Supportive environment required for Pre-entry exams for medics

EDUCATION

By Kyetume Kasanga

KAMPALA - In 2016, medical interns from Uganda's five public universities overwhelmingly protested the Ministry of Health decision to introduce pre-entry exams for medical graduates to be enrolled as interns.

The Ministry argued then that huge numbers of medical students graduated each year but the majority were under-skilled.

The decision was, therefore, to enable government sponsor only those interns who qualified, and improve the quality of human resource in health facilities countrywide.

Now, Makerere University School of Medicine, Uganda's oldest is in advanced stages of introducing the first pre-entry exams in Africa for, not interns but, those intending to pursue Bachelor of Medicine and Bachelor of Surgery degree courses.

This is true to its Vision today, which is "A leading and transformational institution for academic excellence and innovation in health sciences in Africa". In an interview with The New Vision on June 13, 2018, the Dean of the School, Prof. Moses Kamya explained that the intention is to admit students who are "called to be doctors".

Similar exams have already taken root at the Law Development Centre without any hullabaloo, and the College of Engineering, Design, Art and Technology is mooting the same idea.

According to Prof. Kamya, the pre-entry exam will not necessarily increase the number of students joining medical school, but rather enhance diversity and equity.

In fact, medical school in Uganda has become a reserve of students from urban secondary schools who score the points required for entry, rather than those with the capabilities and genuine interest in studying the medicals.

Due to this background, many medical professionals are reluctant to serve upcountry on finishing their courses.

Cases abound of students who get maximum points at UACE but struggle at university with retakes.

According to Dr Ekwaru Obuku, the president of Uganda Medical Association, some medical doctors are even lacking in communication and other skills.

One can only imagine the outcome of such struggles on the lives of patients in the field.

The proposal to introduce pre-entry exams for the medics at Makerere University is before the University Council, the topmost decision making organ of the university, for consideration and preferably approval.

Suffice to note that a number of medical and dental schools worldwide started administering clinical tests as part of the selection process for entry into their courses more than ten years ago.

The BioMedical Admissions Test is part of the admissions process for Medicine, Biomedical Sciences and Dentistry in some universities in the United Kingdom, the Netherlands, Thailand, Spain, Croatia, Singapore, Malaysia and Hungary.

The Test assesses a wide range of mental abilities and behavioural attributes that are considered important for the medical professionals to successfully practise.

It does not require extra preparation as it concerns the skills and knowledge that candidates should already have.

Since it does not test academic ability, it does not draw on any specific areas of knowledge or from a curriculum that needs to be learnt.

In India there are even laws that operationalise the pre-entrance exams into university.

Under the Medical Council Act, 1956 as amended in 2018 and the Dentists Act, 1948 as amended in 2018, the Central Board of Secondary Education and the Medical Council of India jointly implement the common entrance test.

These laws require students who wish to undertake undergraduate medical and dental courses in government or private colleges to clear the National Eligibility cum Entrance Test (NEET).

In Australia, New Zealand, the United States, Canada and the Caribbean Islands, medicine undergraduates take the Medical College Admission Test. Free guides and resources are produced to prepare them for the test whose passing is required to apply for undergraduate admission.

In this test, students are assessed on their skills in critical thinking, problem solving, understanding people, abstract non-verbal reasoning, written analysis and knowledge of scientific concepts and principles.

These abilities are considered important to the study and later practice of medicine. The test is designed to complement the academic results, not to replace them.

The decision to start pre-entry exams for medics in Uganda is, therefore, long overdue.

There should be a body formally empowered to standardidse the exams which should be universal for all medical schools in the country, including private ones.

The eligibility criteria and tools of assessment should sieve out students who have passionately yearned to be doctors all their lives and are able to accomplish the course successfully.

In addition, the course should entail patriotism elements so that graduates do not eye jobs in urban centres only.

What needs discussion is for the university councils to rather make the application or any other fees more affordable than a rip-off cash cow and revenue generation project.

The writer is a Principal Information Officer at the Ministry of ICT & National Guidance.