The HPATs: A race to the top


As UCD welcomes the first medical students to have sat the HPAT exam, Hugh Adler considers the merits of aptitude testing.THE DEBATE CONTUINUES over the ideal way to select the ‘best’ medical students from the large pool of bright, committed Leaving Certs who apply to the CAO each year. UCD has recently admitted the first cohort of students selected using the Health Professionals Admission Test (HPAT), a test already beset by controversy.

Recent years have seen a points’ race among students applying for places in one of Ireland’s five medical schools. Like other aptitude tests, the HPAT is said to test skills and attributes that are underrepresented in curriculum-based exams like the Leaving Cert, which has been accused of over-reliance on rote learning. Entry to medicine – previously requiring at least 575 points – is now based on a combination of Leaving Cert points, essentially capped at 560, and a HPAT with a maximum score of 300.

Be that as it may, this new approach raises many important issues. Disappointment is built into the CAO process – there will always be more students applying than there are places available, particularly for courses like medicine. In an ideal world, exactly 400 Leaving Cert students each year would possess the right ‘aptitude’ for medicine, and a method would exist to identify such students and extract them from the crowd. In reality there are more than 400 such students, but only 400 places – and our selection methods are imperfect.

Much of the public’s ire has focused on the gender balance of the current Foundation Year, as its female-to-male ratio – traditionally a pleasant 60:40 – falls to an unimaginative 50:50. Some commentators have suggested that this is a deliberate design implement of the HPAT, either to neutralise women’s supposed advantage in the Leaving Cert, or to rebalance the medical profession in favour of men – perhaps as a way of reducing the number of doctors taking maternity leave.

The country’s deans of medicine – including UCD’s Prof. Bill Powderly – refuted these suggestions in a letter to The Irish Times in August.

“Any suggestion that men are incapable of competing with women without having their grades artificially inflated by the HPAT is rather insulting”

Whether a 50:50 gender balance is desirable in medicine is an entirely separate argument. Folk wisdom has always stated that the reason the majority of consultant doctors are men is that women take time off to raise families. Ideally the whole system would be made more family friendly, with male doctors being offered paternity leave. Any suggestion that men are incapable of competing with women without having their grades artificially inflated by the HPAT is rather insulting.

Quite apart from accusations of social engineering, many continue to question whether the HPAT is necessary at all. Proponents of the HPAT claim it measures qualities not tested by the Leaving Cert, such as empathy and spatial reasoning.

Classically, surgeons have been described as lacking in any ability to relate to their patients, but this is not always the case in real life. In any case, interpersonal skills grow and change during a six-year degree. As for “spatial reasoning”, it might be considered necessary in a surgeon, but students with poor spatial reasoning can simply chose to go into a non-surgical specialty after graduating.

The points race for medicine benefits nobody, and the adoption of the HPAT was recommended by experts, who presumably knew what they were talking about. Whatever the ramifications of the selection method, the class of 2015 will undoubtedly make a great contribution to the medical profession, and we should take this opportunity to welcome them to UCD.