The Health Minister James Reilly recently called for the controversial HPAT (Health Profession Admissions Test) for entry to medicine to be abolished. He categorically stated: ‘this should be discontinued.’ The minister went on to argue that all it had done was create a new industry around a second exam for students who want to become doctors. The minister’s comments come amid indications that a review of HPAT would confirm it had not achieved what it set out to do, that is, to get a wider mix of students into medical schools. The Minister made a clear argument that it has far from made medicine more accessible to a diverse mix of students.
HPAT, the admissions test selected by the Irish Medical Schools, was introduced in 2009 with the intention of ensuring that those wishing to gain entry to medicine did not have to attain an exorbitant amount of CAO points alone. A points-based system for entry was seen to favour those who could afford the advantages offered by fee-paying schools, grind schools and private tuition. HPAT was promoted as a way of measuring specific relevant skills other than the capacity for rote-learning associated with the Leaving Cert. HPAT tests problem-solving skills as well as verbal reasoning and the ability to understand people’s thoughts and behaviours; skills deemed important for a competent health professional. This test which is independently administered by ACER (Australian Council for Educational Research) awards points, which are then combined with a student’s Leaving Cert points.
A review of the first three years of HPAT is being finalised by the Higher Education Authority (HEA), which in turn will report to Education Minister Ruairi Quinn.
The HEA review established:
• Girls continue to dominate entry to medicine even though HPAT was supposed to open it up to a greater mix of school-leavers, including boys.
• Those who paid for pre-exam courses did better, despite official advice that there was little or nothing to be gained from such preparation. Those who did a preparatory course got almost 10% higher marks than those who didn’t.
• It also found that students who repeated HPAT did better second time around, with as many as one-third of successful applicants to medicine in the past two years repeating the test.
Has the introduction of the HPAT created another industry for those caught up in the points race? Unquestionably; Yes. Whilst the health minister is strongly of the view that there should not be a second strand of evaluation for medicine; ‘I believe people who have achieved 600 points in the Leaving Certificate, if they have chosen medicine, are entitled to do it.’ However, what the review findings have done indirectly is put the unfair spotlight on the CAO system as a whole.
The grind industry is worth a lot of money in Ireland; thousands of students access the professional assistance of experts in diverse subject areas or attend grind schools at weekends or during holiday periods. Therefore, how does the student who cannot access the same additional educational services be convinced that she/he is competing in a fair system. At the end of the day the leaving cert examines who learns and memorises best. If two students are competing for a must sought after place in medicine and both are of equal aptitude and ability; there is no prize in guessing who will win a place. Afterall, one student has been learning her course work from specially tailored notes put together by a teacher getting paid to deliver her/his expertise in the area being studied. Yes, in the majority of cases, that extra competitive edge that comes from affording additional tuition will pip the non-grind student to the post. The exams themselves: both the formation and delivery of the papers bear the hallmarks of a fair examination system; it is the pre-examination preparation phase which is tainted with inequities. The HPAT review findings demonstrate this. It shows how students who access preparation courses for an exam do better compared to students who don’t tap into this pre-exam preparation industry.
If the kernel of the issue lies in the exam preparation phase; how do you redesign a system of testing that will eradicate the unfairness? If you get rid of it, what could take its place? Currently, there are extensive new reforms under consideration to introduce continuous assessment for half the work done by Junior Cert students. This would replace the system of assessing students exclusively in exams. If the reforms currently being developed by the National Council for Curriculum are accepted, some 50pc of the end-of-cycle marks awarded to a Junior Cert student would be based on continuous assessment of their portfolios, rather than being solely based on exam results.
Perhaps, this system could also be looked at for the leaving certificate. There are currently some projects to be submitted for certain leaving cert subjects which can give the exam student up to 40% of their exam mark. However, this is limited to a certain type of subject – namely practical and LCVP. What do you do if you aren’t a practical minded student? You don’t get the opportunity to present your knowledge outside of the traditional exam format. The Minister for Education should perhaps consider that since there are over seven different types of intelligences; it could be time to start to assess them all rather than two or three (depending on the subjects taken, students are predominantly assessed on their verbal and numerical skills only). This could be done by awarding marks for portfolios, behaviour, interviews, activities and various projects; a variety of testing formats that acknowledge the number of diverse intelligences/skills students present with.