Medicine entry test fails to level the playing field

IN APPOINTING new board members to the State Examinations Commission last week, Minister for Education Ruairí Quinn talked up…

IN APPOINTING new board members to the State Examinations Commission last week, Minister for Education Ruairí Quinn talked up the Irish exam system. Its integrity and openness, he said, was recognised worldwide.

That may be the case in relation to the Leaving and Junior Cert exams. But no one is trumpeting the success of the new revised entry system for medicine, known as the Health Professions Admission Test (Hpat).

As reported in The Irish Times last week, a review team of experts in medical education says the new system is creaking.

It has failed to widen access to medicine and gives an unfair advantage to those who can afford expensive preparatory courses, according to a leaked draft report.

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Here’s a question: if the integrity of the Irish examination system is so highly regarded, why is the Department of Education so anxious to retain the discredited Hpat?

The admission test was a well-intentioned reform. Its introduction by former minister for education Mary Hanafin closed off an unfair loophole in the CAO system. Students would be assessed on the basis of one Leaving Cert sitting; the days when students could gain places in medicine after repeating the Leaving in expensive grind schools were over.

Hpat started well. In 2009, 83 per cent of successful applicants were first-time Leaving Cert students, compared with only 59 per cent in 2008. The review of the admission test acknowledges this. It says the new rules levelled the playing field and addressed one of the negative aspects of the points race. This, it states, could be considered “a desirable outcome with a positive educational impact”.

But that is where the good news ends.

The review reveals that students are opting to repeat the admission test exam – sometimes in the same pricey grind schools where their colleagues once repeated the Leaving Cert exam.

A huge number of Hpat candidates take places in courses such as biomedical science, while attending intensive preparatory courses for the admission test.

And it’s well worth their while.

More than 85 per cent of those who repeat the exam secure a higher score on their second attempt. Flushed with success, they abandon their course in biomedical science or whatever – at huge cost to the exchequer.

The draft report specifically refers to this phenomenon. It notes that in 2010, one-third of medical school entrants presented one Leaving Cert result and a repeat Hpat result.

A similar trend was observed in 2011. Many of these candidates exit a third-level place in order to accept a place in medical school. In 2010, for instance, 111 medical school entrants had vacated another third-level course in Ireland and accepted a place in medical school.

This exit from othercourses constitutes a significant hidden cost to the exchequer. The message from the report is stark: the Hpat system has failed. It is not, as its promoters claimed, identifying the best potential doctors.

Instead, it has produced a new system with the same old problem; namely, those who can afford expensive preparatory and repeat courses retain a significant advantage.

It is having one other “backwash” effect.

It is leaving key college courses in areas like biomedical science with much depleted student numbers. These places are coveted by other students who had a genuine interest in studying the course, but they will lie empty after the successful medical applicants abandon them. What a waste of public money.

Curiously, the admission test review team, having exposed the failure of the test, suggest only minor adjustments. These include moves to a less predictable scoring system.

This will have little impact. Repeat Hpat students will continue to secure up to 40 per cent of the available places.

Why has the review team been so cautious? A clue comes in the introduction to its report. It notes that “the revised new entry and selection mechanisms to medicine were introduced at the direction of the Department of Education and Skills”.

It’s clear that the department is in no mood to abandon the admission test. It wants to move away from the old system where the Leaving Cert was the sole mechanism for allocating college places. The Hpat is the template for a revised exam system.

But the review team reveals an awkward truth: the new system is deeply flawed.

The department does not want to return to the shocking situation where students needed the perfect Leaving Cert (at least 575 CAO points) to gain entry to medicine. I have some sympathy with that view but this will not happen if we retain the Hpat requirement that a student has to meet the full entry requirements in one sitting of the Leaving.

We should apply this rule to every college course on offer through the CAO. This would bolster equity of access and fairness throughout the entire third-level system.

It would create a truly level playing field for all our students and increase the chances of first-time Leaving Cert candidates securing their desired places, as happened with medical entry in 2009. There would be resistance to such a move from the grinds industry. Has Quinn the courage to take such a step in the name of equality of opportunity?


Brian Mooney is a former president of the Institute of Guidance Counsellors