DEBATE: THE BEST DOCTORS ARE NOT NECESSARILY THOSE WITH TOP MARKS
Sky-high marks open the door to the degree programme in medicine for the most academically talented young people, but good marks alone are not a guarantee of success as a student or medical doctor.
By Allan Flyvbjerg, Dean of the Faculty of Health, Aarhus University, and Charlotte Ringsted, Vice-Dean for Education at Health, Aarhus University.
The debate about the best way to admit the many applicants to the universities has once again flared-up, as new sky-high average mark requirements have quashed the dreams of many applicants. Aarhus University is no exception. This year applicants must have an average mark of 11 to be accepted to study medicine at Aarhus University – an increase of 0.3 compared to last year. We had to reject almost 1,800 young people who had applied for a place on the degree programme.
We should therefore ask ourselves a simple question; do the very high marks turn our students into even better doctors? We do not think this is necessarily the case. We can see our quota 2 students doing outstandingly well. We therefore wish to give more young people the opportunity to secure a place on the degree programme of their dreams, despite not having an average mark of 11. This was the basis for our decision to double our quota 2 admissions to medicine with effect from 2016, so that twenty per cent of the applicants will in future be admitted based on other factors than their average mark.
Adapting admission requirements to the labour market
Since taking this decision, we have worked to draw-up other admission requirements, which to a greater extent reflect the attributes required for working as a medical doctor. We have asked the people who will be employing our medical students in the future, along with our partners, including the hospitals, the Danish Medical Association and patient organisations, about the important things for a medical doctor to be able to do. They point towards robustness, empathy, and communicative and collaborative skills as the most important human competences for doctors. We will therefore test our quota 2 applicants for these competences with the help of e.g. interviews.
We know that working as a medical doctor requires good communication skills. Denmark’s National Agency for Patients' Rights and Complaints has previously estimated that as many as fifty per cent of all patient complaints could be avoided with better communication between patients and doctors and other healthcare professionals. We also know that as a doctor, you can risk having responsibility for life-and-death decisions. To be able to administer this responsibility in a respectful and proper manner requires an ability to emphasise with the patient and relatives. A lack of empathy can, in itself, make a critical situation worse – and vice versa. For the doctor, this requires the psychological resilience to be able to handle the pressure that comes with working as a doctor. This is why it makes a lot of sense to look beyond average marks when we admit medical students in the future.
Increased quota 2 admissions reduce drop-out rates
Our new entrance examination at Aarhus University is a further development of the good experiences they have had at the University of Southern Denmark, where increased quota 2 admissions has reduced the drop-out rate. A reduced drop-out rate is in everyone's interest. For the students, choosing the wrong degree programme is often an expensive mistake – both personally and financially. It is also important to minimise drop-out rates for financial reasons viewed from society’s perspective. A medical doctor education costs almost DKK 600,000. It is also clear that an interrupted degree programme is a waste of resources and, not least, a thorn in the side of those who were not admitted, when we end up having to reject four out of five applicants.
Critics might say that it is an expensive admission process. This is true. However, experience from the University of Southern Denmark shows that the university recoups this cost due to the reduced drop-out rate.
We cannot do without quota 1, but we also need to recognise and act in accordance with the fact that a top-notch performance in upper secondary school is not the only factor that forms the basis for us being able to train talented medical doctors.
This article was published in Danish in Altinget.dk on Friday 21 August 2015.