Graduate entry may be the best medicine for doctors

Students who take a post- graduate approach to studying medicine have the edge over those who enter straight from school, according to new research from the Royal College of Surgeons in Ireland (RCSI).

The findings emerge as a debate rages about the pressure on Leaving Cert students to score high points in order to be in with a chance of getting a place on prestige courses.

There has also been controversy about how colleges deliberately limit places in order to drive points up.

Higher Education Authority (HEA) chief executive Tom Boland said it was important that colleges publish the number of places available on courses and the number of offers made, and of greater importance was that there were more broader entry routes.

While there is transparency about the places available in medicine, the fevered competition among CAO applicants for medical schools has pushed points requirements to the limits.

The RCSI research involved comparing students on its undergraduate and graduate entry medicine programmes. Graduate entry students do not come straight from school, arriving instead from a range of backgrounds having done another degree first – perhaps law, Irish or English.

The research found graduate entry students performed at least as well, even though they do their medical course over four years rather than five or six.

Professor Seamus Sreenan, Director of Graduate Entry Medicine Program, RCSI
Professor Seamus Sreenan, Director of Graduate Entry Medicine Program, RCSI

And, in what may come as a surprise, graduate entry students with non-science backgrounds do as well as those who come with a science-related degree.

It is, however, a costly route, because on top of funding an undergraduate degree, entrants pay about €16,000 a year for each of the four years of the programme.

Commenting on the findings, Prof Seamus Sreenan, the RCSI’s director of Gradate Entry Medicine, said graduate entry medicine students in their final two years did “slightly better in assessment” than undergraduate students at the same stage, despite the shorter duration of the course.

He said the study found that “having a scientific background at time of entry to graduate entry medicine confers no significant advantage in the final clinical assessments”.

Prof Sreenan said the typical age of their graduate students was 25, though some were older.

He said graduate entry created greater diversity among students, and students were generally older and more mature.

“We believe this creates a richer mix of experience in the students graduating and ultimately working in our hospitals,” he said.

It is the first time in Ireland that there has been objective analysis of the performance of graduate entry and undergrad- uate entry medical students.

As well as the RCSI, a number of universities run graduate medicine programmes that are open to candidates who hold a minimum 2:1 honours degree in any discipline and attain a certain standard in an aptitude test known as Gamsat.

The pressure on Leaving Cert students to achieve high points for entry to undergraduate medicine was one of the reasons for a significant expansion of graduate entry medicine programmes.

Between 2008 and 2010, the number of places at graduate level more than doubled to 240, compared with about 470 in undergraduate courses. The competition for places is less pressurised than through the CAO.

The RCSI research, carried out between 2008 and 2013, has been published in leading journal BMC Medical Education.