Evaluation of a combined bachelor's (Bach)/MD program at UC San Diego School of Medicine

Abstract

Purpose A substantial number of medical schools offer combined baccalaureate (BA)/ MD programs and grant conditional acceptance to medical school at the time of admission to the affiliated undergraduate program. The purpose of these programs includes attracting academically talented students, reducing competitive pressures and encouraging honor students to become physicians. Although many combined BA/ MD programs exist, evidence on their impact is largely lacking. In this study, we analyzed the combined BA/ MD program at the University of California, San Diego, School of Medicine (UCSD SOM), the Medical Scholars program. Participants’ demographics were analyzed as well as their performance in USMLE 1 and USMLE Step 2 CK exams. Methods Since its implementation in 2003, 107 students have been admitted via the Medical Scholars program until 2016. The quantitative admission criteria include a SAT score of 1500 and above or 2250 and above (depending of the SAT scoring system used) or an ACT score of 34 and above. Also, a High School GPA of four and above is required among other qualitative judgements (e.g. extracurricular activities, volunteer experience). Academic performance and demographics of students from the Medical Scholars program (n=107) were compared with non-Medical Scholars (n=1552) for the matriculating class of 2003 until 2016. Results A total of 107 students entered UCSD SOM from 2003-2016 through the Medical Scholars program. The average number of Medical Scholars was eight students (S.D.=4.1) per matriculating class. This relates to an average of six percent in each matriculating class. For Medical Scholars and non-Medical Scholars, there was no significant difference between their USMLE Step 1 (232 (S.D.=20) compared to 230 (S.D.=20); p=0.6, unpaired t-test) and USMLE Step 2 CK performance (244 (S.D.=17) compared to 239 (S.D.=19), p=0.3, unpaired t-test). Demographics of students participating in the Medical Scholars program from 2006-2016 (n=107) revealed a significant racial/ ethnic difference between Medical Scholars and non-Medical Scholars (p<0.0001, chi-square test). Eighty-seven percent of the Medical Scholars were Asian (n=93) compared to 38% (n=589) of non-Medical Scholars. Eleven percent (n=12) of the Medical Scholars were white versus 44% of the non-Medical Scholars (n=681). Minorities underrepresented in Medicine compromised only 2% (n=2) of the Medical Scholars compared to 18% (n=282) of non-Medical Scholars. In addition, only two percent (n=2) of Medical Scholars self-identified as socioeconomically disadvantaged compared to 19% (n=311) of the non-Medical Scholars. Discussion The academic performance of students in the Medical Scholars program was equivalent to students admitted via the traditional pathway. Analyzing the demographics of Medical Scholars revealed an absence of URiM students and also a lack of students with socioeconomic disadvantage. As medical schools have made significant changes to diversify their applicants and to include more URiM students as well as students with socioeconomic disadvantage our study suggests that combined BA/MD programs may enhance socioeconomic and racial/ethnic disparities. The results have implications for medical schools seeking to implement or redefine their combined BA/MD program.