Are graduate entry programmes the answer to recruiting and selecting tomorrow's doctors?

OBJECTIVE: In the wake of the introduction of graduate entry programmes, this paper aims to promote discussion and debate on student recruitment and selection, with a view to achieving a better match between the medical student population and the health needs of the population as a whole. SETTING: Government initiatives in the UK and Australia have increased the number of medical school places, with a substantial proportion allocated to graduate entry students. In the UK, a government priority is to widen access to applicants from disadvantaged areas and lower socio-economic groups. In Australia, additional concerns for the government include ensuring medical services for rural and remote areas and improving indigenous health. At the same time, the governments in both countries are shifting costs in the direction of a 'user pays' system. OUTCOME: Graduate entry programmes represent a particular approach to minimising the effects of disadvantage, increasing the representation of students from diverse backgrounds, achieving a better match between the medical student population and the general population, and encouraging more flexible and inclusive selection and admissions policies. They also have certain disadvantages. It is possible to define a set of principles to increase the diversity of the medical school class with respect to both academic and personal qualities, whether in undergraduates or in graduate entrants. CONCLUSIONS: Graduate entry programmes can contribute to increased student diversity, but are unlikely to have much impact without other strategies to reinforce this aim. A nationwide collaboration could provide opportunities for research to establish more efficient and effective ways of selecting tomorrow's doctors.