Some training programmes only admit a limited number of first-year students, due to the lack of lecturers or facilities, for example. In the past, a lottery system was used for such programmes, but that has been banned since 2017.

Students now wanting to embark on a study programme with a restricted capacity must first be selected. This is not without consequences: there are claims that selection increases the pressure on school pupils to perform well. It can also lead to unequal opportunities, for young people with a migrant background or from low-income families, for example.

During a debate in the House of Representatives last week, D66 member Jan Paternotte therefore proposed scrapping the ban on the lottery system for study programmes with restricted capacity. Along with the CDA, his party submitted a motion. That motion got a majority today. Governing parties VVD and ChristenUnie voted against it.


Among medical students, opinions about decentralised selection vary. Earlier this year, the lobby organisation for medical students questioned over three thousand members. The results showed that one in ten followed a – sometimes very expensive – course to improve their chances of being selected. Over forty students said that they had purposely repeated 5vwo to obtain a higher average exam grade.

The lobby organisation finds these developments ‘concerning’ and is therefore appealing for the reintroduction of the lottery system. “Anyone with a suitable prior education should be eligible for admission to study medicine. The danger of the current system is that it won’t create a diverse population of doctors.”


Whether the decentralised selection produces better or worse doctors is not known. In 2017, researchers from Groningen University concluded that the study results of selected and lottery-drawn medical students did not vary much.

But according to Maastricht University, selected medical students did perform better. This may be because school pupils there are not tested on knowledge but only on competencies.