ONE sympathises with the student with six top grade A-level passes who could not win a place at medical school (Echo, Sept 4).

Matriculation is intensely competitive, but generally only the grades of three A-levels are taken into account to try and ensure fairness between different types of school.

Many heads discourage attempting more, so that students can spend more time on non-exam focused study in sixth form.

Part of the problem is that universities find the present grading system at A-level does not identify the most able students well, because of grade inflation.

A solution might be to revise the banding so that only the top ten per cent of passes get Grade 1; the next 20 per cent, Grade 2; the next 20 per cent, Grade 3; the next 20 per cent, Grade 4; and the remaining 30 per cent, Grade 5.

From the patients' point of view it is good there is much enthusiasm from able candidates for medical training, as this must mean standards are kept high, but it can be very disappointing for those strong applicants who cannot obtain a place.

Dr Malcolm C Bateson, Bishop Auckland, Co Durham.