Variation in medical school graduates

**Singh.Simran** · 16-02-2008, 05:41 PM

I've seen that report. Don't think it means anything though - Giz would say it's a class/priviledge thing, and that grades/"poshie" med school entry/good finals results follow on - but even as a less agressive stance, it may be that its more a skills thing and the same skills are tested. Doesn't mean that these are the same skills as for being a doctor, so it would be a misinterpretation to say that those with strings of As make the best doctors.

**Spencer Wells** · 16-02-2008, 05:49 PM

^ But if those with the best A level grades do better in finals, and those that do better in finals have better career progression....

**rjm** · 16-02-2008, 06:25 PM

I dont think it does necessarily suggest good career progression, I think it just shows those people that are good at exams, and that in itself is a skill. Some people have a mentality that they can revise, they know how to approach exams and perhaps have even been coached in it - I went to a secondary school where we had an exam in every subject during an exam week at the end of the year from year 7. I am sure this put me in good stead for learning a good revision technique/understanding my learning style and knowing how to answer exams - I'm sure to some extent this explains why I have 10 A/A* grades at GCSE, 4 As at A-level, a 1st class intercalated BSc, and a medical degree with honours, and part1 MRCPCH as an F2. I do not think any of this suggests I am a better doctor. I wouldnt be surprised if those medical schools that do better in MRCP are the type of medical schools that attract students who are "good" at exams. Plus I also wouldnt be surprised if oxbridge do a lot more exams than your average medical school and hence again people get practice in how to approach exams.

As for career progression, what would be interesting to see is time from qualification to appointment as a consultant relative to med school, and time from completion of part 1/part 2/PACES to consultant appointment. However, it is also important to remember that appointment to consultant level is not the ultimate end point, and surely its a journey. When I take time out to do a PhD, that will put me 3 years behind my peers, does that delay my career progression? Is time the only factor?

I think this paper is interesting, and even amongst students/junior doctors is is generating a lot of questions.

**yazoo** · 16-02-2008, 11:29 PM

Originally Posted by rjm

I dont think it does necessarily suggest good career progression.

It directly affects career progression. There are certain ST posts that cannot be entered without membership exams. And CCTs that cannot be awarded until exit exams are passed. Obviously, the precise nature of these varies from one specialty to another, but exams are vital unless you have no interest in being a consultant.

When I take time out to do a PhD, that will put me 3 years behind my peers, does that delay my career progression? Is time the only factor?

No. Any sensible system rewards such endeavour. Even in the current mayhem, a PhD is rewarded reasonably.

**Singh.Simran** · 17-02-2008, 05:35 AM

Originally Posted by Spencer Wells

^ But if those with the best A level grades do better in finals, and those that do better in finals have better career progression....

Then either we have proof of a good meritocracy at all levels, or proof of poor sociointellectomedicological mobility

As for which it is? A mixture of both. I think sure the top few are deserving, but there are also plenty in there who have always had life made easy for them, and that perpetuates itself.

**rjm** · 17-02-2008, 05:29 PM

I think to some extent there is an element of that, and I would be interested to know if students who are financially aided though university by their parents do better in finals/exams - is there evidene that if you dont have to work that you have more time to study and do better, or do people who also work for money do as well because they learn to be better organised and use time more effectively. Plus there is the issue of being able to afford textbooks/onlne resources etc. I wouldnt necessarily say that makes life "easy" though. People have lots of pressures from different directions.

**Singh.Simran** · 18-02-2008, 05:13 AM

Very true.

But i know for a fact that what the system does do is heighten and increase distinction between people; someone (to use both educational and socialist points in one) who is either slightly poorer or slightly stupider at, say, age 11, might end up in a considerably worse school environment than someone clever enough for grammar or rich enough for private; by the time gcses and a-levels come round, regardless of application, the fact that the former has such a more stresssful and less well-resourced environment, not conducive to the superhuman feats oxbridge etc want us to acheive these days, he will not have a bats chance in hell of getting into the same courses as the other bloke; so he qualifies not as a professional, maybe not uni at all, and ends his days fairly happy as some form of labourer. Meanwhile the other is a vaguely competent but not shining doctor.

All fairly plausible scenarios i'm sure youll agree - but was the tiny distinction at the start really fair and in proportion to the near unimaginable gulf quite easily produced 30 years later? Indeed if i exagarrate somewhat i could have the former in Feltham and the latter running the country.

The way its set up, with such rigid selection at each stage and the fact that that selection is so determinest to your future, makes this not a meritocracy so much as a luck many years ago ocracy.

Sadly it's hardly easy to fix either... some appropriate measures to give credit to those who do well taking into account factors outside their own control (yes, call it positive discrimination if you will) might help, but in the end real social mobility is hard to acheive in any meaningful way, as far as i can see, without some new post-apocalyptic wordl.

**agneishd** · 18-02-2008, 09:03 PM

Very good, although you mispelled "world" at the end there

**Singh.Simran** · 19-02-2008, 01:06 AM

Shup neish.

**nd1008** · 19-02-2008, 02:06 AM

oi i have family in feltham.
he also spelt exaggerate and determinist wrong.

I'll keep it brief: I definitely agree with the "slightly poorer" argument, as this pertains when determining your schoool environment at a young age: this is essentially when educational development is nascent and so would have a large influence in the future.
But I definitely disagree with the slightly stupider argument, as I think the current system in place (assuming that the quality of resources and teaching is equal) enables those "slightly stupider" as you say, to eventually tend towards a particular standard which is approximately equal to those who are "clever". This is because teachers and schools obviously have objectives and they want students to achieve the best possible grades overall: hence their primary objective is to maximise the grades of their students: thus they would rather have two low A*, than one high A* and a B. The way in which they teach would therefore contribute to making grades more uniform and would diminish the gap between students on each end of the spectrum (unless of course the clever ones do loads of research by themselves). Rather than causing the distinction to diverge, I think that (provided that the assumptions are harboured) the system in place causes convergence of performance in examinations, and hence reduces this so called gulf between individuals. So I agree with only half of your argument: the poor thing, but not the stupider thing.

btw, do you debate for a living or something lol?!