Graduate entry vs undergraduate entry

In Australia, there are two methods of entry into medicine available. Some people get in straight out of high school, into a 5 or 6 year undergraduate entry program. Others get in after completing a bachelor degree first, and then complete a 4 year graduate entry medicine program. The undergraduate program has been criticized for having less mature applicants in recent times, which has lead to many universities switching from the traditional undergraduate entry in Australia to graduate entry medicine.

Undergraduate medicine gives those who are relatively sure that medicine is the right career path for them the chance to get straight into the degree, having the least amount of time required studying at university before graduating with a medicine degree. It is perhaps the most cost-effective of the options too, both for the student and the university, as the student can practice sooner and the university does not need to use as many years of resources to teach the student. So for people who are sure that medicine is right for them, this path is very good for them.

However, there are quite a number of people who claim that graduate entry medicine is much better than undergraduate entry. The reasons given are often because of higher levels of maturity due to the applicants being older and having a bachelor degree already, and perhaps more life experience too. Also, the graduate entry program has less dropouts and more diversity of applicants.

It may be the case that graduate entry applicants are more mature at the start of the medicine degree. Perhaps a lot of undergraduate entry medicine students may not be perceived mature enough to be interns at the start of the medicine degree, while graduate entry students may be. However, 5 or 6 years is a long time to mature, and it is after those years when undergraduate medicine students will be interns; not at the start of the degree. Furthermore, a range of studies have indicated that age is inversely correlated to grades at medical school. Also, it is more economical to train younger students who can practice for many years compared to older applicants who cannot do so.

Graduate entry applicants may have prior knowledge in areas such as biomedicine that can lead to a deeper understanding of the key concepts compared to undergraduate entry applicants. However, in most universities, there is no such requirement. Unless there is a requirement to have prerequisites, the prior knowledge of some applicants may not help that much, and the course will not use the full potential of the students given their prior knowledge.

It may be the case that graduate entry applicants are more mature and diverse, but at the cost of having less years of practice. The undergraduate entry is perhaps more cost effective for those who want to do medicine out of high school, but has higher dropouts. However, unless there is a need for more knowledgeable graduates, where graduate entry with prerequisites makes sense, there does not seem to be a compelling reason not to have undergraduate entry medicine.


[note: I did try to get into undergraduate entry medicine but my UMAT score was not high enough for an interview. I don't think the UMAT does its job well. However, unless graduate entry programs require prerequisites and train to a higher standard than undergraduate medicine, I don't see a compelling reason for undergraduate medicine not to exist.]

Hello, welcome to my blog.

Hello everyone. As you probably can guess from my title, I am currently going through the process of applying to graduate entry medicine in Australia. Right now, I have just completed my second year biomed exams.

Second year has been much harder than first year in terms of the core subjects. However, everything we learnt this year would be quite useful for medicine. Anyway, I think I did reasonably well and I'll get my results in a few weeks.

I plan to apply to the University of Melbourne's new "MD" medicine program as a first preference next year. This is although my best chance under the current entry criteria would be to preference UQ first, since they don't have an interview and only have a hurdle GPA which I could pass simply by passing every subject with a 50 from now on at uni (although  the UQ selection criteria is speculated to change to "GPA rank" in the future) and rank 100% by GAMSAT score. I pass this year's threshold with a high margin.

My current GPA is not bad (above average relative to people who get into medicine graduate entry), but not as high as many of my peers. My GAMSAT, although very good for most unis, has some shine taken away from it due to Melbourne's "equal weighting" of sections instead of having a double weighted science section like most unis. I'm not sure why Melbourne would think that weighting "reasoning in humanities and social science" and "written communication" on par with "reasoning in biological and social sciences" would increase predictive ability (2/3 arts weighting!!!) but I guess that's how it is.

My main concern is the interview though. It's better than in the past where Melbourne weighted the interview 100%, but I still would have liked the interview to be foregone, since the other aspects of my application are much better.

Anyway, for a view of predictability of GPA, GAMSAT and Interview, here's a study by UQ. Note that they used a panel interview though, rather than a multi-mini interview. The MMI format was designed to eliminate interviewer bias and effects due to first impressions which are hard to overcome, and "halo" effects, so that the result should be more accurate. Nevertheless, the GAMSAT and interview were not very strong predictors compared to GPA: [1]

I don't particularly like interviews being part of the selection process, although others have discussed that topic a lot. I don't particularly think that the formation of a standardized test for selecting medical school applicants is a bad thing though; I consider exams to be a "gold standard" if the exam content is right. It does seem like the MCAT in the USA has relatively good predictive ability[2]. However, I think the GAMSAT under-emphasizes the value of remembering facts in science; being a reasoning test for the most part. Of course, reasoning is a good skill to have, but I think the most difficult part of studying is remembering everything. Perhaps that is why GAMSAT isn't such a good predictor.

It would seem like the "fairest" way to select people would be to just use the GPA to rank people, and disregard GAMSAT and interview. However, there are two problems I can see with that:

1. Universities other than Melbourne do not require prerequisites for graduate entry medicine. There at least needs to be a screening test to determine if applicants have enough science knowledge to succeed in a 4-year course; less time than the 5 or 6 year MBBS courses that undergrads do.

2. Grading practices are not equal for all subjects, or degrees, or universities. University of Melbourne is trying to address this by using their MAGPA in the future, although without standardization comparing against other unis as well, this may not be as effective as it can be[3]. But without such standardization, akin to scaling in VCE or HSC, there is no real fair comparison between different degrees or simply different subjects.

Of course, another solution to improve predictability would be to make the GAMSAT more like the MCAT, although that would disadvantage people from non-science backgrounds especially. Also the high predictability of the MCAT in the USA for medical school performance is from a background where most universities require science prerequisites for medical school admission, so the predictability may not be so great in Australia where that is not the case. However, I contend that the predictability would probably be better than the GAMSAT is right now.


Anyway, that's all for now. Enjoy reading!

From nucleophilic addition-elimination