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Medical school selection is a sociohistorical embedded activity: A comparison of five countries.

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Title: Medical school selection is a sociohistorical embedded activity: A comparison of five countries.
Authors: Cleland, Jennifer, Blitz, Julia, Amaral, Eliana, You, You, Alexander, Kirsty
Source: Medical Education. Jan2025, Vol. 59 Issue 1, p46-55. 10p.
Subjects: School environment, Diversity & inclusion policies, Socioeconomic factors, Equality, School entrance requirements, Race, Experience, Students, Medical schools, Student rights, Social values, Student attitudes, Interpersonal relations, Practical politics, Honesty, Social classes, Values (Ethics)
Geographic Terms: Singapore, Brazil, South Africa, United Kingdom, China
Abstract: Introduction: The medical school selection literature comes mostly from a few countries in the Global North and offers little opportunity to consider different ways of thinking and doing. Our aim, therefore, was to critically consider selection practices and their sociohistorical influences in our respective countries (Brazil, China, Singapore, South Africa and the UK), including how any perceived inequalities are addressed. Methods: This paper summarises many constructive dialogues grounded in the idea of he er butong (和而不同) (harmony with diversity), learning about and from each other. Results: Some practices were similar across the five countries, but there were differences in precise practices, attitudes and sociohistorical influences thereon. For example, in Brazil, South Africa and the UK, there is public and political acknowledgement that attainment is linked to systemic and social factors such as socio‐economic status and/or race. Selecting for medical school solely on prior attainment is recognised as unfair to less privileged societal groups. Conversely, selection via examination performance is seen as fair and promoting equality in China and Singapore, although the historical context underpinning this value differs across the two countries. The five countries differ in respect of their actions towards addressing inequality. Quotas are used to ensure the representation of certain groups in Brazil and regional representation in China. Quotas are illegal in the UK, and South Africa does not impose them, leading to the use of various, compensatory 'workarounds' to address inequality. Singapore does not take action to address inequality because all people are considered equal constitutionally. Discussion: In conclusion, medical school selection practices are firmly embedded in history, values, societal expectations and stakeholder beliefs, which vary by context. More comparisons, working from the position of acknowledging and respecting differences, would extend knowledge further and enable consideration of what permits and hinders change in different contexts. Authors from 5 countries offer guidance on how medical school selection reflects the history and values surrounding our institutions in an effort to foster understanding and change. [ABSTRACT FROM AUTHOR]
Copyright of Medical Education is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Medical school selection is a sociohistorical embedded activity: A comparison of five countries.
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  Data: <searchLink fieldCode="JN" term="%22Medical+Education%22">Medical Education</searchLink>. Jan2025, Vol. 59 Issue 1, p46-55. 10p.
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  Data: <searchLink fieldCode="DE" term="%22Singapore%22">Singapore</searchLink><br /><searchLink fieldCode="DE" term="%22Brazil%22">Brazil</searchLink><br /><searchLink fieldCode="DE" term="%22South+Africa%22">South Africa</searchLink><br /><searchLink fieldCode="DE" term="%22United+Kingdom%22">United Kingdom</searchLink><br /><searchLink fieldCode="DE" term="%22China%22">China</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Introduction: The medical school selection literature comes mostly from a few countries in the Global North and offers little opportunity to consider different ways of thinking and doing. Our aim, therefore, was to critically consider selection practices and their sociohistorical influences in our respective countries (Brazil, China, Singapore, South Africa and the UK), including how any perceived inequalities are addressed. Methods: This paper summarises many constructive dialogues grounded in the idea of he er butong (和而不同) (harmony with diversity), learning about and from each other. Results: Some practices were similar across the five countries, but there were differences in precise practices, attitudes and sociohistorical influences thereon. For example, in Brazil, South Africa and the UK, there is public and political acknowledgement that attainment is linked to systemic and social factors such as socio‐economic status and/or race. Selecting for medical school solely on prior attainment is recognised as unfair to less privileged societal groups. Conversely, selection via examination performance is seen as fair and promoting equality in China and Singapore, although the historical context underpinning this value differs across the two countries. The five countries differ in respect of their actions towards addressing inequality. Quotas are used to ensure the representation of certain groups in Brazil and regional representation in China. Quotas are illegal in the UK, and South Africa does not impose them, leading to the use of various, compensatory 'workarounds' to address inequality. Singapore does not take action to address inequality because all people are considered equal constitutionally. Discussion: In conclusion, medical school selection practices are firmly embedded in history, values, societal expectations and stakeholder beliefs, which vary by context. More comparisons, working from the position of acknowledging and respecting differences, would extend knowledge further and enable consideration of what permits and hinders change in different contexts. Authors from 5 countries offer guidance on how medical school selection reflects the history and values surrounding our institutions in an effort to foster understanding and change. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Medical Education is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1111/medu.15492
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      – Code: eng
        Text: English
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        PageCount: 10
        StartPage: 46
    Subjects:
      – SubjectFull: School environment
        Type: general
      – SubjectFull: Diversity & inclusion policies
        Type: general
      – SubjectFull: Socioeconomic factors
        Type: general
      – SubjectFull: Equality
        Type: general
      – SubjectFull: School entrance requirements
        Type: general
      – SubjectFull: Race
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      – SubjectFull: Experience
        Type: general
      – SubjectFull: Students
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      – SubjectFull: Medical schools
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      – SubjectFull: Student rights
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      – SubjectFull: Social values
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      – SubjectFull: Interpersonal relations
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      – SubjectFull: Practical politics
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      – SubjectFull: Honesty
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      – SubjectFull: Social classes
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      – SubjectFull: Singapore
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      – SubjectFull: Brazil
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      – SubjectFull: South Africa
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      – SubjectFull: United Kingdom
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      – SubjectFull: China
        Type: general
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      – TitleFull: Medical school selection is a sociohistorical embedded activity: A comparison of five countries.
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              Text: Jan2025
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