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We are all limited by our imagination. And our imagination is contained by experience, our own and that of those known to us. Therefore someone born into an environment where no predecessor has been to medical school, possibly not even to university, will need to be arrogant or brave to believe that this is an opportunity open to them (¡°Bulk of pupils from a few schools¡±, News in brief, 18/25 December).

Pupils at schools where few, if any, previous pupils have trodden this course will not find the encouragement and knowledge required to give them that extra boost they need to get on to a level playing field. Often in life, it is the first step that is the most difficult, and offers only small reward. For many school pupils, this step would be to believe that they might be accepted at medical school.

Medical school admissions departments struggle to find strategies to identify the candidates who will make the best doctors, especially given that the field of medicine can be so varied. The personalities that make for a good GP are probably very different from those that make a good surgeon. Many years ago I heard that one of the Scandinavian countries allocated places by lottery, and that those doctors were no better or worse than those selected with meticulous/rigorous selection procedures.

Robert Stanowski
Swansea