Do exams maketh man?

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Today, getting a place to study a clinical subject (medicine, dentistry, and veterinary science) requires the candidate to achieve very high grades in the state university entrance exams (the ‘A Levels’). Grades lower than A or A* (the highest) greatly reduce a candidate’s chances of obtaining a place on a course to study for any of these three professions.

Note: in the A Levels, the top grade is A or A*, the lowest is E. Thus, A is better than B, and B beter than C … and so on

In 1969, I applied to study physiology at University College London (‘UCL’). In those days, most departments at the college required applicants to attend an interview session before they gave the candidate an offer conditional on the person achieving specified A Level grades. The Physiology Department invited prospective students to spend a whole day at the college. I turned up, not knowing what to expect.

During my day at the department, I was interviewed one-to-one by two different sets of staff members. They did not ask straightforward questions that could be answered if you had learnt the A Level syllabus by rote. For example, I was asked: “What would limit the size of the largest insect?” This is not something covered by the A Level syllabus. To answer this, I had to think ‘out of the box’, using my knowledge of insect anatomy and physiology. Another interviewer asked me about my hobbies. One of them was, and still is, collecting maps. “How interesting,” the questioner answered a bit dubiously, “It is also my hobby. What exactly interests you about maps?” I cannot remember my answer, but it seemed to satisfy him.

In addition to these intimate interviews, there were group sessions, during which small groups of candidates discussed topics with some of the academic staff. We were also given coffee, lunch, and tea. At each of these refreshment breaks, we mingled with students and academic staff, all of whom engaged each of us in conversation. By the end of the day, the members of the department must have gained a fairly detailed impression of the candidates they had met.

After a few days, I received a letter (there was no email in 1969) offering me a place conditional on my achieving at least three E grades (lowest grade of pass) at A Level. The Physiology Department and others at UCL made this kind of ridiculously low offer if they wanted a candidate. They knew from the extensive interview process what kind of student they were going to get and did not want him or her to have to worry about achieving high grades. Of course, they preferred their students to obtain high grades at A Level, and we all did. They would have accepted us with lower grades, but this was rarely necessary. Most of the graduates of the Physiology Department eventually moved on to completing higher degrees (masters and doctorates).

Until the early 1980s, candidates wishing to study dentistry or medicine were interviewed and offered places providing they achieved a minimum of C grades in their A Levels.

During the 1970s, I became friendly with someone who used to interview prospective dental students at UCL. She sat on an interviewing panel with the then Dental Dean, Mr Prophet, and another senior dental clinical academic. Each candidate was asked about aspects of his or her life, anything to get them talking. Each candidate was also asked whether they either played a musical instrument or did some kind of handicraft (for example sewing or model-making). Anyone who did either of these things was likely to be sufficiently dextrous to be able to practise dentistry. After the candidate left the room, the interviewers asked themselves only one question, providing the youngster they had just seen had satisfied them that he or she was dextrous. The question they asked themselves was: “Would we be comfortable being treated by him or her?”

Candidates, who had satisfied the interviewing panel, were offered places on the dental course conditional on them achieving mid-range grades at A Level: three grade Cs. The admissions panel were quite lenient. If someone they wanted under-achieved at A Level, say they only manged to get two Cs and one D, they admitted the candidate. It is worth noting that of all the dental schools in London at that time, that at UCL produced a higher proportion of dentists who went on to become dental academics than any of the other dental schools, all of which asked for students to achieve grades higher than Cs for admission.

I qualified as a dentist in March 1982. A couple of years later, I re-connected with ‘Mr G’, the technical tutor, who taught me the art and science of removable prosthetics (i.e. making dentures). I used to see him regularly because he carried out some prosthetic laboratory work for my patients.

In the mid-1980s, things had changed at UCL. To gain admission into the dental course, candidates were required to achieve top grades (all As) at A Level. The first year of the dental course was then, as it had been in my time, not clinical: it was taught in departments other than those in the Dental School. The subjects studied were academic (rather than clinical): biochemistry, general anatomy, physiology, and special dental anatomy. In the second year, the students moved into the Dental School, where they began clinical their studies on patients without teeth – in the Prosthetics Department, which is where I first met Mr G.

During the second year, we burnt our fingers and got covered with plaster of Paris while making dentures for our toothless patients. We also studied dental materials, both practically in the lab and theoretically in the lecture theatre. The materials course involved some essay writing, as did most of the other courses we had to take. Nobody in my class year struggled over these. We might have resented spending time on them, but we managed.

One day in the mid-eighties, by which time all the students in the second year of the dental course had achieved high grades at A Level, Mr G told me something that surprised me. He said that many of the students entering the second year, were incapable of writing essays. So much so, that the Prosthetics Department had to put on a course of essay-writing to teach these high achievers how to write. Worse than that, when the students were told to look up things in the library, they turned around to Mr G and said things like: “Why should we? You do it. You’re paid to teach us.”

With such an arrogant attitude, how were these people going to handle the often-nervous patients in their dental chair?

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When our daughter and her class-mates applied for (non-clinical) undergraduate studies, the criterion for getting considered at all, was predicted A Level grades. If the predicted grades were low, universities would not even begin to consider a candidate. If they were high enough, then the chances of being given a conditional offer increased. Few universities bothered to interview candidates. They tended to rely on grade predictions, teachers’ reports, and ‘personal statements’ written by the candidates. It is said that a picture is worth a thousand words. I would say that a face-to-face interview  far more  valuable than any grade predictions or ‘personal statements’ as a means of selecting people seeking admission to a university, or even a job.

Photographs of students in Coimbra (Portugal), taken by Adam Yamey

Why I practised dentistry

UCL 1 University College London Portico

University College London Portico

I retired from dentistry exactly one year ago. This is how I got started 36 years ago…

I began studying dentistry after I had completed my PhD in physiology in 1976. My original intention was to obtain a clinical degree so that I would be able to widen the choice of post-doctoral opportunities beyond the field of specialisation relating to my doctoral thesis.

I entered the dental school at University College London (‘UCH’) ‘armed’ with a doctorate. There were two kinds of teaching staff at the school. The academic staff were attached to the University and the clinical ‘demonstrators’ were dentists who came into the hospital on a part-time basis to assist with teaching in the clinics where the students learned to treat patients. All the demonstrators used to address me as ‘Doctor Yamey’, but the academic staff, many of whom did not have PhDs, used to address me as ‘Mister Yamey’.

At the end of each course we studied, we would have to pass an examination. This consisted of a written paper along with a practical examination. All of the examinations included a face-to-face spoken test, a ‘viva-voce’ (or ‘viva’).

During my pharmacology viva, I was asked several questions by a pair of examiners. One of the examiners told me that I had answered one question incorrectly. I was sure that I had answered correctly, so I said: “I am certain that what I have said is right.” The two examiners looked at each other, and I began to worry. Then, the examiner who had not contradicted me said: “You know, he’s right.”

During another viva, the task was to look at a microscope slide, and then to comment on it to the examiners. When I had looked at the slide, I turned to examiners, and thought I heard one of them saying: “Where is it from?” Absentmindedly, I said: “It’s an unusual surname. It originates from Lithuania.” I had thought that I was being asked about my name, rather than the slide. Fortunately, I was able to give a satisfactory account of what I had seen under the microscope.

At the end of the first year, we were examined in general human anatomy. I entered the room where my viva was being held and sat down with the two examiners. One of them, an external examiner, said to me: Do you remember me?” I looked at him blankly before he said: “I used to meet you walking on Hampstead Heath with your parents. Please give them my regards.” At that moment, I knew that I had passed the examination.

The final year examinations, which determined whether you would or would not be awarded a degree in dental surgery were quite harrowing. Most people considered that the viva conducted by the dean of our dental school and a dean visiting from another dental school was the most frightening part of the finals. And, when I took the finals, we learnt that the visiting dean, the external examiner, had a fearsome reputation. So, I was somewhat nervous when I entered the room to face the deans. After answering a couple of questions evidently satisfactorily, the dean of our dental school said: “Well, of course we’re looking forward to you joining our staff when you qualify…” At that moment, I realised that I must have qualified.  I said that during the five-year dental course, I had discovered that I enjoyed treating patients, and that I would enter practice rather than academia.

One of the many things that appealed to me about practising dentistry is the constant contact with a huge variety of people. This is not the case in academic research. It can be a lonely business. The other appeal of practising dentistry is that often, but not always, a problem can be identified and solved. Someone loses a filling. The dentist replaces it: problem solved. In academic research, as each question begins to be solved, many others present themselves: it is never-ending.