Chapter 5: Discussion of the findings of the study
5.2 The factors related to access to health sciences education in universities
5.2.4 Health sciences sets the bar
As a result of the competitive admission to health sciences education in South Africa, Faculties of Health Sciences are able to set the admission standards to admit the highest qualified students irrespective of considerations of disadvantage. This is enshrined in the law where the Higher Education Act 101 of 1997 allows for the higher education
institution to determine the admissions criteria in consultation with the institutions Senate.
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The Act does make reference to appropriate measures for redress of past inequalities and that no institution may unfairly discriminate against anyone. In the current study, one subcategory emerged out of this category, namely, matriculation scores and other criteria.
5.2.4.1 Matriculation scores and other criteria
Participants in this current study reported a variety of admission criteria which included matriculation scores (National Senior Certificate (NSC) and the previous Senior Certificate (SC)) together with interviews and National Benchmark Tests (NBT`s). It has been shown that high matriculation scores is one factor associated with academic success and in some research has been shown to be the most influential factor (Naidoo, Motala & Joubert, 2013; Mills, Heyworth, Rosenwax, Carr & Rosenberg, 2009). However in the South African context of varied school experience and the need to address inequities of the past matriculation (NSC and SC) scores alone are inadequate (Naidoo, Flack, Naidoo &
Essack, 2012). These authors do suggest that matriculation subject results are a valuable tool in the selection and admission of first year health science students (Naidoo, Flack, Naidoo & Essack, 2012). All the universities, with the exception of one which used 5 academic subjects, use National Senior Certificate (NSC) results of six subjects which includes some compulsory subjects such as mathematics, life sciences, English, which they translate into points and then a variety of other criteria are used with these results, in- person interviews and standardized tests such as the National Benchmark Tests (NBT`s) amongst others. Three of the universities who participated in this study reported using a quota system of admissions in order to give priority admission to designated groups of students, for example, Black students and those from Quintile 1 & 2 schools, language (50% English speaking and 50% Afrikaans speaking irrespective of race), and an
allocation for students from Southern African Development Countries. Quintile ranking of schools is a South African Department of Basic Education ranking which categorises
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schools from 1 to 5 depending on their poverty ranking. The poorest schools are included in quintile 1 and the more affluent in quintile 5. The universities which made efforts to enable educationally disadvantaged students to access health science education were also those who had made transformation explicit in their mission statements.
Reid & Cakwe (2011) in a study done on the contribution of South African curricula to prepare health professionals for working in rural or under-served areas in South Africa reported that only two Faculties of Health Sciences explicitly mentioned, in their mission statements, the training of previously disadvantaged students. Medical schools have been criticised for targeting the academically brightest students rather than those who have potential and the government then sends deserving students to Cuba to study – this suggests that the values and practices of some medical schools is at odds with the
principles of transformation. The initiative of the South African government to send Black South African students to study medicine overseas is in response to the dire shortage of medical doctors in the country and the limited number of opportunities to train doctors at local universities (Hammett, 2007). The effectiveness of this strategy has not been evaluated. The money spent on sending these students overseas might be better spent in capacitating the local universities so they are able to increase student numbers.
Standardized testing such as the National benchmark tests (NBT`s) are used to supplement NSC scores by many faculties of health sciences and were reported to be important to very important in access by 61% of those who participated in this study. The National
Benchmark Tests are a South African battery of tests used by higher education institutions to assess academic readiness of prospective first year university students as an adjunct to the NSC scores. An Australian study which looked at the predictive validity of the
undergraduate medicine and health sciences admission test (UMAT) for medical student`s academic performance found that the UMAT did not have useful validity in predicting
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academic performance at university (Wilkinson, Zhang & Parker, 2011). These authors thought it could be because the students selected into medicine were highly selected and high performing and so perform very well on the UMAT (Wilkinson, Zhang & Parker, 2011). NBT`s are useful when making decisions about whether students should be placed in extended programmes and what additional support is needed, just one of the initiatives in an arsenal of student support services. In the context of poor schooling there might be more students who need extra curricula support that those who don’t and so higher education needs to develop other strategies to deal with the large numbers of under prepared students. Reid & Cakwe (2011) described the use of the Health Science Placement Test which they say is used by most faculties and is aimed at identifying potential rather than absolute ability however in the current research no participant mentioned the use of these tests.