On the origins of physicians: Darwinian or Lamarckian evolution?

Achieving acceptance to a North American and some European medical schools is one of the most difficult academic tasks faced by undergraduate students. The limited number of spots allows for only a fraction of the most highly promising applicants to be accepted each year. Perhaps one of the difficulties that many students face when applying to medical school is that due to the current restriction on enrollment, the application process poses selective pressures, independent of the applicants' suitability for the medical profession. Here I discuss, based on personal experiences, how I believe the process could become more just to all applicants. Allowing public needs and student interest to better dictate the number of graduating physicians could help relieve some of the current admission pressures, including the rather arbitrary selection of a small fraction of applicants from a large group of sufficiently proficient students. I believe that this proposal, if implemented, will likely not only remove some biases of our admission system, but also sufficiently change the landscape of those accepted, to include students with a genuine professional interest in the underserviced field of family practice. Clin Chem Lab Med 2010;48:1389-92.