AI SENATORI (E NON SOLO)

Tutti, ma proprio tutti, hanno ormai preso atto che i test applicati in tutti questi anni per l’accesso a Medicina sono stati un disastro: mal preparati, mal gestiti, inaffidabili, esposti ai ricorsi, discriminanti, distraenti dallo studio proprio delle scuole superiori.

Ora pare che al Senato si voglia rapidamente correre ai ripari, mantenendo però il numero chiuso e quindi i test.

Prima di cercare ‘nuove’ modalità di prove inattendibili e costose per applicare comunque il numero chiuso, invitiamo tutti a leggere anche quanto risultato in Olanda da un’indagine scientifica.

Va comunque ribadito che ancora peggio sarebbe, in termini di impegno e di costi, il modello simil-francese: libera iscrizione, superare 3 materie entro dicembre per potere partecipare al test per continuare a Medicina. Ipotesi questa che incredibilmente non è stata ancora scartata nella Commissione Istruzione del Senato. Sul sorteggio e sul numero chiuso v. anche Numero chiuso. Chi deciderà veramente? cliccando qui.

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Olle ten Cate

Rationales for a Lottery Among the Qualified to Select Medical Trainees: Decades of Dutch Experience

Journal of Graduate Medical Education 2021 Oct;13(5):612-615

Per leggere l’intero articolo cliccare qui.

Alla fine dell’articolo:

5. When There Is No Convincing Evidence to Support Selection on Qualitative Factors

Dutch scholars have compared various medical school selection procedures with a weighted lottery. Five doctoral dissertations completed from 2016 to 2020 (most by government-subsidized researchers) and numerous publications show mixed results. Although there is some indication that students who chose to be admitted through selection criteria performed somewhat better in medical school than those admitted through a lottery, the results are generally inconclusive. No differences among students after graduation from medical school have been reported.

Concluding Thoughts

Applicants for medical school and residency generally prefer selection criteria over a lottery system and find rejections that feel beyond their control difficult to accept. However, the suggestion that ‘‘if you really want to, you can get into medical school’’ denies reality, when there are more applicants than positions. For example, the Netherlands has had a 1:3 acceptance ratio over 35 years of admissions. Many rejected applicants would have undoubtedly been excellent physicians, just as the vast majority of Dutch students admitted through a lottery have become doctors providing high-quality health care. There is no indication that countries applying elaborate selection procedures have built better health care systems. When all applicants qualify through demonstrated competence, Sandel’s lottery among the qualified is defensible. Whether admitted through lottery or chosen by a residency selection committee or performance test, not being selected remains painful. But students must also accept that not all opportunities are always available, and a redirection of life may bring more joy and satisfaction than a continuous battle against competitors. This editorial is not a plea to minimize differences among learners or to disregard unique strengths of individuals. On the contrary, every learner should be stimulated to excel in unique ways. What is problematic is when individuals are forced to conform and compete with others on limited criteria that do not correlate well with the competencies that really matter, to health care quality and to patients.