Choosing and training tomorrow's doctors : by guess and by God or by grand design

Let us look first at how Lettsom got selected for his medical training? It seems to have been extraordinarily informal by today's standards. He was sent at the age of 16 to be apprenticed to a surgeon in Yorkshire, where he apparently learned some of the underpinnings of medicine, as well s Latin (many of the textbooks were written in Latin). Then, after five years, he was accepted at St Thomas's" just on the strength of two letters of recommendation. Subsequently, after he had dealt with his inheritance in the Virgin Islands and practised medicine there for a year, he completed his Doctorate in Medicine in Leiden" where once again the selection process involved no more than a letter of recommendation. It is much more complicated to get into medical schools now! so when do we, and should we, do now? what, after all, is the goal of the medical admissions process?