Until now, the average high school grades are announced whether an applicant is suitable for studying medicine or not. Due to the high number of applicants, the universities/colleges were forced to set their performance limits extremely high. Applicants to medical studies only had a chance of direct admission if they had a grade average of 1.1. Until now, anyone who achieved a lower average high school grade could only hope for admission via the waiting period or with the help of the university selection process.
When you see this, you can hardly imagine that these conditions exist in a country with a huge shortage of doctors. For this reason, the admission process and the course of study itself were reformed with the 2023 Master Plan. This master plan came into force on December 31, 2019 and has changed the entire medical course from admission to the practical year.
What changed as a result of the 2023 master plan?
- Introduction of a state study aptitude test with free and repeatable participation
- Introduction of teaching offerings and support programs with an insight into general medicine
- Introduction of a uniform, transparent selection process with only one quota. The following criteria should be taken into account in the selection process:
- Result of the subject-specific study ability test
- High school grade
- completed vocational training
- Voluntary services e.g, Voluntary social year
- Abolition of partial study places
- Abolition of the waiting time quota
- Establishment of general medical chairs
- Changed allocation of study places: 10% of study places should be allocated to students who undertake to practice in a country doctor’s office for at least 10 years
Changed allocation of study places
In 1977 it was stipulated that the waiting period must not exceed the duration of the course of study. So far, the demand for medical study places is so high that the waiting time would usually be around 14 semesters. This exceeds the standard period of study by at least one year. With the master plan in 2023 and the new reform, the waiting time quota has now been replaced by the additional suitability quota.
Another topic that deals with the allocation of study places is location preference. Previously, applicants were allowed to specify a maximum of six desired university locations in descending order of preference on the application and information portal. The problem was that some universities/colleges only accepted applicants who classified the respective university/college as their first location preference when applying. Because it was not possible for applicants to fill their first location preference twice, some universities/colleges were unfortunately no longer eligible for an application. This regulation was abolished with the reform.
Nowadays, whether an applicant is admitted to medical school or not is still extremely dependent on the average grade. Unfortunately, this criterion is not very meaningful, as the high school grade does not provide any information about the applicant’s personal skills and talents. In addition, the high school exams in the various federal states differ in their level of difficulty and therefore the grades are not comparable.
In order to prevent this scenario in the future, a subject-specific study aptitude test will be introduced with the Master Plan 2023. This is where students will need UCAT tutoring and it should be offered free of charge and several times a year. In order not to rule out that the examinee’s well-being or daily moods influence the test results, the test should be repeatable. In addition, so-called state lists will now be created for the high school average grades, which allow applicants from their own federal state to compete. All 16 country lists are then combined into a federal list, which takes into account the population size of the states and thus ensures compensation for disadvantages.
Once the master plan comes into force, there will only be one quota for all applicants in the selection process. The process is currently divided into three quotas (the best high school quota, the university selection process and the additional aptitude quota, but by applying you automatically take part in all three quotas. In the future, the sole quota will take into account the following criteria: the results of the subject-specific study aptitude test, the average high school grade, completed vocational training and completed voluntary service, e.g., the Voluntary Social Year.
Since the profession of doctor requires much more than “just” scientific understanding and discipline, social and communication skills, quick comprehension and empathy should also be taken into account when applying in the future. However, the number of study places cannot be increased due to the reforms of the master plan and the prevailing shortage of doctors. The reason for this may be the cost. A single study place in the field of human medicine costs the state over $200,000 for the entire course.
Strengthening general medicine
The density of doctors in rural areas has decreased significantly in recent years. This represents a huge problem, especially for the rural health system. A reform should help against this. The 2023 master plan stipulates, among other things, that 10% of all study places should be awarded to applicants who commit to working in a country doctor’s office for at least ten years.
Currently, students very rarely choose the area of general medicine as their specialization. In order to make studying general medicine more attractive for students, there should be integrated courses in cooperation with other teaching subjects. In addition, support programs and elective offers are being developed that give students an insight into the work of a general practitioner.
An attempt is also made to give students a little more insight into general medicine during the last two semesters of their medical studies. In the future, one of the three terminals in the practical year (PY) should be required as an outpatient terminal in general medicine. But it is also possible that it replaces the mandatory terminal in surgery or internal medicine.
More practice within medical studies
Within the standard course of study, students can only apply their theoretical knowledge from the fifth semester onwards, apart from the nursing internship. This significantly reduces students’ motivation in the first semesters of their studies. At some universities/colleges, the so-called model course of study is offered with the 2023 master plan. Here students can gain real practical experience from the first semester onwards. The hurdle in the form of the physics exam is also eliminated with this type of course.
It is not yet clear how exactly medical studies should be made more practice-oriented. In order to increase the quality of medical professionals in the USA, students should work more on their communicative and social skills during their studies and generally gain a stronger connection to reality. Digitalization should also play an important role in the further development of medical studies.
How medical studies will continue to change in addition to the reform for the distribution of study places due to the 2023 master plan will remain to be seen in the future. We hope that this will improve the shortage of doctors in the USA and that many young people will have the opportunity to study in an exciting way.