Thursday, 20 September 2012
Topical Issue Debate
Health Professions Admission Test Administration
The health professionals admissions test, HPAT, is not doing what it is supposed to do. It is designed to test the aptitude of potential medical students but it is not doing so in a fair and transparent manner. Some 85% of those who repeat the HPAT secure a higher score on their second attempt. I do not understand how this is possible. The HPAT system is supposed to test for personality traits. The core idea behind the test is to ensure that potential medical students have the aptitude and personality required to become top-notch doctors with suitably caring and empathetic personalities. However, students who repeat the test do significantly better after taking preparatory courses. These students do not magically receive personality transplants in the intervening; they learn how to beat the test and the system.
The test was also introduced to increase the number of boys who enter medical schools. It achieved its aim in its first year but girls are now outscoring boys again. In the second part of the test, which focuses specifically on empathy, girls are outscoring boys. It has also given an unfair advantage to those who can afford expensive preparatory and repeat courses. It has simply become a revenue generator for course providers. I concur with the Institute of Guidance Counsellors that the test is adding yet another financial barrier to students who hope to embark on a career in medicine. One institute offering a HPAT preparation course charges a standard rate of €625 for a platinum package which supposedly includes two full days of quality preparation from an expert educator.
The recent report by the review team of experts in medical education indicates those who can afford expensive preparatory and repeat courses do 10% better on the test. It is estimated that more than 50% of HPAT candidates take these expensive coaching courses. Instead of broadening the type of doctors Ireland produces we are in danger of restricting the profession to those who come from the higher echelons of society. It is wrong and unfair that a student who studies hard, makes sacrifices and gets 635 points in the leaving certificate examination cannot enroll in his or her course of choice, as happened this year. Students with six A1s in relevant subjects such as biology, chemistry and physics cannot get into medical school but a student who has a C1 in biology may do so if he or she paid for a cramming course.
Many students take up a college course in a related field while they are learning how to beat the test and leave the course after the first or second year once they successfully fool the HPAT. In 2010, 111 students vacated another third level course in Ireland to accept a place in medical school. This has financial repercussions for the State.
I thank Deputy Mitchell O'Connor for raising this matter. The determination of selection criteria and processes for admission to medical schools is a matter for the universities and the medical schools in line with their statutory autonomy in academic affairs. A new entry process for admission to medical schools was introduced in 2009 on foot of a recommendation of the Fottrell working group on undergraduate medical education and training. The report of the Fottrell working group formed the basis for a programme of wide ranging reform and expansion of medical education and training in Ireland. These reforms also provided for an increase in the number of undergraduate places from 305 to 485 and the introduction of a new graduate entry medicine programme with 240 places annually.
The report recommended that leaving certificate results should no longer be the sole selection method for entry to medical education at undergraduate level and that a two stage mechanism should be applied consisting of the results obtained in leaving certificate and a standardised admissions test which would assess non-academic skills and attributes regarded as important for the practice of medicine. The new entry mechanism, which was introduced by the medical schools in 2009, is based on a combination of leaving certificate results and performance in an independent admissions test, HPAT, designed to measure students' problem solving, understanding and reasoning skills.
At the outset the medical schools committed to a review of the new entry mechanism within three years of its introduction. On foot of this commitment, a national research group evaluating revised entry and selection mechanisms to medicine was convened under the auspices of the council of deans of faculties of medical schools in Ireland in 2009. The research group comprised representatives from the academic medical education staff of each medical school, university admission officers and the Central Applications Office. Several international medical education experts have advised the group and continue to do so.
The research group has undertaken a comprehensive evaluation to determine the educational impact, reliability, validity and stakeholder acceptability of the new entry and selection approach. An interim report has recently been completed by the group and is due to be published on the websites of the medical schools in the next few days. I have been advised that the findings of the report of the research group will now be considered by the academic councils in the five institutions concerned. Approval of the academic councils would be required for any possible modifications to the operation of the admissions test.
I have listened to the Minister of State's contribution but I continue to question the validity of the HPAT. I understand it has been recommended that students will only be allowed to sit the test once. In the interest of students who are currently studying for the leaving certificate or are cramming to resit the test, I urge that a decision be made to allow them to resit the test.
The test needs to be phased out or at least amended so that it is fit for purpose.
I draw the attention of the Minister of State to the following actual example. Three leaving certificate students all have higher mathematics in their top six subjects. Not including extra mathematics points, student A achieves 525 points, student B achieves 550 points and student C achieves 600 points. Adding the extra mathematics points, student A will have 550 points, student B will have 575 and student C will have 625 points, a perfect leaving certificate. With the introduction of HPAT, every five points over 550 is worth one point. Thus, student A achieves 550 points, student B has 555 and student C is reduced to 565 points. The system reduces the gap between 525 and 625 points to 15 points. This dismisses the months of work to achieve the difference between these two scores.
I urge greater transparency in our education system. Project Maths skewed the leaving certificate results this year. Some will say more students did honours and that 97% of them passed the paper. If students attempted all sections of the honours paper this year they achieved 49% of the total mark. In 2010, students who attempted all sections of the paper scored 38% of the overall mark. In Scotland, for example, the pass rate for students aged 18 on the advanced level mathematics paper was 66%. Ours was 97%. There is something glaringly wrong with our HPAT tests and with the correction of the Project Maths papers of June 2012.
With all due respect to her, I ask Deputy Mitchell O'Connor for the courtesy of allowing me respectfully to respond to her query. I would be happy to engage with her on the issue of Project Maths, knowing that she has made some quite vociferous statements in the last month or so regarding Project Maths. The offer is there for her to engage further on the issue of Project Maths. Is that fair enough?
As Minister of State with special responsibility for STEM and Project Maths, I am happy to sit down with her myself in that regard.
I have not seen the findings of the report of the research group. As I have indicated, the report is expected to be published within the next few days. I have not seen the report but Deputy Mitchell O'Connor suggests she has already seen some of its recommendations.
The report will be submitted to the academic councils of the institutions concerned for consideration. It is understood that the report will be considered by the academic councils before the end of the year, most likely in November or December. The implementation of any changes will be a matter for the institutions and their medical schools.
More generally with regard to third level entry mechanisms, the Minister for Education and Skills has also received an interim report from the Irish Universities Association of their consideration of recommendations in the NCCA-HEA transitions report which was published last September. The universities have also established a task force to develop more specific proposals regarding changes to the entry criteria for third level programmes, which is also expected to consider issues relating to high points courses such as medicine. The task force is expected to complete this work by the end of the year.
I respect the fact that the Deputy has raised these issues. Concerns are being brought to her attention and she has articulated them in the House. I am sure the Minister and I would be delighted to engage with her further on the question of Project Maths, or at least have officials engage with her. I am sure the Minister would be happy to sit down with her to discuss this area.