James Myburgh explains how race requirements influence admittance to study medicine (2007 article)
Race is steadily reclaiming its centrality in South African life, as the African National Congress government endeavours to make all "all centres of power and influence" reflect the country's demographics. What this means for 2006 matriculants is that the ease of admission to the more desirable university courses this year will have been heavily influenced by their particular racial classification. This is evident from the admissions policies of the different medical schools in the country.
The medical faculties have, since the late 1990s, been under pressure from the Minister of Health to make the racial composition of their first year intake to medicine conform to that of society as a whole. The ‘historically black' medical schools of the University of Kwa-Zulu Natal, Limpopo (Medunsa), and Walter Sisulu University (Transkei) currently limit the numbers of non-black students to a small and in the latter two cases, nominal, minority. Most other medical schools are attempting to meet certain racial targets set by the Minister of Health, and have adapted their admissions policies accordingly.
Professor Letticia Moja Dean of the Faculty of Health Sciences at the University of the Free State says that the Minister of Health had initially set a target of 70% of the intake to medicine to be Black (African) and Coloured. However, a series of meetings were then held between the Deans of the different medical schools and the Ministers of Education and Health in 2003 and 2004. At these meetings a target was negotiated whereby the second year class in every medical school had to be at least 65% Black/Coloured by 2007. In 2006 after the admissions figures made clear that this target was not attainable by 2007, it was extended to 2008.
The means by which implementation is monitored is that medical schools have to reply through their dean to the committee of medical deans that has to report back to the minister. They also submit detailed statistics of their first year intake to the department of health once the registration process is complete. (See Table 1 for the 2006 figures).
There seems to be a concerted effort by most of the ‘historically white' medical schools to meet these targets - whether out of anticipatory compliance or ideological commitment. Nonetheless, it is unlikely that they will be attained by 2008 due to the continued shortage of ‘suitably qualified' black and coloured applicants. The medical faculties continue to require that all applicants meet their minimum selection criteria - and as a result racial targets are not always met.
When initially approached many of the medical faculties denied that they were operating ‘quota' systems. But whether this is true or not really comes down to a question of semantics. For instance, in 2006 UCT set down a specific number of places for each of the four racial groups for entry into first year medicine, which it met. It says however that these were "guidelines" and therefore not "quotas". The Oxford English Dictionary meanwhile defines a "quota" simply as "the part or share which is, or ought to be, contributed to a total sum or amount."
In order to meet targets candidates are placed into separate applicant pools according to which race they belong to. Candidates then have to compete for a certain number of places, allocated to their group, with others from the same racial category. What this means in practice is that Black and Coloured applicants need only meet the minimum requirements for entry to be offered places. The places left open for white and Indian applicants are, by contrast, heavily over-subscribed. This means, broadly speaking, that while for entry into medical school those classified as ‘Black' and ‘Coloured' can gain acceptance to medical school with B or C aggregates and passes in mathematics and science, those classified as ‘White' or ‘Indian' usually need A aggregates before they are considered for admission.
The underlying reason why these targets are proving difficult to attain - and why they require fairly drastic discrimination against Indian and White applicants - is due to the very poor quality of government school education in the townships and rural areas. As a result there is an acute shortage of black pupils with good passes in higher grade mathematics and science.
Despite the likelihood that many of the medical schools will fall short of the racial targets set by the Minister of Health in 2008, there has been a radical shift in the racial composition of first year medicine since the end of apartheid. In 1991 of 1170 students in first year medicine 72% were White, 16% Black, 10% Indian and 3% Coloured. In 2006 out of a total of 1447 first year medical students, 46.5% were Black, 14.1% Indian, 9.7% Coloured and 29.7% White.
The Department of Health continues to insist that full ‘demographic representivity' (i.e. conformity to the racial proportions of the population as a whole) remains its ultimate objective - so it is very possible that if and when the current racial targets are eventually reached, they will be revised upwards again. If this principle was ever fully applied to the first year intake to medicine the proportion of places permitted Whites and Indians would be limited to 9.6% and 2.5% respectively.
Table 1: Admissions to medicine by race 2006
Source: Department of Health
Individual policies of the different medical faculties (not including Limpopo and Walter Sisulu University)
Most of the medical schools no longer just use the matriculation results to evaluate candidates. The Health Science Placement Tests and non-academic personal reports are used as well. The minimum criteria for acceptance to the MBCHB degree also differ from faculty to faculty. Many of the medical schools also accept a cohort of older students to study medicine who have already completed some tertiary education.
University of Cape Town
UCT has put in place the most stringent racial targets of all the ‘historically white' medical schools. In 2006 and 2007 of the 163 places available in first year medicine to school leavers 60 places were reserved for Black, 32 for Coloured, 22 for Indian, and 49 for (effectively) white, applicants. These targets were met in 2006.
UCT's Admissions Policy and Selection Criteria for 2007 states that for a reasonable chance of entry into first year medicine Black and Coloured students would need 39 points (for instance, 3B's and 3C's) while White and Indian students would need 47 points (five A's and a B). In addition, other mechanisms are used to rank applicants within each group - including the Health Science Placement Test and a personal report in the case of Indian and white applicants.
UCT also aligns itself with the goal of complete demographic representivity. In response to a query from Moneyweb it stated that: "The University Council, which is responsible for admissions policy, believes that over time classes will be broadly representative of the national population as a whole. In the short to medium term admissions targets will move towards this goal.... Our Health Sciences Faculty recognizes that, ideally, the demographics of our MBChB class should be broadly representative of the South African population. We do our best to improve the profile of our first year class every year, and generally make offers to as many as possible Black and Coloured applicants who qualify for offers."
Minimum matriculation requirements: All applicants must have received a matriculation exemption and passed Mathematics and Physical Science with at least 40% (E) at higher grade or 50% (D) at standard grade to be eligible for consideration. UCT says that these (or the equivalent) minimum criteria for Mathematics and Physical science were introduced when the medical degree at UCT was first offered in 1912.
University of Kwa-Zulu Natal
After numerous requests over a period of several weeks for information on the NelsonRMandela School of Medicine's admissions policies was eventually referred to Professor Nceba Gqaleni, the Deputy Dean. He referred the query on to the Registrar, Dr Edith Mneney. Moneyweb was then told that it would have to submit an access to information application, if it wanted the figures.
It is not quite clear why UKZN is so reluctant to provide this information (which it has easily at hand) for it has often done so previously. The University of Natal has used a quota system to select students since at least the early 1990s. In the 1993 intake 60 of 120 places were reserved for Black students, 55 for Indian students and 5 for Coloured students. In 1999 it was reported that the racial targets had been revised to 69% Black, 19% Indian, 9% Coloured and 3% White. The medical school defended itself from accusations of racism on the basis that these were targets, rather than rigid quotas, and in reality more Indian than black students had been admitted to first year medicine in 1999. See Table 2.
UKZN stated last year that it continued to operate a quota system in admissions to medical school, with the top applicants in each racial category being selected. From the 2006 figures for admissions it is seems that the racial targets have been slightly amended from 1999, but are now being fully implemented.
Table 2: Admissions to medicine at UN (1999) and UKZN (2006)
Minimum matriculation requirements: Matriculation exemption. No specific subject requirements for entry, although some subjects (such as maths and science) receive greater weight than others.
University of the Free State
The policy of the medical school of the University of the Free State is to try and meet the 65% target set by the National Department of Health by offering places to Black and Coloured applicants who meet the minimum criteria.
If the medical school falls short of the target it is because there is a limited pool of Black and coloured applicants who meet these minimum criteria. And even if the medical school is able to get quite close to this target in terms of offers -- applicants apply to a number of different medical schools so often don't take up places.
Minimum matriculation requirements: For school leavers these are matric exemption and a M-Score of 36 (e.g. 6 C's at higher grade), a C symbol on higher grade for English or Afrikaans (whichever is the language of tuition), and two science subjects with a C on higher grade or a B on standard grade.
University of Pretoria
The University of Pretoria medical faculty states on its website that "The National Department of Health has set targets according to which the profile of the selected students has to reach an increasing representation of previously disadvantaged individuals."
"Black and Coloured applicants are collectively regarded as previously educationally deprived applicants and are evaluated in separate sub-categories of the main categories scholars and students."
Minimum matriculation requirements: For Afrikaans or English, maths and science a "no less than C" at higher grade is required. The minimum point score for Coloured and Black applicants is 22 (for instance, 4 B's and 2 C's at higher grade) and 25 for whites and Indians (5 B's and 1 A at higher grade).
University of Stellenbosch
In response to a query the spokesman for the university, Mohamed Shaikh, stated that "although the Faculty of Health Sciences does not have a quota system, it dos strive to align the race profile of its student body in the MBChB programme with that of the population of the country. Special attention is therefore given to the selection of deserving candidates from previously disadvantaged communities. No student will, however, be selected if he or she does not meet the selection criteria."
The university failed to answer questions on what its precise racial targets were, or whether it evaluated applicants in separate racial categories.
Minimum matriculation requirements: B aggregate (70% average) with a D in higher grade maths and science or a C in standard grade maths and science.
University of the Witwatersrand
In response to a query from Moneyweb the Faculty of Health Sciences at Wits stated:
"We adhere strictly to the decision of the Faculty, taken at the Advisory Committee on Admissions Policy, to admit according to a 50:50 ratio in relation to the two applicant pools; namely Black/Coloured & White/Indian. Applicants compete within their relevant pools for admission. Our aim is to apply this ratio but, if we find that we cannot admit strictly according to this ratio based on our admissions criteria, we would then fill the class from whichever group yields candidates who do meet our criteria."
The admissions figures for 2006 across the faculty (i.e. not just to medicine) were: 47% Black, 4% Coloured, 21.5% Indian, and 27.5% White.
Minimum matriculation requirements: E for higher grade Mathematics or a C at standard grade; E for higher grade Physical Science or Biology or Physiology, or a C at standard grade; E for English at higher grade.