Selection of medical students in Taiwan

Dear Sir

Physicians should be able to play the role of medical experts, communicators, collaborators, managers, scholars and advocators. To select appropriate medical students in Taiwan, since 1994 (Eva et al. 2004), entrance examinations have shifted from a single written examination of cognitive domain to multiple modalities that probed non-cognitive characteristics. We conducted a study to review the student selection methods the Taiwan medical schools have applied, and to report the related problems.

There are 12 medical schools in Taiwan. In 2010 and 2011, admission information was retrieved from school official website. Surveys asking for student enrolment size, methods applied for student selection and admission procedure were distributed to each school. A focus group of school representatives then met for validation and communication on the topics of student selection.

We identified three approaches in selecting medical students: Joint College Entrance Examination (JCEE), self-application (SA) and school recommendation (SR). For the approaches of SA and SR, multiple assessment modalities including interviews were used. The number of newly enrolled students per school ranged from 43 to 136 in 2010, and 40 to 136 in 2011, and 9.6–70.4% (mean: 41.7 ± 13.7% in 2010, and 37.9 ± 18.9% in 2011) of them were selected through interview-based procedures. The first step in removing unsatisfactory candidates was solely based on the JCEE score. In the second step, students were interviewed and the personal files were reviewed. Several medical schools used multi-mini interview (Tsai et al. 2008), with the number of interview stations ranging from two to ten. Personal files were composed of students’ scores of the Department Required Test, high school grades, extracurricular activities, awards and others. The size of candidate pool was found to be too small to allow selection in function. The participants expressed concerns on the inequality derived from the rural-urban disparity. They also indicated the system may select ‘good test takers’ rather than ‘good doctors’.

Currently in Taiwan, multiple assessment tools including interviews have been widely applied in selecting medical students. The core values underlying the selection remained the ‘cognitive achievement-based’ scores, and a ‘real change’ is deemed difficult to achieve. The problems were derived from the system, examinations and personnel training.