title: [Selection of medical students: a process influenced by history and culture].
abstract: OBJECTIVE
  Every medical school in the world has a procedure for selecting students for medical studies, intended to identify those who are capable of becoming doctors, according to specific expectations. The means of selection, however, vary significantly from one school to another and from one country to another. France has chosen to undertake this selection at the end of the first year of university studies. This method is costly in that it requires medical schools to organize a whole year of curriculum for thousands of students, fewer than 30% of whom will be chosen for further medical studies. It is also counterproductive for students, a significant proportion of whom are not admitted despite above-average results on their examinations.
  
  
  METHODS
  This article examines the historical and cultural factors that have led to the current organization. Our study is based on an analysis of government archives dealing with medical education reforms from 1905-1970.
  
  
  RESULTS
  We argue that the format of the current selection process is linked to ideas of freedom of access for students and of equal opportunity for admission to medical studies.
  
  
  CONCLUSIONS
  We conclude that for any reform to be acceptable it must take into account the historical and cultural elements (for the most part stemming from the French Revolution) that form the basis of the current system.
authors.affiliation: Service de santé publique et économie de la santé, Groupe hospitalier Lariboisière-Fernand Widal, AP-HP, Paris. christophesegouin@hotmail.com
authors.forename: Christophe
authors.initials: C
authors.lastname: Segouin
authors.forename: Pierre-Henri
authors.initials: PH
authors.lastname: Bréchat
authors.forename: Stéphane
authors.initials: S
authors.lastname: David
authors.forename: Brian
authors.initials: B
authors.lastname: Hodges
authors.forename: Dominique
authors.initials: D
authors.lastname: Maillard
authors.forename: Alexandre
authors.initials: A
authors.lastname: Lunel
authors.forename: Dominique
authors.initials: D
authors.lastname: Bertrand
mesh_terms: D002961:Civil Rights; D003469:Culture; D003479:Curriculum; D004501:Education, Medical / Q000266:history*; D005602:France; D005610:Freedom; D049673:History, 20th Century; D006801:Humans; D012570:School Admission Criteria / Q000639:trends*; D012577:Schools, Medical / Q000592:standards*; D013337:Students, Medical