Students would no longer need the perfect Leaving Certificate to take an undergraduate degree in medicine under radical new plans proposed by the Minister for Education, Mary Hanafin.
But the universities are opposing her plans to give no additional credit to those students with over 550 CAO points in the competition for places.
The universities also favour a system whereby students achieving between 570 and 600 points would gain marginal additional credits.
Under the Hanafin plan, from September 2009 entry to undergraduate medical programmes would be based on a combination of Leaving Cert points and results obtained in an internationally-recognised admission test for medicine.
The Minister also wants other high-points courses, such as dentistry, pharmacy and veterinary medicine, to accept entry through this combination of CAO points and aptitude testing.
But her plans have already drawn a cool response from some universities, where the power of the various academic councils to set entry requirements is jealously guarded.
Discussions on these issues involving department officials, the Higher Education Authority (HEA) and university representatives have been continuing in recent weeks.
Last night, the Minister defended her plans, saying: "You do not need to have a perfect Leaving Cert score to be a good doctor."
Under the Minister's plan, those applying for entry to medicine would be given a total score based on their performances in both tests as follows:
Leaving Cert results between 480 and 550 points;
An admission test score (up to a maximum of 300 points).
At present, those with a near perfect Leaving Cert of mostly A1s and just some A2s are still unable to gain a place in medicine, which requires at least 570 points.
Last night, Ms Hanafin said: "I want to move away from a situation where you need to strive for the perfect Leaving Cert to do medicine. This will have the effect of reducing the pressure for Leaving Cert students, but it is still the case that students need to be academically very bright to study medicine."
Under the new plan, students wishing to apply for a place in one of the five undergraduate medical schools would have to secure a minimum of 480 CAO points.
They would also have to sit an admission test likely to be an internationally-recognised test suitable for 17/18-year-olds. This test would be taken in the year preceding the Leaving Cert exam.
It is expected that fees for the test would be waived in individual cases where students are exempt from the Leaving Cert exam fee in order to ensure that less-well-off students are not at a disadvantage.
The plan for reform of undergraduate medical education comes at a time when the number of places is expanding. A total of 40 additional medical school places come on stream this month and 35 more are due next year and in 2009.
Some 70 additional places were also provided last year.
The planned reform of undergraduate education follows the introduction of graduate entry to medicine for the first time. In all, 240 places are open to graduates with a higher second-class degree.
A group of 60 graduate students will begin the programme next month at the new graduate medical school in the University of Limerick and in the Royal College of Surgeons in Ireland. The fees for these places have been set at €12,000 a year for students, with the Government paying the balance of €13,000 per student to the medical schools.