Excellence, access, and the public good: Building socially responsive admissions practices for health science programs

Abstract

The health sciences have a public calling to provide socially responsive health care for all of society, particularly those most in need. This call is reverberating in universities and has particular relevance for health science professions. Despite universities’ public mission, admissions practices in the health sciences exhibit a fundamental tension between excellence and access, with excellence defined by rankings and research productivity, and access defined by broader public access both to universities themselves and to the knowledge created there. Health science programs’ popularity among students intensifies the exclusivity of admissions processes, at the expense of access. This paper presents both a psychometric and social justice critique of existing admissions criteria and processes. A psychometric perspective demonstrates that admissions processes have inherent bias and fairness issues not limited to reliance on standardized test scores, but extending to measures such as interviews, grade point averages, personal statements, recommendation letters, and CVs. Evaluating admissions criteria using a social justice lens focuses attention on procedural, background, and stake fairness, as well as practices that tend to exclude underrepresented groups. Potential improvements to admissions include applying promising practices from holistic approaches, reducing applicants’ financial burden, instituting admissions criteria that more broadly represent all groups, involving underrepresented groups in adjudicating candidate applications, implementing equitable educational strategies, and evaluating the degree to which programs’ climate and theoretical underpinnings are conducive to recruiting from underrepresented groups. Finally, to fulfill our public call for social responsiveness, it is essential to frame admissions to health science programs in terms of serving the public good by training candidates from underrepresented groups and by positioning excellence as access.