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Only the best: medical student selection in Australia

To the Editor: I share Mahar’s concern regarding any future screening of prospective medical students for signs that they are likely to develop mental or physical impairment.1 Although Wilson and colleagues do acknowledge that screening may not be ethical, the separate issue of their seeming conflation of likelihood of illness with impaired ability to practise in the long term is problematic.2 Mental illness, and particularly depression and anxiety, are common disorders in medical students.3

Even in the context of medical schools’ “fitness to practise” procedures, which Wilson et al consider more practical, it is important that criteria and processes for removal of students are not so broad that they can be applied selectively. Further, the tendency for the medical mind to seek to eliminate personified risk factors of future problems should be resisted; further research may not be “paramount”.2 It is not the possibility or probability of developing later illness that matters (dark actions wait at the end of that uncertain path) — individuals should be judged on the acts that demonstrate potential harm to patients.

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