Impact of holistic review on student interview pool diversity
- 582 Downloads
Diversity in the physician workforce lags behind the rapidly changing US population. Since the gateway to becoming a physician is medical school, diversity must be addressed in the admissions process. The Association of American Medical Colleges has implemented a Holistic Review Initiative aimed at assisting medical schools with broadening admission criteria to include relevant, mission-driven attributes and experiences in addition to academic preparation to identify applicants poised to meet the needs of a diverse patient population. More evidence is needed to determine whether holistic review results in a more diverse selection process. One of the keys to holistic review is to apply holistic principles in all stages of the selection process to ensure qualified applicants are not overlooked. This study examines whether the use of holistic review during application screening at a new medical school increased the diversity of applicants selected for interview. Using retrospective data from the first five application cycles at the Oakland University William Beaumont School of Medicine (OUWB), the author compared demographic and experiential differences between the applicants selected using holistic review, including experiences, attributes and academic metrics, to a test sample selected solely using academic metrics. The dataset consisted of the total group of applicants selected for interview in 2011 through 2015 using holistic review (n = 2773) and the same number of applicants who would have been selected for an interview using an academic-only selection model (n = 2773), which included 1204 applicants who were selected using both methods (final n = 4342). The author used a combination of cross-tabulation and analysis of variance to identify differences between applicants selected using holistic review and applicants in the test sample selected using only academics. The holistic review process yielded a significantly higher than expected percent of female (adj. resid. = 13.2, p < .01), traditionally underrepresented in medicine (adj. resid. = 15.8, p < .01), first generation (adj. resid. = 5.8, p < .01), and self-identified disadvantaged (adj resid. = 11.5, p < .01) applicants in the interview pool than selected using academic metrics alone. In addition, holistically selected applicants averaged significantly more hours than academically selected students in the areas of pre-medical school paid employment (F = 10.99, mean difference = 657.99, p < .01) and community service (F = 15.36, mean difference = 475.58, p < .01). Using mission-driven, holistic admissions criteria comprised of applicant attributes and experiences in addition to academic metrics resulted in a more diverse interview pool than using academic metrics alone. These findings add support for the use of holistic review in the application screening process as a means for increasing diversity in medical school interview pools.
KeywordsHolistic review Medical school admissions Medical school selection
The author thanks Dr. Julia Smith, Dr. Robert McAuley, and Dr. Eileen Johnson for guidance and support for this study, from conception to completion.
Compliance with ethical standards
Approval for exempt status for this study was granted by the Oakland University Institutional Review Board on December 2, 2015.
- Addams, A. N., Bletzinger, R. B., Sondheimer, H. M., White, S. E., Johnson, L. M., & Association of American Medical Colleges. (2010). Roadmap to diversity: Integrating holistic review practices into medical school admission processes. Washington, DC: Association of American Medical Colleges.Google Scholar
- Association of American Medical Colleges. (2013). Roadmap to excellence: Key concepts for evaluating the impact of medical school holistic admissions. Washington, DC: Association of American Medical Colleges.Google Scholar
- Association of American Medical Colleges. (2015). Using MCAT data in 2016 medical student selection. Washington, DC: Association of American Medical Colleges.Google Scholar
- Ballejos, M., Rhyne, R., & Parkes, J. (2015). Increasing the relative weight of noncognitive admission criteria improves underrepresented minority admission rates to medical school. Teaching and Learning in Medicine, 27(2), 155–162. https://doi.org/10.1080/10401334.2015.1011649.CrossRefGoogle Scholar
- Basco, W. T., Gilbert, G. E., Chessman, A. W., & Blue, A. V. (2000). The ability of a medical school admission process to predict clinical performance and patient’s satisfaction. Academic Medicine: Journal of the Association of American Medical Colleges, 75(7), 743–747. https://doi.org/10.1097/00001888-200007000-00021.CrossRefGoogle Scholar
- Castillo-Page, L. (2008). Diversity in medical education: Facts & figures 2008. Retrieved from American Association of Medical Colleges website: https://www.aamc.org/download/386172/data/diversityinmedicaleducation-factsandfigures2008.pdf.
- Coleman, A., Lipper, K., Taylor, T., & Palmer, S. (2014). Roadmap to diversity and educational excellence: Key legal and educational policy foundations for medical schools. (2nd ed.). Retrieved from Association of American Medical Colleges website: https://members.aamc.org/eweb/upload/14-050%20Roadmap%20to%20Diversity_2nd%20ed_FINAL.pdf.
- Donnon, T., Paolucci, E. O., & Violato, C. (2007). The predictive validity of the MCAT for medical school performance and medical board licensing examinations: A meta-analysis of the published research. Academic Medicine: Journal of the Association of American Medical Colleges, 82(1), 100–106. https://doi.org/10.1097/01.ACM.0000249878.25186.b7.CrossRefGoogle Scholar
- Grbic, D., Garrison, G., & Jolly, P. (2010). Diversity in U.S. medical school students by parental education. Analysis in Brief, 9(10), 1–2.Google Scholar
- Liaison Committee on Medical Education. (2017). Functions and structure of a medical school. Retrieved from Liaison Committee on Medical Education website: http://www.lcme.org/publications.
- Page, S. E. (2007). The difference: How the power of diversity creates better groups, firms, schools, and societies. Princeton: Princeton University Press.Google Scholar
- Smedley, B. D., Bristow, L. R., & Butler, A. S. (2003). In the nation’s compelling interest: Ensuring diversity in the health care workforce. Washington, DC: National Academies Press.Google Scholar
- Steinecke, A., Beaudreau, J., Bletzinger, R. B., & Terrell, C. (2007). Race-neutral admission approaches: Challenges and opportunities for medical schools. Academic Medicine: Journal of the Association of American Medical Colleges, 82(2), 117–126. https://doi.org/10.1097/ACM.0b013e31802d85bd.CrossRefGoogle Scholar
- Terregino, C. A., McConnell, M., & Reiter, H. I. (2015). The effect of differential weighting of academics, experiences, and competencies measured by multiple mini interview (MMI) on race and ethnicity of cohorts accepted to one medical school. Academic Medicine: Journal of the Association of American Medical Colleges, 90(12), 1651–1657. https://doi.org/10.1097/ACM.0000000000000960.CrossRefGoogle Scholar
- Urban Universities for HEALTH. (2014). Holistic admissions in the health professions. Findings from a national survey. Retrieved from Urban Universities for Health website: http://urbanuniversitiesforhealth.org/media/documents/Holistic_Admissions_in_the_Health_Professions.pdf.
- Wayne, S. J., Kalishman, S., Jerabek, R. N., Timm, C., & Cosgrove, E. (2010). Early predictors of physicians’ practice in medically underserved communities: A 12-year follow-up study of University of New Mexico School of Medicine graduates. Academic Medicine: Journal of the Association of American Medical Colleges, 85(10 Suppl), S13–S16. https://doi.org/10.1097/ACM.0b013e3181ed1bee.CrossRefGoogle Scholar