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Reducing Access to Medical Education 13th October 2003 It is difficult to comment on the Minister for Education and Science's plans for changing medical and other professional courses when one knows so little about them. But two things seem clear - they will cost parents, students and the taxpayer in general a great deal of money and they will not help women make progress in these fields. The Minister proposes to have a common undergraduate course, although students who have taken other undergraduate courses will also be able to apply for places in the postgraduate schools of medicine, dentistry etc. That we should take in graduates in the arts and humanities is no bad thing, we do to a limited extent already. But these students do have to undertake the complete course in medicine and they may not fare well in a truncated one. From the Minister's point of view, and I'm not cynical enough to think it is his main motivation, fees will have to be paid by someone - parents, student loans etc. for the post graduate schools, only those for undergraduate ones being paid for by the state at present. While I'm sure his main concern is to improve professional education it is as well to remember that he did try to restore fees at undergraduate level some months ago without success. Those who run our medical schools say they are grossly underfunded at present. Our schools get about one quarter the amount given per student compared to the U.K. There must be a big temptation to favour relying on parents for fees than the Minister for Finance. As we are all aware, taking in a large number of no-nationals at commercial fees has been used for years as a means of making up the short fall in funds needed. A campaign has begun here to allow nationals compete for these commercial places too. The Minister's proposals will certainly favour such students because they do have the money to pay fees and there is nothing the matter with that. But students from poorer backgrounds unless they get large bank loans had better settle for shorter courses. There has always been pressure on students from poorer families to get into the work force as soon as possible. And what about those who want to study courses like physiotherapy and radiography? They will now have to undertake courses of six years, apparently, rather than four as at present. And pay for the latter half of their studies too. it is hard to see how this move will encourage students into these disciplines. The Minister's complaint about the present method of entry is that the points gained in the Leaving Certificate are too high. But at least the method is fair and transparent. If one looks at the schools students come from as they enter medical school one can see they are quite diverse. What will be the method of entry of the graduates to the postgraduate schools? Will it be on academic merit - which only means students will not know until they are three years older which discipline they can enter. It has been suggested that eighteen year olds are not "mature" enough to make career choices, but why single out certain disciplines only? How are people more likely to know they have a vocation to be a lawyer than a doctor? Right enough there is a fall out of young doctors from the medical profession but do we know how great it is and why? Recently a friend of mine, a consultant in clinical medicine said she no longer took students on ward rounds because they would see the most of their medical lives would be spent aching as social workers. She said she spent half the round trying to organise discharge places or help at home for her patients and this sight made the students very despondent. This was not the reason they had worked so hard to get 570 points. Social Science is a very worthwhile course but the entry level is considerably lower. Finally - women. When I graduated I was one of eight women in a class with forty eight men. Those people referred to as "role models" were very few and far between. There were a couple of women consultant anaesthetists and pathologists, but they were mainly in academic medicine I do remember but no medical specialists and let's not mention surgery. There were, however, a few very popular women general practitioners. Amazingly, some patients did appear to like the choice of a woman doctor and in this area the punters could vote with their feet. At present at least 50% of medical school intake is female. They do well in college. In 2002, nine of the ten Foundation and no Foundation scholars in Trinity were women. We all know women doctors' difficulties begin when they are undertaking postgraduate degrees and have small children. I do not see any immediate possibility of men being able to bear children so changes such as the working time directive may help young women. A good C.V. definitely requires time spent in research. When looking at job applications men seem to have more publications than women. Quality differences as opposed to quantity I am in no position to comment on but I often wish candidates could put forward only their six best papers. It is hard not to feel women and poorer students will be seriously disadvantaged by a changed method of entry into the medical sciences. There has been a huge increase in the number of women in all these areas but the poor are still out in the cold. These are the very students the Minister says he is trying to promote at third level. His plans will do the opposite I think. Senator Mary Henry, MD |
