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  1. #1
    TC
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    Should there be an upper age limit for entry to medical school?

    Following on from a number of recent threads alleging age discrimination by certain medical schools - should there actually be an upper limit?

    I think this is a very difficult issue. In an ideal world, a medical degree should be open to all - not just those wishing to become doctors but those simply interested in learning about medicine. However, unfortunately the current shortage of doctors in this country means this privilege needs to be restricted to those initially planning to practice.

    The current shortage of doctors is at the more senior levels. Junior doctor levels are improving and projected figures suggest there may be a surplus of medical school graduates in around 2-3 years time.

    The major issue remains in retainment of doctors and ensuring in future sufficient numbers of senior practitioners. Service hours and service years are also likely to be affected by the increasing proportion of female graduates although projections as to its effect can only be speculative.

    Clearly someone starting medical school in their 40s could only realistically be expected to work for 10-15 years after graduation. Of those only 5-7 years would be at a senior level and therefore would not help in alleviating the current shortage at this level. Whether such individuals would complete these years and whether their drop out rates will be comparable with younger students are also purely speculative due to the traditional reluctance by schools to such students being admitted.

    Personally, I think perhaps the most open way to proceed at this point with regards to this issue is for CHMS to set a maximum percentage of students over the age of 35-40 allowed to be admitted to each medical school (say 5% of each yearly intake).

    What do other people think about this? I would be interested to know (not an essay topic or research ) - just pure interest.



  2. #2
    Enigmatic Moderator Jake's Avatar
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    Quote Originally Posted by TC
    Personally, I think perhaps the most open way to proceed at this point with regards to this issue is for CHMS to set a maximum percentage of students over the age of 35-40 allowed to be admitted to each medical school (say 5% of each yearly intake).

    At the last CHMS meeting I attended, this issue was discussed. The general consenus seemed to be an upper age limit should be (and is) in place, but this is not fixed and candidates can be admited to medical school (over a certain age) at the university's discretion. I believe this was the general gist, Will Watson may be able to add further to this.
    Dr Jake

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    F2 Doctor Oxford Foundation School

  3. #3
    Senior Member Cymro's Avatar
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    The sheer cost of training a medical student means that it's not feasible to admit someone who will have a relatively short career. Of course, not every eighteen year old who starts studying medicine will necessarily complete the degree or practice in the NHS or this country, but the majority will. I know to set an age limit of 35-40 would be labelled discriminatory or un-PC by some, but really it's an issue of practicality. I would sympathise with someone who, for whatever reason, was unable to pursue a medical career earlier in life, but que sera.

    Cymro.

  4. #4
    Member bugsysmum's Avatar
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    hmm. I suppose my view is not an objective one. I can certainly see from a budgetary point of view the pitfalls of training mature students. Unfortunately we live in a world where cost is very much considered first and foremost. My belief is that good quality healthcare costs money. You cut costs, very often quality takes a back seat. I work in the NHS and see it everyday. I feel that people should be assessed on merit.
    It goes without saying that mature students often have lots of skills to offer the profession than lets say an 18yr old who doesn't yet have life experience. Young student often have had a life of learning and are moving into a career which involves lifelong learning. How much of real life do they really miss out on. I think mature students inject this (real life skills experience) and create a healthy balance in a classroom environment. However saying this - if i had two candidates that were equally qualified academically and emotionally one was 25 and one was 35 it goes without saying who i would employ. I would not compromise quality though too save a buck of too. I hope this makes sense and have not offended anyone.
    Regards
    Bex (a mere spring chicken! - not)

  5. #5
    Awesome Moderator Will Watson's Avatar
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    Quote Originally Posted by Jake
    At the last CHMS meeting I attended, this issue was discussed. The general consenus seemed to be an upper age limit should be (and is) in place, but this is not fixed and candidates can be admited to medical school (over a certain age) at the university's discretion. I believe this was the general gist, Will Watson may be able to add further to this.
    Spot on, although the DfES was being unhelpful and I think CHMS are seeking exemptions from current legislation (not sure if that has been successful or not). The Nottingham GEP is the only one to formally impose an upper age limit that I'm aware of.

    I must say I agree with TC: given the limited availability of medical school places and the amount of money the NHS spends, workforce planning must be taken into account in admissions.
    "Clevinger, the Corporal and Colonel Korn agreed that it was neither possible nor necessary to educate people who never questioned anything." - Joseph Heller, Catch-22

  6. #6
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    Quote Originally Posted by bugsysmum
    It goes without saying that mature students often have lots of skills to offer the profession than lets say an 18yr old who doesn't yet have life experience. Young student often have had a life of learning and are moving into a career which involves lifelong learning. How much of real life do they really miss out on. I think mature students inject this (real life skills experience) and create a healthy balance in a classroom environment.
    I understand where you're coming from but I think that perhaps it's a mistake to make such a sweeping generalisation. To have life experience is almost always a good thing, but does not necessarilly convey the qualities required for medicine.

  7. #7
    Member bugsysmum's Avatar
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    Cheeks - i agree with you entirely. It was not meant as a sweeping generalisation. This is why i said people should be assessed on merit. I do agree that there are definately serious issues in training mature students and feel that there should be a limit, but what that should be is a difficult decision.. To set boundaries would take away the descretion of the admissions drs.
    Young people are often mouldable and more adaptable to change.
    I work in the NHS and see many excellent doctors. I also see DR's that have no regard for patients dignity or humility. There are always the "square peg round holes" that get through the system i know. This is why it is essential people are chosen on their academic and personal qualities and not just the fact that they want the "status" which i see so often.

  8. #8
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    A couple of points to add to the discussion.

    1. Given the expressed major concerns about 'budgetary’ considerations, I wonder why the CHMS do not require applicants below 40 to 'pay back' one single day to the 'system'.

    If cost/return is so important to some people why are below-40 applicants not required to justify the cost of their training in the same way you advocate for above-40 applicants?

    For someone being sponsored by the armed forces – regardless of age – they are required to guarantee a minimum return of service, or repay the sponsorship. Therefore, if your concerns are cost-based, then why are you not proposing that ‘standard’ (below-40) applicants sign up for a minimum return of service to the NHS, or pay back the money they have cost the taxpayer?

    How can you justify discriminating against 40-plus candidates on a basis of the reason you propose, when the same medical schools who form the CHMS actually actively encourage application from ‘standard’ applicants on the basis that a medical degree is a good grounding for other professions, and thus on the basis of the expectation of the medical schools themselves that some of their student will go off into the media, legal professions, sport, pharmaceutical industry, etc, etc.?

    According to the Head of School at Swansea, the problem is not getting mature applicants to commit, but rather getting 'standard' applicants to commit themselves to more than a couple of years. That is his conclusion, based on his considerable experience.

    Would it not be more practical - as 'practicality' is being used to justify discrimination - to insist that standard applicants sign themselves up for a 25-30 year return of service or pay back the cost of training?

    If your concern is ‘practicality’, then you will get a much better return by doing this than by discriminating against a minority of people who are over 40, but who will most likely 'give back' very good service to the NHS, and who in many cases have already 'given' a great deal to the health service.

    2. If the CHMS is so set on medical schools discriminating against applicants over 40 (and over 30 in some cases), why does the CHMS not make it policy?

    The CHMS advised Oxford that age discrimination raised human rights issues - and advised that they should not include any reference to any overt age restriction in their prospectus. Is this a responsible way for an organisation to operate?

    When challenged on their ageist policies, medical schools refer directly back to the CHMS, but when the CHMS is challenged to justify their 'policy' they claim it is not 'policy' but mere a 'matter for discussion'. Is this a responsible way for an organisation to operate?

    3. When an applicant can be admitted to the armed forces as a Medical Officer at the age of 46, and the armed forces are willing to sponsor that person throughout their degree and training, why should medical schools take it upon themselves to prevent such an applicant from being admitted to the course due to age discrimination?

    If the candidate is good enough to serve their Country, and be sponsored for doing so, why should medical schools discriminate on the grounds of age?

    4. Why do you rate 'service' to the healthcare system only in terms of years, instead of quality? And then only in terms of years at 'senior level'?

    There are many 'standard' (below-40) entrants who will never go on to senior level - either because they do not want to or because they are not selected - and still they are admitted, and still of value to the system as a whole. But for mature applicants, the rules are suddenly different, and unless they ALL can become consultants, then there is suddenly a problem in them being admitted?

    5. Many mature applicants come with considerable experience and relevant qualifications - and in some cases this will mean that their length of specialist training can be reduced. Why is it that medical schools are not willing to recognise this?

    6. Many of the arguments I've seen here and elsewhere for persisting in age discrimination are almost identical to those that use to persist in keeping women out of the medical profession - 'value', 'service', 'practicality' – they thought they were right then, but now we know they were totally wrong then, so why do you think you are right now?

    Ok, that’s enough! There are lots of question marks, but I do not expect answers to them all!
    Last edited by Scrutiny; 14-07-2005 at 10:23 PM.

  9. #9
    Junior Member matt-the-burgess's Avatar
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    could'nt agree more scrutiny. They have loads to offer. My father just graduated from a degree in radiotherapy and at 47 can only work in the NHS. They too have grades seniority and a shortage at that. He wasnt discriminated against and as a result gained a place a first and the academic prize three years running! The only student ever to do so. Foe him and i'd say for many others too! a life of work and theknowledge of how rubbish that can be that allowed him to focus on what he really wanted to do! so i say up the 40s. Im applying to med school in sep having just finished a degree in microbiology! I'll be classed as a mature student and think i am. You do a hell of a lot of growing up at uni something im sure the older members will vouch for! I'd make a much better doctor now aged 22 than i would have aged 18. Im not saying that this is the case for all but everyone should be considered as individuals, just like my dad was!

    yours

    Matt

  10. #10
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    Quote Originally Posted by Scrutiny
    If cost/return is so important to some people why are below-40 applicants not required to justify the cost of their training in the same way you advocate for above-40 applicants?
    They should be.

    Therefore, if your concerns are cost-based, then why are you not proposing that ‘standard’ (below-40) applicants sign up for a minimum return of service to the NHS, or pay back the money they have cost the taxpayer?
    Again, they should.

    Would it not be more practical - as 'practicality' is being used to justify discrimination - to insist that standard applicants sign themselves up for a 25-30 year return of service or pay back the cost of training?
    Yes. Although I'd move to a graduate entry only system too, you can't expect 17yr olds to sign their life away like that.

    3. When an applicant can be admitted to the armed forces as a Medical Officer at the age of 46, and the armed forces are willing to sponsor that person throughout their degree and training, why should medical schools take it upon themselves to prevent such an applicant from being admitted to the course due to age discrimination?
    Because presumably the armed forces are not paying the cost for that individual's education at medical school (except for the relatively trivial contribution of fees).

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