Wanted: Medical student, compassionate and personable

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willow18

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The article gets boring after a while, nevertheless, it gives ya a glimpse into a somewhat different getting-into-med-school system. Oh, before you read, the "psychometric test" is the Israeli version of the SAT.

http://www.haaretz.com/hasen/spages/704189.html

Wanted: Medical student, compassionate and personable

Medical schools in Israel have come to the conclusion that in addition to a high psychometric score, it is important for a doctor to feel compassion. To this end, the schools recently decided to alter their admissions procedures to start examining qualities such as sensitivity, integrity and interpersonal communication.

The new test was developed by the National Institute for Testing and Evaluation (NITE), the body responsible for psychometric testing, and the National Center for Medical Simulation, which charge NIS 600 to administer the test. The medical schools have not given up on the psychometric test, which is still the decisive factor in acceptance, but have now added interviews, personal questionnaires and situation simulation games involving dilemmas faced by doctors.

This method is not perfect. It turns out that it works to the detriment of Arab applicants. In addition, it raises fundamental questions, including whether stressing the human side of the physician has filtered down to the curriculum and training sessions, or whether it stops with the admission exams; and whether it is even possible to predict who will be a good doctor.


Taking initiative

Tel Aviv University has been using the new evaluation method for the past two years, the Technion - Israel Institute of Technology introduced it this year, and Hebrew University in Jerusalem decided about two weeks ago to adopt it. Israel's fourth medical faculty, Ben-Gurion University of the Negev, has been using a different admissions method since its inception, focusing on qualities such as empathy, sensitivity and teamwork.

Prof. Moshe Mittelman, head of the admissions committee at TAU, feels that the doctors graduating from the university are already "very good, professional and humanistic."

"Still," says Mittelman, "it bothered us that here and there you meet a doctor about whom you say, 'He may know medicine, but he is not a decent human being.' We are a school that educates people to work in the medical profession, which is not only science but also humanism and dealing with people."

The new evaluation test, nicknamed MOR, the Hebrew acronym for "medical studies screening system," lasts a full day and consists of biographical questions, a questionnaire that examines a person's judgment and decision-making capabilities, and situation simulations. The answers to the biographical questionnaire are evaluated using fixed criteria. Thus, for example, Dr. Naomi Gafni of NITE explains that candidates receive points for involvement in a certain hobby for years, such as playing the violin, because this attests to perseverance.

The questionnaire also examines past accomplishments of the candidate, whether he has belonged to any volunteer organization, helped the public or has undergone difficult situations and coped with them sensitively. The situation simulation presents the candidate with three moral dilemmas.

"This questionnaire is designed to test the candidate's ability to understand that the problem is complex, and still make a decision," says Gafni.

For example: The father of a policeman with the Immigration Police is a chronic care patient. His family has interviewed a number of caregivers, but has not been impressed by any of them. They finally find a caregiver warmly recommended by close friends who has just finished his previous job. It turns out, however, that he is a foreign worker without a residency permit. The family is interested in hiring the caregiver, but the policeman is hesitant.

The medical school applicants also participate in role-playing games that simulate situations such as coping with an angry patient who has been waiting a long time for his appointment.

How is the ability to feel compassion tested?

"There are questions that check whether the candidate has ever been in a situation that requires empathy," says Gafni, "if a person close to him was seriously ill. Work experience is also an indicator. If a person has been involved in therapeutic work, this indicates a natural desire to help."

What if a candidate is young and has no work experience, or no one in his family has been seriously ill?

"Then perhaps he has relevant life experience from other areas, such as motivation toward leadership, because a doctor has to take initiative, to know how to analyze situations and make quick decisions. A younger person is less ready to go to medical school."

The community decides

The medical schools are not ready to give up the psychometric tests, despite the contention that the medical profession does not demand high psychometric skills. At TAU, half an applicant's final score is derived from the psychometric and matriculation exam scores, and the other half from the MOR test. The Technion calculates the MOR test as 30 percent of the final score. Hebrew U.'s medical school director, Prof. Ehud Razin, says he has not yet decided how much weight to give the MOR score.

The psychometric test is also the decisive factor for the initial screening. At TAU, the applicants with the top 300 psychometric scores are invited for MOR testing, out of 1,200-1,500 applicants. At the Technion, only 200 candidates are invited to take the MOR test. At BGU, on the other hand, head of admissions Prof. Gabriel Schreiber explains that 500 applicants with the highest psychometric and matriculation scores, or with high grades in previous studies, are sent for MOR testing. The larger group of candidates gives an opportunity for those with lesser marks to be accepted by the faculty.

The candidates at BGU are invited to two interviews of about an hour each, with two different pairs of interviewers. The briefs the interviewers receive do not mention psychometric scores in order to maintain impartiality. Schreiber explains that half the interviewers are doctors, while the other half are school teachers, social workers, psychologists, judges and religious leaders. The idea is to allow the community to participate in the choice of their future doctors.

Due to the importance still accorded the psychometric tests at other faculties, only 20 percent of the applicants at TAU are accepted based on high MOR scores. This figure is expected to be even lower at the Technion. The heads of the various admissions committees say that considering the conservative nature of medical faculties, even these figures are a giant step forward.

"The Technion is very conservative," says Dr. Gad Bar-Yosef, head of the Technion's medical faculty admissions committee. "One of the considerations was that we did not want to make too drastic a change without trying the process first."

"If nothing comes of this apart from the message that we care about personal qualities," says Mittelman, "that, too, is sufficient."

However Dr. Netta Notzer, head of medical education at the Faculty of Medicine at TAU, says that this is definitely not enough. She feels that the very change in the admissions system does not ensure that future graduates will be better than their predecessors. She believes there should be an emphasis on changing education and training methods, too.

"Let's assume I accept a student who is more empathetic. If we do not nurture that over the years, that quality will disappear," says Notzer.

TAU has begun to introduce such changes into its curriculum, and Hebrew U. and the Technion are also advancing in that direction. They are still far behind BGU, however, where students go to the hospitals in their very first year of studies and the curriculum stresses qualities such as sensitivity, developing communication skills and a non-condescending attitude toward patients.

Notzer says that in a few years candidates will have "cracked" the tests and will be able to give "the right answers." She believes that screening future doctors should be done during their training. Notzer says that if the training program included things such as role models who could teach the students, and advancement from one year to the next were determined not only by anatomy and pathology exam marks, but also by a student's attitude toward patients, there would probably be no need for a screening test like MOR.

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willow18 said:
A younger person is less ready to go to medical school.

Quite an interesting article, will comment more later :thumbup:
 
its about time that israel's health education woke up! up until now only "4.0 and 40+ mcats" have been accepted. people with zero experience in community service, research or even in human relations have been excepted.
 
kasha said:
its about time that israel's health education woke up! up until now only "4.0 and 40+ mcats" have been accepted. people with zero experience in community service, research or even in human relations have been excepted.


quite right.
110 (out of 120) High-school grade.
745+ Psychometric (out of 800)
(These are not official)

Crazy but true.
If you do not make the stat cut, you're not even given a chance.
Most students give up/study in Europe.
I condone this new testing method. I think it will improve the quality and breadth of Israeli students.
 
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