Selection Of Medical Students

The government of The Netherlands has decided to abolish the numerous fixus (weighted lottery) for medical education. This meant that only 2850 students were able to go to med school a year. The numerous fixus was mainly based on high grades on high school. Universities are allowed to make there own selection criteria for admittance to med school. They could still use the average high school grades but they can’t increase the number of medical students since medical education is very expensive. In The Netherlands a med student costs a 120.000 Euros a year, for comparison a students at Law school costs about 30.000 Euros a year.

But how do you select medical students. Which criteria should you use. Universities in The Netherlands have been experimenting with selection of medical students. One of them recently published the results of a controlled experiment. This experiment is unique since due to the transition phase in selecting students for medical education in The Netherlands they were able to compare different selected groups of medical students.

They compared 389 medical students that were admitted to medical education by selection with 938 students who had been admitted by weighted lottery between 2001 and 2004. The weighted lottery means that students with a undergraduate grade point average of 8 or higher ) on a scale where 1 is poor and 10 is excellent) have unrestricted direct access to medical school. Medical schools were allowed to select a maximum of 50% of their students on basis of other characteristics. So at the end they had 3 groups, the lottery system based on grades, in which the chance rises with the average grade, a group with unrestricted direct access (8 or higher average grade) and through local selection.

But how did they select the med students?

The main criterion was the quality and extent of extracurricular activities, so what else did the student do besides going to high school.

Only activities that had lasted for 2 years or more and had been carried out during the 3 years immediately prior to application were taken into account. These activities were divided into five categories:

• activities in health care;
• activities in management and organisation;
• activities related to a talent (such as music, sport or science);
• (extracurricular) academic education, and 5 additional pre-university education.

They also did five cognitive tests on a medical subject during 4 consecutive days.

Did this help?
The only significant difference between groups was a lower drop out rate of medical school , this was 2.6 times lower in the selected group compared to those admitted to medical education by lottery. The groups didn’t differ in the percentage of optimally performing students or grade points for their first examinations. The authors explain this with the argument that the selection process excluded most of the potential drop outs.

Hope they follow these groups to see how they are doing on clinical rounds, for me it’s still difficult to define good students that will become good doctors. Doctors have to have more skills besides being smart. From this research we can learn that those students accustomed to working hard and who are motivated to follow a long education will succeed to become physicians. Do you know how to select med students please let me know in the comments.

Urlings-Strop, L., Stijnen, T., Themmen, A., & Splinter, T. (2009). Selection of medical students: a controlled experiment Medical Education, 43 (2), 175-183 DOI: 10.1111/j.1365-2923.2008.03267.x