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Should medical schools relax academic admission criteria?

BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6456 (Published 14 November 2019) Cite this as: BMJ 2019;367:l6456

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  1. Drew Tarmey, programme director, physician associate studies and academic lead for recruitment and admissions, medicine1,
  2. Diana F Wood, clinical dean and director of medical education2,
  3. Mark S Lillicrap, clinical subdean, curriculum2,
  4. Holly C Canuto, director of education, Medical Sciences Tripos3
  1. 1School of Medical Sciences, Faculty of Biology Medicine and Health, University of Manchester, Division of Medical Education, Manchester, UK
  2. 2University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
  3. 3University of Cambridge School of Biological Sciences and Fitzwilliam College, Cambridge, UK
  1. Correspondence to: D Tarmey drew.tarmey{at}manchester.ac.uk, D F Wood dfw23{at}medschl.cam.ac.uk

We need to recruit more medical students, and not requiring A level chemistry may help to create a more equitable and diverse medical workforce, says Drew Tarmey. But Diana Wood, Mark Lillicrap, and Holly Canuto argue that studying chemistry helps with medical study and that more evidence is needed before changing admission criteria

Yes—Drew Tarmey

I’m not about to argue for the removal of all standards and benchmarks for admission to medical school. However, the evolution of post-16 curriculums and a need to broaden access to medical careers mean that we must look beyond academic qualifications when selecting medical students.

The requirement for a post-16 chemistry qualification has long been sacrosanct for most UK medical schools. Historically, it was one of the hardest subjects and therefore served as the simplest of selection criteria. Our understanding of the fundamental sciences has since moved on, as have undergraduate medical curriculums. Today, the A level biology curriculum arguably provides better preparation for undergraduate study because it includes most of the basic biochemistry and physiology a student will need before starting medical school.

A level chemistry

We should also look beyond the core sciences. For example, in 2019 some 30 570 more students were entered for mathematics than for chemistry at A level.1 Mathematics teaches numeracy and problem solving, psychology provides a good grounding to understand evidence based medicine, and history develops critical reasoning skills.

Graduate entry medicine courses have already shown that specific qualifications before enrolling at medical school are not associated with overall success at medical school.2 Furthermore, academic ability can be reliably ascertained from overall performance in pre-university assessments …

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