Abstract Purpose Holistic review for admissions is designed to mitigate the common systemic barriers applicants may face in their medical school application journey and the common mistakes committed by admissions committees, but limited literature outlines how this can be modeled. This study examined a blinded holistic admissions approach that emphasized mission and value alignment and the resulting characteristics of applicants by admission status. Method Application data from 2,027 applicants to The University of Texas at Tyler School of Medicine with complete secondary applications for the 2022 to 2023 cycle were analyzed. Applicants were categorized by the most advanced stage they reached in the admissions process: not selected for interview (n = 1,742), interviewed (n = 239), or accepted (n = 46). Data included information on students' geographic ties to East Texas, institutional mission alignment, academic preparation information, and Computer-Based Assessment for Sampling Personal Characteristics (CASPer) test results. Results In the not selected for interview and interviewed groups, mission commitment was significantly negatively associated with geographic ties (r = –0.189 and –0.209., respectively) and academic preparation (r = –0.195 and –0.241, respectively). In the not selected for interview group, higher mission commitment scores were significantly associated with lower CASPer scores (r = –0.110). In the interviewed group, higher geographic ties were significantly associated with lower academic preparation (r = –0.143) and lower CASPer scores (r = –0.280). Demographically, the accepted group had higher than expected counts of individuals who reported free or reduced lunch eligibility (14 vs 8), Pell Grant eligibility (22 vs 12), and family incomes of less than $50,000 per year (14 vs 6). Conclusions This study demonstrates successful and effective implementation of a mission-aligned holistic admissions process, with accepted students exemplifying the mission of the institution and representing traditionally underrepresented groups.
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