applicants to medical schools in the United Kingdom being offered a place overall and at each medical school, with particular emphasis on ethnic minority applicants.Design Data provided by the Universities and Colleges Admissions Service on 92 676 applications to medical schools from 18 943 candidates for admission in 1996 and 1997. Statistical analysis was by multiple logistic regression.Main outcome measures Receipt of a conditional or unconditional offer of a place at medical school.Results Eighteen separate measures were independently associated with the overall likelihood of receiving an offer. Applicants from ethnic minority groups were disadvantaged, as were male applicants, applicants applying late in the selection season, applicants making non-medical (so called insurance) choices, applicants requesting deferred entry (so called gap year), and applicants at further or higher education or sixth form colleges. Analysis at individual medical schools showed different patterns of measures that predicted offers. Not all schools disadvantaged applicants from ethnic minority groups and the effect was stable across the two years, suggesting structural differences in the process of selection. The degree of disadvantage did not relate to the proportion of applicants from ethnic minority groups.Conclusions The data released by the Council of Heads of Medical Schools allow a detailed analysis of the selection process at individual medical schools. The results suggest several areas in which some candidates are disadvantaged, in particular those from ethnic minority groups. Similar data in the future will allow monitoring of changes in selection processes.

Key messages

• The Council of Heads of Medical Schools has made publicly available, on the website of the Universities and Colleges Admissions Service, detailed data on individual applications for medical school in 1996 and 1997
• These data allow analysis of factors influencing selection at individual medical schools in the United Kingdom, although some important measures such as GCSE grades, estimated A level grades, and assessments of personal attributes are not available
• In 1996-7 certain groups, in particular ethnic minority groups and male applicants, were disadvantaged during selection
• The disadvantage of applicants from ethnic minority groups seems stable across years, with some schools consistently showing no evidence of disadvantage
• Provision of similar data in the future will allow continued monitoring of selection and of the proposals for change made by the council

     

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.     

Applications submitted to regional research committees in 1976 and their outcome.

In 1976 regional research committees in England and their equivalent in the Welsh Office judged 608 proposals for funding under the locally organised research scheme. Of these, 521 were new proposals and 87 were resubmissions. Medically and dentally qualified applicants made 451 (87%) of the new proposals; nearly two-thirds came from teaching areas and 21% from staff of academic departments. Two hundred and ninety new proposals were approved, 154 rejected, and 77 were referred back for modification. Approval was commoner for applications from teaching areas, from medical staff, and for the less expensive projects. Some regional committees did not support research into the organisation of health services. Under a quarter of the resubmitted projects were rejected. The scheme is not yet used by a wide range of health-care professions. Medical staff in teaching areas still use it most. In some regions prospective researchers, especially those without previous experience, need a comprehensive and easily identifiable counselling service, so that the fund may be exploited in the way originally intended and the number of unsuccessful proposals reduced.     

Audit of admission to medical school: I--Acceptances and rejects.

A prospective study of the process of application, selection, and admission to medical school was performed. St Mary''s Hospital Medical School received 1478 UCCA applications for admission in October 1981: 94 (6.4%) applicants entered St Mary''s in October 1981, 436 (29.5%) entered other medical schools, 176 (11.9%) read a subject other than medicine, and 772 (52.2%) did not enter university. The study included 12.6% of all applicants and 12.9% of all entrants to British medical schools in October 1981. Educational qualifications, demographic variables, type of schooling, family background, and the manner of application were examined in relation to overall selection. A level achievement was the major determinant of acceptance. O level achievement, early application, and medical parents had significant but smaller independent effects on the chance of acceptance. Social class, age, sex, and school type did not predict acceptance when corrected for academic and other factors. Few differences in personality, career preference, cultural interests or attitudes were found between those accepted and those rejected.     

基于专利分析的3D生物打印产业发展态势研究

目的:揭示3D生物打印产业技术研发态势和专利布局,以期为相关机构提供竞争情报,为行业发展提供数据支撑。方法:基于3D生物打印领域产业调研和技术分解,构造检索式获取数据,多维度量化分析领域专利。结果:3D生物打印产业发展可分为孕育期、萌芽期和高速发展期;该产业集中度较低,处于分散竞争阶段;申请人多依据地缘因素选择合作对象,合作方之间多为不同类型的机构;中国申请人的专利申请量占全球的比重已接近50%,但美国申请人的专利篇均被引频次仍远超中国;美国申请人更关注海外市场。结论:3D生物打印产业尚未形成规模效应,有必要整合业内资源,打造产业集群;中、美两国在该产业都具有优势地位,中国亟待加强海外专利布局;综合权衡专利数量和质量,美国申请人的专利竞争力仍高于中国,中国需培育更多核心专利。     

Teaching medical students to lie: The disturbing contradiction: medical ideals and the resident-selection process

Although truthfulness and honesty have long been considered fundamental values within the medical profession, lying and deception have become standard practices within medicine''s resident-selection process. Dishonesty is incorporated into and encouraged during this process, and there is little need for medical students and other participants to reflect upon their actions. This essay, which won the $1500 first prize in CMAJs 1996 Logie Medical Ethics Essay Contest, looks at the serious consequences of this lying and deception. Dr. Tara Young discusses the moral dilemma applicants for residencies face during their final year of undergraduate training.     

Medical Student Enrolment in Canadian Universities

Statistical returns from the 12 Canadian medical schools revealed in 1962, for the fourth consecutive year, a larger first-year enrolment (946, 970, 1006 and 1057). This is attributed to an increase in qualified applicants and expansion in size of the first-year class in the face of a physician shortage. The proportion of women graduates increased from 5.2% in 1958 to 10.1% in 1962 (U.S.A., 5.6%). The academic calibre of entering students showed little change over five years, 1957-61. Recent impressions indicate an upward swing. Loss from withdrawals and dismissals was chiefly in first year (9.1%, 7.6% and 9.0%: 1959-60 to 1961-62), 40% being attributed to “nonacademic” causes. Foreign students now comprise 12.6% of the medical student body. A decrease in American and an increase in Commonwealth student numbers was noted. Recommendations include attention to drop-outs before and after registration and provision for stand-by applicants; the general adoption of some objective measure of qualification, e.g. the Medical College Admission Test; an on-going registry of applicants to Canadian medical schools for later retrospective studies and re-examination of admission policies for non-residents.