the JUPAS pool. In other words, whether the split is 50% vs 70% HKU vs CUHK like in the past few years, or 70% vs 50% like in earlier periods, there are only so many JUPAS candidates who are deemed qualified for medical studies by both schools overall. The introduction of the Medical Registration (Amendment) Bill 2021, which opens the door for those who graduate from 100 pre-approved non-local medical schools to practise medicine in Hong Kong without the need to sit local licensing examinations, is likely to pose further uncertainty to admissions uptake at the two local medical schools in future. The competition for the same pool of candidates will shift from essentially between two schools to 102 schools. Furthermore, the government manpowerplanned quota will increase from the current 530 to 590 for the 2022-5 intakes, thus making the medical programmes even less selective than currently. These two fundamental policy changes will almost certainly impact medical student admissions from next year onwards, likely further reducing the proportion admitted through the JUPAS route. Having made the diagnosis, what is the solution? Should we lower admission standards that would inevitably lead to higher failure rates? We have witnessed a disproportionate number of students who came in just above the admission threshold struggle through the first- and second-year summative examinations, as well as fall victim to maintaining mental and emotional wellness. Or perhaps we could lower the normative standards in our largely self-regulated curriculum, although that would be shirking our dual responsibility as a guarantor of quality doctors for the future. On another front, we could preferentially admit less qualified applicants on grounds of redressing intergenerational disadvantages, and then provide extra remedial help to get them through the curriculum. How would one operationalise this though – by using the JUPAS route as a proxy to mark out the unfairly disadvantaged? If so, would this be consistent with government policy dating from the first SAR Administration that proactively encouraged a diversity of school types, for instance by introducing the Direct Subsidy Scheme (DSS) that has now accumulated 24 newly established and 35 government-aided/private independent schools which have switched over to the DSS. Most of these schools, in addition to the international schools, offer in whole or in part non-DSE programmes of study thus their students apply through the non-JUPAS route. Besides, any deliberately biased admission policy, however well intentioned and justified, has been tried for half a century in the US. ‘Affirmative action’ purports to correct a legacy of discrimination against applicants of colour. It has indeed broadened opportunity generally but has largely failed in its mission. Over the past 20 years, the proportion of African-American students admitted to the top 100 most selective American campuses has fallen by 60%, according to the non-profit Education Trust.7 In part, the policy has failed because its legal basis had been 5 International Baccalaureate 6 General Certificate of Education Advanced Level 7 https://edtrust.org/ 9 The 205th Congregation
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