Medical School Admissions Process Research Articles

Analysis of the current status of interview evaluations in Korean medical schools and professors' perceptions of the interview evaluations process.

This study aimed to investigate the overall operational status of medical school admission interview evaluations in South Korea and explore the operational experience of universities conducting interview evaluations. This study used a mixed-methods approach, combining quantitative and qualitative methods. Through a nationwide survey and data collection from 39 medical schools, the quantitative analysis explored interview evaluations procedures, the purpose of the interview evaluations, and the competencies expected of medical school freshmen. Concurrently, qualitative data were obtained through focus group discussions with 12 professors from 10 medical schools, providing in-depth insights into the operational experiences and challenges faced during interview evaluations. In the quantitative data, interview evaluations were most prevalent in the "comprehensive school records screening" for rolling admissions (85.5%), but less common in regular admissions (18.6%). Private schools (64.2%) showed a statistically significant higher proportion of interview admissions than public schools (11.1%) in the "high school grades focused admission" (p<0.01). Metropolitan areas (50.0%) conducted interview evaluations more frequently than non-metropolitan areas (11.1%) in the "College Scholastic Ability Test-focused admissions" (p<0.05). In the qualitative data, professors recognize the dominant role of "negative selection" in filtering out unsuitable candidates. Challenges in maintaining a consistent evaluator pool and team-based question development were acknowledged. Strategies, such as seeking student feedback for question improvement and conducting study meetings for interviewer preparation are essential. This study illuminates the operation of admissions interview evaluations in South Korea, revealing variations across regions and admissions types. These findings offer insights for enhancing medical school admission processes, guiding future research and policy.

An exploration of values in medical school admissions processes: the interplay between contextual factors, admissions practices, and validity.

Medical school admissions is a contentious and high stakes selection activity. Many assessment approaches are available to support selection; but how are decisions about building, monitoring, and adapting admissions systems made? What shapes the processes and practices that underpin selection decisions? We explore how these decisions are made across several Canadian medical schools, and how values shape the creation, monitoring, and adaptation of admissions systems. Using phenomenography (a qualitative method suited to examining variability), the authors analyzed interviews with 10 current or previous heads of admissions from 10 different undergraduate medical education programs in Canada. Interviews were conducted in English and French, and data was collected between 2016 and 2017 (therefore participants no longer hold these roles). Data was coded and analyzed iteratively, focusing on identifying underlying values, and exploring how these values shape admissions practices and considerations for validity. Eight different intersecting values were identified. Of these, four were shared across all participants: critically questioning the process and tools, aiming for equity, striving for better, and embracing the challenges of change. The expression of these values depended on different contextual variables (e.g., geographic location, access to expertise, resource availability), and values shaped how admissions systems were built, enacted, and monitored for quality. Ultimately, values shaped: (1) admissions practices resulting in different candidates being offered admission, and (2) how arguments supporting score interpretation are built (i.e., validity). This study documents various values that influence admissions processes, practices, and quality monitoring. The values that shape what is assessed, how it is assessed, and how fair and defensible practices are conceptualized have significant impact, ultimately determining who is selected. These values-whether implicit or explicit-result in intended and unintended consequences in selection processes. However, these values are rarely explicitly examined and questioned, leaving it uncertain as to which consequences are the intended outcomes of deliberately chosen values, and which are unintended consequences of implicitly held values of admissions systems and their actors.

Predicting Medical Student Performance With a Situational Judgment Test in Admissions.

To explore correlations between AAMC situational judgment test (SJT) scores, other admissions data, and learners' medical school performance. First- and second-year medical students from 8 U.S. MD-granting medical schools completed a prototype version of the AAMC SJT in 2017. Outcomes included research-only faculty ratings of student performance, final course grades, and faculty evaluations of student performance, 2017-2018 and 2018-2019 academic years. Bivariate correlations were used to investigate the relationship between SJT scores and student performance outcomes and hierarchical regressions to investigate whether SJT scores provided incremental validity over MCAT total scores and cumulative undergraduate grade point averages (UGPAs) for predicting student performance outcomes. In general, there were small positive correlations with research-only faculty ratings from the first year of medical school, with the highest for social skills/service orientation ( rcorrected = .33, P < .05). Correlations were higher, with the highest for social skills/service orientation and cultural competence ( rcorrected = .33 and .36, respectively, P < .05) in the second year in medical school. SJT scores improved prediction of research-only faculty ratings over MCAT total scores and UGPAs for reliability and dependability/capacity for improvement, cultural competence, social skills/service orientation, and the overall composite score in the first year and for resilience and adaptability, social skills/service orientation, cultural competence, and the overall composite score in the second year. SJT scores demonstrated small correlations with course grades ( rsample-weighted = .10, P = ns) and faculty evaluations related to professionalism skills ( rsample-weighted = .14, P < .05); however, MCAT total scores explained most of the variance associated with course outcomes. These studies provide initial evidence that SJT scores may add value to the medical school admissions process because scores were related to faculty ratings of professional behaviors and provided unique information relative to MCAT scores and UGPAs.

Undue Burden the Medical School Application Process Places on Low-Income Latinos

Undue Burden the Medical School Application Process Places on Low-Income Latinos

A geographic-location-based medical school admissions process does not influence pre-clerkship and licensing examination academic performance.

Students are selected for admission to the Northern Ontario School of Medicine University (NOSM U) MD degree program using criteria aiming to maximize access of persons thought most likely to practice in the region, including use of a geographic context score (GCS) which ranks those with lived experience in northern Ontario and/or rurality most highly. This study investigates the effect of this admissions process upon medical school academic performance. We used a retrospective cohort design combined with multiple linear regression analysis to investigate the relationship between admission scores and performance on pre-clerkship courses, and the Medical Council of Canada Qualifying Exam Part 1 (MCCQE1).The GCS did not significantly explain performance variance on any pre-clerkship course, nor on the MCCQE1, while the undergraduate Grade Point Average correlated with most assessment scores. The number of prior undergraduate biomedical courses predicted science and clinical skills performance, particularly in Year 1, but not with MCCQE1 scores. Performance on Year 2 courses, particularly foundational sciences and clinical skills, significantly predicted MCCQE1 scores. Our data suggest that admission geographic context scoring is unrelated to future academic performance. Further, students with fewer prior undergraduate biomedical courses may benefit from increased support and/or a modified program during the early years.

A brief report of aspiring medical student perceptions and behaviours concerning research experiences for selection into Canadian medical schools.

Aspiring medical students behave based on their perception of what is valued in the selection process. While research experience is not explicitly considered in most Canadian admissions policies, it is commonly held as valuable within aspiring medical student communities. The purpose of this study is to describe the perceptions and behaviours of aspiring medical students with respect to gaining research experience in support of their medical school applications. We surveyed prospective applicants of Canadian medical schools between August 2021 and November 2021, then compiled descriptive statistics pertaining to their perceptions and behaviours. Respondents affirmed the belief that research experience is valued in medical school admissions processes. They reported spending approximately 13 hours per week engaged in research, which usually did not yield publication or presentation recognition. Aspiring medical students invest substantial time and energy in research experiences to benefit their applications. There is room for medical schools to be more transparent about the value of research experience in their admissions processes.

Medical students' perception of their 'distance travelled' in medical school applications.

Within medical school's holistic review of applicants includes a review of their distance travelled to get to this point in their education. The AAMC defines distance travelled (DT) as, 'any obstacles or hardships you've overcome to get to this point in your education or any life challenges you've faced and conquered'. What medical students consider as their distance travelled has not been explored. The authors sought to identify the factors medical students perceive are important for medical school admissions to consider when assessing someone's 'distance travelled' by asking current medical students to share their DT experiences along with the barriers and facilitators they encountered on their medical school journey. The authors conducted semi-structured interviews with US medical students through purposeful sampling methods. The social-ecological model framework was used to develop questions to elicit participants' experiences that contributed to their distance travelled. Interviews were conducted in 2021 and ranged from 60-75 minutes. Transcribed interviews were qualitatively analysed using interpretive description. A total of 31 medical students from seven medical schools were included in the study. Overall, participants defined distance travelled as an applicant's hardships (e.g. being the primary caregiver for a family member) and privileges (e.g. having physician parents) they experienced. Three major themes were identified: (1) individual-level characteristics and factors, (2) interpersonal relationships and (3) aspects of the participants' community and society. Our findings show that medical school applicants considered DT to be a valuable component of a holistic medical school admission process. Participants' experiences of DT were varied and complex. Our research suggests that admissions teams for medical schools should incorporate more comprehensive recruitment practices and inclusive methodological frameworks to accurately capture the diversity of identities and experiences of medical school applicants and to consider the factors that shape their journey to medical schools.

Against Intelligence: Rethinking Criteria for Medical School Admissions.

Intelligence, as measured by grades and/or standardized test scores, plays a principal role in the medical school admissions process in most nations. Yet while sufficient intelligence is necessary to practice medicine effectively, no evidence suggests that surplus intelligence beyond that threshold is correlated with providing higher quality medical care. This paper argues that using perceived measures of intelligence to distinguish between applicants, at levels that exceed the level of intelligence required to practice medicine, is both unfair to applicants and fails to serve the interests of patients.

A longitudinal cohort study observed increasing perfectionism and declining resilience, ambiguity tolerance and calling during medical school which is not explained by student personality

BackgroundThe medical degree is a long and challenging program, not just academically, but regarding the expectations engrained in the culture of medical education. The recent proliferation of literature on the poor mental well-being among students suggests a dilemma that often lays the onus on students to improve their health. The link between personality and vulnerability to psychological distress is acknowledged. This longitudinal study looked at personality in 1st-year and changes in levels of certain psychological traits, as proxy indicators of well-being, in 4th-year. We aimed to determine to what extent changes in psychological traits over time may be attributed to personality.MethodsMedical students completed surveys at the start (1st-year: baseline) and finish (4th-year: follow-up) of their medical degree (N = 154). Temperament and character personality, Perfectionism-Concern over mistakes (CoM), Ambiguity Tolerance, Resilience, Calling to medicine, and demographic variables were measured. Paired t-tests compared changes in psychological traits from baseline to follow-up. Linear regression examined whether personality at baseline would predict levels of psychological traits at follow-up.ResultsThe temperament and character profile of the sample was as expected, and congruent with previous studies, which describe a mature personality. Over four years, levels of Perfectionism-CoM significantly increased, while Resilience, Ambiguity Tolerance and Calling to medicine decreased. Harm Avoidance, Persistence, Self-Directedness and Cooperativeness at baseline significantly predicted levels of these traits at follow-up, but effect sizes were weak. Correlations were in the expected direction and weak.ConclusionsMost commencing medical students, including this cohort, have mature personalities with an industrious temperament and an adaptable character. Yet over four years of medicine, Ambiguity Tolerance, Resilience and Calling declined while Perfectionism-CoM, already elevated at baseline, continued to increase to the final year. Of concern is the increased perfectionism that is strongly associated with poor mental health and psychological distress. The findings suggest a closer look at the entirety of the education environment and how its culture, including secondary school and the medical school admissions processes may influence these trends in students. As medical educators we should question why the pathway to medicine places such unhealthy pressure on students who aspire to be doctors.

Perspectives of Historically Black College and University Advisors to Premedical Students During the COVID-19 Pandemic

Black students remain underrepresented in medicine despite national efforts to increase diversity in the physician workforce. Historically Black College and University (HBCU) students play a vital role in increasing representation in the workforce. Currently, there is a paucity of literature understanding the impact of COVID-19 on premedical students from HBCUs. Understanding the adverse impact of the pandemic on HBCU students is essential to inform strategies that promote holistic medical school admissions and increased diversity, equity, and inclusion in the medical workforce. To explore premedical advisors' perspectives on the impact of the COVID-19 pandemic on HBCU premedical students pursuing admission to medical school. In this qualitative study, semistructured interviews of HBCU premedical advisors were performed from March 2020 to March 2021. One-on-one interviews were conducted with 21 advisors with a depth of experience as advisors, varied educational backgrounds, and diverse geographic representation. Data analysis was performed from March 2021 to December 2021. The experiences of HBCU premedical students during the COVID-19 pandemic from the perspective of the premedical advisor. Among the 21 participants, 13 (62%) were female, 15 (71%) were Black or African American, 11 (52%) had a doctorate degree, and 7 (33%) had more than 10 years of experience as advisors. Participants described 3 major themes: (1) balancing academic responsibilities with family demands; (2) distraction, disruption, and isolation in the virtual learning environment; and (3) harmful impact of new stressors for HBCU applicants in the medical school admissions process. In this qualitative study of HBCU advisors to premedical students, advisors described how the COVID-19 pandemic adversely affected undergraduate HBCU premedical students; students faced family hardships, challenges with virtual learning, and uncertainty in the medical school admissions process. These findings suggest that medical schools should continue to create direct interventions to address the challenges that HBCU students faced during the height of the pandemic and as longitudinal consequences of the pandemic. Addressing these issues may improve physician workforce representation and promote more equitable patient care for underserved communities disproportionately affected by COVID-19 and other health disparities.

The roles of personal interview and cognitive abilities at admission to medical school in predicting performance of medical students in their internal medicine sub-internship

BackgroundThe medical school admission process is complicated, perhaps reflecting unresolved debates concerning the most important skills necessary to become an ideal physician. The Goldman Medical School at Ben-Gurion University in Israel is known for placing great emphasis on the personal attributes of candidates in addition to their academic excellence. To this end, 1-h consecutive interviews are embedded in the admission process. This study aims to determine whether there is an association between candidates’ personal interview ratings and the ratings assigned to these students at the conclusion of their 6th year internal medicine sub-internship.MethodsOur study sample included 136 students who were admitted to the medical school in 2015, and who completed their 6th year internal medicine sub-internship in 2019–2020. Our data were derived from the admissions information for each candidate and from structured interviews concerning medical competence and personal traits, which were completed by medical personnel who were in contact with these students during their clinical rounds.ResultsHigher interview ratings of candidates during the admission process were associated with a higher probability that students would be evaluated as top-rated internists 6 years later (Odds Ratio (OR) = 9.4, p-value = 0.049), independent of gender (OR for male vs female = 0.2, p-value = 0.025) and age (OR = 1.3 per each year, p-value = 0.115). Although significant, the numeric difference in interview rating was relatively small (median 9.5 and 9.4 for top-rated and not top-rated internists, respectively).ConclusionsOur study shows that high personal interview ratings assigned to candidates as part of the medical school admission process are predictive of high performance ratings of students after they complete their 6th year internal medicine sub-internships. These findings demonstrate the value and importance of using semi-structured personal interviews in the medical school admission process.

Call to Action: Eliminate Barriers Faced by Medical Students With Disabilities.

When physicians have a disability or chronic condition, they can offer deeper insight and ability into managing the needs of patients with similar conditions. Yet an alarming 2021 survey found that only 40.7% of physicians feel confident that they provide the same level of care to people with disabilities (PWD) as those without. This may contribute to troubling health care disparities for the over 61 million Americans living with disabilities. In a recent report, The American Medical Association (AMA) recognized that increased concordance between patients and physicians with disabilities is key to resolving health care inequities for PWD, yet although 1 in 5 patients reports a disability, only 1 in 33 physicians identifies as such. This is because prospective medical students with disabilities face many barriers in medical education and practice. We call for specific changes to medical school admission processes and curricula to promote a more just and diverse workforce which includes more physicians with disabilities.

Beyond ‘born not made’: challenging character, emotions and professionalism in undergraduate medical education

In this article we explore the historical antecedents and ongoing perpetuation of the idea that medical professionals must adhere to a specific ‘character’. In the late nineteenth century, an ideal...

A Comparison of Australian and American Medical School Admission Experiences

Attaining admission into medical school has been described as a very competitive process by successful matriculants. The processes that medical schools use to stratify applicants can greatly differ between institutions. These systemic differences flow over onto the applicant level, such that individuals from different geographic regions can have varied and diverse application experiences depending on local medical school admissions protocols. This piece compares the medical school admission processes of Australia and the United States of America, in the form of a narrative recount of a successful medical school matriculant in each country, with the individual experiences of matriculants from alternative pathways blended into the piece. The authors discovered significant differences in admissions protocols between the two countries, with the greatest differences revolving around admissions exams, applicant profile (high school students versus college students), degree types and alternative entrance pathways.

Performance of Black and Indigenous applicants in a medical school admissions process.

BackgroundDiversity in medical schools has lagged behind Canada’s growing multicultural population. Dalhousie medical school allows Black and Indigenous applicants to self-identify. We examined how these applicants performed and progressed through the admissions process compared to Other group (applicants who did not self-identify).MethodsRetrospective analysis of four application cycles (2015-2019) was conducted, comparing demographic data, scores for application components (Computer-Based Assessment for Sampling Personal Characteristics (CASPer), MCAT, GPA, supplemental, discretionary, Multiple Mini Interview (MMI)), and final application status between the three groups.ResultsOf 1322 applicants, 104 identified as Black, 64 Indigenous, and 1154 Other. GPA was higher in the Other compared to the Indigenous group (p < 0.001). CASPer score was higher in the Other compared to the Black group (p = 0.047). There was no difference between groups for all other application components. A large proportion of Black and Indigenous applicants had incomplete applications. Acceptance rates were similar between all groups. Black applicants declined an admission offer substantially more than expected (31%; p < 0.001).ConclusionsBlack and Indigenous applicants who completed their application progressed well through the admissions process. The pool of diverse applicants needs to be increased and support provided for completion of applications. Further study is warranted to understand why qualified applicants decline acceptance.

Combining Ethics Inquiry and Clinical Experience in a Premedical Health Care Ethics Internship.

The professional formation of physicians begins in the premedical years, and educators are now recommending that medical ethics and humanities courses be considered essential components to becoming a physician rather than elective prerequisites for medical school admission. As a result, questions have arisen about how to teach students ethical reasoning skills before their professional training, as they have limited opportunities now to develop these skills and the related competencies in a real-world medical context. The authors describe Santa Clara University's Health Care Ethics Internship (HCEI), an undergraduate college experience that emphasizes ethical inquiry and immerses students in health care settings to foster deep learning. The HCEI includes mentored clinical rotations integrated with classroom inquiry into ethical theory, structured reflection, and professional development considerations. A survey of former students (academic years 2001-2002 to 2017-2018) explored their perceptions of these program components and the impact of the experience on their preprofessional readiness, career choice, and professional capabilities. Of 185 former students who could be contacted, 89 (48.1%) completed the survey. Students reported that the HCEI: (1) assisted them in gaining admission to medical school, (2) had a positive influence on their career decisions, (3) increased their professional capabilities, (4) helped them develop preprofessional competencies, (5) gave them knowledge and experience they used in their personal and professional ethical decision making, and (6) increased their moral sensitivity and ethical responsibility. Integrating clinical rotations into ethics education exposes premedical students to real-world ethical questions, helps them develop a nuanced understanding of a health care career, and prepares them for the medical school admissions process. Other universities should consider implementing a similar program to prime their students for continued professional and moral development during medical school and residency.

Does the AAMC's Definition of "Underrepresented in Medicine" Promote Justice and Inclusivity?

In 2003, the Association of American Medical Colleges reframed the concept underrepresented minorities as underrepresented in medicine (URiM), which defines representation in medicine relative to representation in the US population. Schools are permitted to construct URiM definitions, suggesting the importance of regarding them as fluid works in progress as US demographics evolve. Where medical school admissions processes consider applicants' backgrounds and experiences of identity minoritization to be valuable, progress toward inclusive representation has been made. This article considers whether school-based URiM definitions are ethically sufficient and canvasses possible next steps in realizing equitable representation in medical education.

Medical School Admissions: A Review of Global Practices, Predictive Validity, and Practice Points for Africa

Background: Processes for selection of candidates into medical schools vary globally. Knowledge of the predictive validity of a selection method is important for policy revision.&#x0D; Aim: To survey the practices used by medical schools to select students and their predictive validity.&#x0D; Methods: Search terms developed from the research problem were used to search Google Scholar, PubMed, and Educational Resources Information Centre (ERIC). These were “medical school,” “predictive validity,” “success,” “academic achievement” “admission criteria,” and “student selection.” Retrieved articles were screened for relevance and sorted according to countries ofpublication. Authors narratively reviewed the articles from each country and collated the findings. Best practices were recommended for African-based medical schools.&#x0D; Results: Articles retrieved from 14 countries were included in the review. USA, Canada, UK, Australia, and New Zealand operate centralized medical school admission programs and administer nationwide admission tests. These tests cover cognitive and non-cognitive domains. The validity of these tests in predicting medical school success were extensively studied and reported. Other countries do not operate centralized medical school admission programs. Most of these rely on cognitive excellence to select students. Few reports are available on the validity of selection practices in Africa. Most rely on cognitive excellence which highly predicted academic success during preclinical studies. Predictivity decreased during clinical phases and non-cognitive variables became better predictors of success.&#x0D; Conclusion: Medical school admission processes should consider cognitive and non-cognitive factors. With non-cognitive factors, candidates with right attitudes are selected. African countries should align their practices to that of Western countries.

Medical School Admissions: A Review of Global Practices, Predictive Validity, and Practice Points for Africa.

Background: Processes for selection of candidates into medical schools vary globally. Knowledge of the predictive validity of a selection method is important for policy revision.&#x0D; Aim: To survey the practices used by medical schools to select students and their predictive validity.&#x0D; Methods: Search terms developed from the research problem were used to search Google Scholar, PubMed, and Educational Resources Information Centre (ERIC). These were “medical school,” “predictive validity,” “success,” “academic achievement” “admission criteria,” and “student selection.” Retrieved articles were screened for relevance and sorted according to countries of publication. Authors narratively reviewed the articles from each country and collated the findings. Best practices were recommended for African-based medical schools.&#x0D; Results: Articles retrieved from 14 countries were included in the review. USA, Canada, UK, Australia, and New Zealand operate centralized medical school admission programs and administer nation-wide admission tests. These tests cover cognitive and non-cognitive domains. The validity of these tests in predicting medical school success were extensively studied and reported. Other countries do not operate centralized medical school admission programs. Most of these rely on cognitive excellence to select students. Few reports are available on the validity of selection practices in Africa. Most rely on cognitive excellence which highly predicted academic success during preclinical studies. Predictivity decreased during clinical phases and non-cognitive variables became better predictors of success.&#x0D; Conclusion: Medical school admission processes should consider cognitive and non-cognitive factors. With non-cognitive factors, candidates with right attitudes are selected. African countries should align their practices to that of Western countries.

Virtual Multiple Mini-Interview during the COVID-19 Pandemic.

The multiple mini-interview (MMI) is one of the most effective and popular interview methods for medical school candidate selection. A standardised set of scenarios with associated questions and responses is predetermined and candidates rotate through various stations to meet examiners in face to face, in-person mini-interviews during a finite time allotment. The objective of the MMI is to generally assess the candidate’s characteristics in different domains such as ethics and morality, communication skills and critical thinking. The MMI method can be reliable and feasible, more so than traditional interview methods.1 Because of the coronavirus disease 2019 (COVID-19) pandemic and resulting social distancing policies, MMIs were suspended for 2020 admissions in many medical schools across the world. It was considered that a virtual interview process would facilitate the benefits of a face to face meeting without concern for COVID-19 transmission. We designed a modified MMI using a virtual interview with structured standards of operations for our 2020 medical school admission process. Some MMI scenarios (eg, those that required teamwork) were not selected because of difficulties in assessing candidates via videoconference methods. To ensure efficient time control, matching groups of interviewers and candidates were scheduled beforehand. By contrast with the conventional MMI protocol, whereby each candidate student rotates through each station, interviewers, rather than students, rotated through virtual rooms using a videoconferencing platform. This technique was convenient as it enabled support staff to invite each candidate to wait in a separate virtual room before the MMI started. When interviewers arrived in the virtual rooms, support staff were asked to leave the rooms and candidates to identify themselves. Each interviewer used a single station assignment to interview and interact with each candidate. Support staff were specifically assigned to inspect each virtual station and help manage any technical problems. With well-trained staff and a high-speed Internet connection, interviewers and candidates participated in a simultaneous and effective virtual MMI in different locations throughout the country. The video-recording of each MMI station during the virtual interviews allowed interviewers to review candidates' performances and make thoughtful selection decisions. A virtual MMI protocol was successfully implemented for our 2020 medical school admissions. Virtual MMIs break the barriers of conventional MMIs and appear able to attain an acceptable level of effectiveness. Candidate students are familiar and comfortable with online tools and travel costs are self-evidently reduced. The important features of MMIs, such as number of stations, number of candidates and station length, can be retained in the virtual adaptation. Some remaining challenges include the limitations of virtual MMIs in assessing some specific candidate characteristics, such as stress tolerance, in an unfamiliar environment. Nonetheless, a virtual version of the MMI for medical school admission is feasible and can be implemented during the COVID-19 pandemic. Effective time management, selected scenarios, trained staff and effective technology are the essential keys to success.