Is the “holistic” review a load of nonsense?

[notEinstein]

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I was reading through old SDN threads, mostly from people who served on admissions committees. A common theme kept coming up: applications are often run through a scoring algorithm—a mix of GPA, MCAT, research, etc.—and only those with a high enough score have their application actually reviewed by a human.

If your algorithm score is too low, your application is automatically filtered out. No one ever reads it.

So someone could win a Nobel Peace Prize, rescue a hospital full of babies during a disaster, and log 10,000 hours of leadership—but if they’re one point below the cutoff, it doesn’t matter. No one ever sees that application. It’s filtered out.

How can a process ever be considered holistic if this is how the process works?

 

[wysdoc]

I was reading through old SDN threads, mostly from people who served on admissions committees. A common theme kept coming up: applications are often run through a scoring algorithm—a mix of GPA, MCAT, research, etc.—and only those with a high enough score have their application actually reviewed by a human.

If your algorithm score is too low, your application is automatically filtered out. No one ever reads it.

So someone could win a Nobel Peace Prize, rescue a hospital full of babies during a disaster, and log 10,000 hours of leadership—but if they’re one point below the cutoff, it doesn’t matter. No one ever sees that application. It’s filtered out.

How can a process ever be considered holistic if this is how the process works?

I don’t think this is true that only some are read by humans. Work on your secondary essays to bring out your fit points for each school and see where it goes

 

[Goro]

We have heard from. multiple Adcom members that rejected app do get a second look to rescue the diamonds in the rough.

This is especially true at those schools who reward reinvention , like Columbia, Drexel, or Emory

 

[Mr.Smile12]

Mission fit matters. We know way too well that the high-metrics applicants don't make the best students or the best doctors.

You also misinterpret the AAMC EAM holistic review model. The target of the contact lens remains focused on metrics, but we are asked to balance these easy metrics with other attributes and experiences that could shape what we see in the metrics.

However, how we process applications is not reliant solely on a computer or formula. Otherwise AI might as well choose our applicants for us. There are always going to be readers involved in screening applications. You get rejected by committee vote.

There is also the GPA/MCAT grid that shows that there are no guaranteed spots based on GPA or MCAT in regular admissions.

Nail your mission fit and an appropriate school list.

Mission Fit: Key to Your Success | SDN

Every application cycle, applicants request expert reviews on the Student Doctor Network to help them assess “What Are My Chances” (WAMC) at getting

www.studentdoctor.net

Believe me, no faculty member wants to teach people who won the Nobel Prize... we have enough trouble dealing with them as colleagues. 🙂

 

[polymerization]

As much as I admire the work admissions folks do (and aspire to participate in as a medical student), I don't think it's unreasonable to question the fairness of this contest given that what makes a review truly "holistic" involves a subjective process that has now essentially been outlawed in admissions wholesale.

They are coming after not just the schools themselves in cases like Harvard and Columbia, but the accrediting bodies for universities, medical schools, and residencies—insisting that considering anything intrinsic/unquantifiable as preparation for an academic program is inherently unfair.

Holistic review as the EAM model describes it is now legally tenuous, and the students who stand to benefit from the additional consideration this model provides are now totally helpless to face an application process for which the rules have significantly changed—whether admissions are willing to say it aloud or not.

To be clear, admissions essentially created these standards for themselves and in many cases do not want to see them rolled back. It is typical for these folks to tell you that they will review applications "as they always have," but this too is just a pinky promise. You don't go to court and swear on a stack of pinkies. More concerning are the folks already within the admissions infrastructure that were waiting to be emboldened by precisely this environment to act out horrific personal beliefs on applicants who have been told that "honesty is the best policy."

To make a very long story short, the people doing this intuitively understand that academics have long been a sport for the wealthy. Historically, people with power want to keep it, and an easy way to keep a population docile, confused, and dependent is by refusing to educate them, and then wielding their own outsized education as demonstrable proof that their power is deserved.

Ultimately, holistic review is going away because those in power want applicants to medical school to be righteous. That may seem morally charged, and it is, from their perspective. Historically, only straight, wealthy, land-owning, God-fearing white men could become physicians, to the point where simply identifying as a physician became a proxy for that set of demographics. They want to return to that storied past...and create a generation of medical providers that may very well turn a blind eye to what is happening to them, the uneducated swine of society. In that way, power creates the problem (inequity of all kinds) and denies the solution (basic healthcare and opportunity). It is de facto slavery and torture...but no one standing to benefit from change is educated enough to diagnose and treat (heh).

None of this is fair, and I think that you're right to wonder whether you're having your leg pulled. For the people making the decision today to cap Grad PLUS loans at 150k given the 300-400k cost of attendance of a typical medical school, it's as inane a decision as deciding what they want for lunch. For the people dependent on those loans to ascertain their ability to raise their standard of living through education, it's career-ending.

As Vonnegut has so clearly impressed upon me... so it goes.

 

[Mr.Smile12]

We will see if the EAM model is legally tenuous. It was created in response to original state initiatives to disallow race/ethnicity in overall college admissions decisions in California and Michigan, so those states (and AAMC by extension) has had a head-start. EAM came about at around the time AAMC was implementing new concepts and tools to build our current framework. The AAMC competencies are the building blocks, and I think those have averted legal challenges. It provided the framework for the 2015 revision of the MCAT and many other upstream changes for ERAS that we are currently witnessing.

Holistic review as a concept is not going away. With AI bots, we're going to see more reliance on in-person assessments such as Casper and Kira Talent (IMO) or on-site essays (that didn't go away for pharmacy admissions in many cases; some dental schools have manual dexterity assessments at their in-person interviews). Power skills will be desired, and one cannot remove that expectation that easily.

I am also keeping my eyes on the other extreme: if we do away with holistic review, then we creep close to final selection by lottery.

News in Brief: Queen’s Medical School moving to lottery admission system - The Queen's Journal

The University is changing the name of the Queen’s Cancer Research Institute (QCRI) following a large donation. The renaming of QCRI was confirmed during Senate’s closed session on March 28.

www.queensjournal.ca

 

[polymerization]

We will see if the EAM model is legally tenuous. It was created in response to original state initiatives to disallow race/ethnicity in overall college admissions decisions in California and Michigan, so those states (and AAMC by extension) has had a head-start. EAM came about at around the time AAMC was implementing new concepts and tools to build our current framework. The AAMC competencies are the building blocks, and I think those have averted legal challenges. It provided the framework for the 2015 revision of the MCAT and many other upstream changes for ERAS that we are currently witnessing.

Holistic review as a concept is not going away. With AI bots, we're going to see more reliance on in-person assessments such as Casper and Kira Talent (IMO) or on-site essays (that didn't go away for pharmacy admissions in many cases; some dental schools have manual dexterity assessments at their in-person interviews). Power skills will be desired, and one cannot remove that expectation that easily.

I am also keeping my eyes on the other extreme: if we do away with holistic review, then we creep close to final selection by lottery.

News in Brief: Queen’s Medical School moving to lottery admission system - The Queen's Journal

The University is changing the name of the Queen’s Cancer Research Institute (QCRI) following a large donation. The renaming of QCRI was confirmed during Senate’s closed session on March 28.

www.queensjournal.ca

Any change in institutions like this will always be justified as benefitting equality and social progress, whether or not it actually does. My concern is not that "holistic review" itself will become a forbidden term (as we are both aware so many have been identified in research this year), but rather that the word itself will become vacuous in meaning. Anyone taking SJTs and writing secondaries can see quite plainly that terms like "mission fit" and "professionalism" can mean different things to different people, but are so often used in daily language as if referring to a monolithic, objective, fair, and neutral standard. If it can mean anything, then it can mean the complete opposite of its common-sense use. Given that EAM explicitly comes out of investigations on diversity by the AAMC and the current administration's severe allergy to anything of the sort...well, it doesn't bode well—even if admissions tries to codify diversity in euphemism.

In a recent admissions session at an Ivy, I asked tough questions and they said "well, they can't tell us what we put in our mission statement, and diversity is part of our mission." Come again? My alma mater shuffled through 3 interim presidents before having the lieutenant governor of my extremely conservative state appointed—a career politician lacking any relevant education or experience. That came after the interim presidents oversaw the highly unpopular mobilization of university police to engage in immigration crackdowns at a school famous for matriculating Dreamers.

I don't believe the opposite of holistic review is a lottery, but rather open matriculation to anyone that can afford it out of pocket and meets some arbitrary threshold. It is typical of these systems to create circumstances where things appear fair on their face, but are ultimately exclusionary by proxy. So long as rich people have things only they can aspire to and execute, they will use those things as sites of concentrated power and authority...even if they have to work for it. Once they get it, it's rules for thee, not for me.

I would not be surprised if this is the case and physicians reclaim a monopoly on rendering diagnosis and treatment over NPs, PAs, etc. It will certainly be in the interest of "patient safety" and "standards," but it will really be because those providers weren't resourced enough to afford learning medicine "the right way," which coincidentally costs more than selling both your kidneys on the black market.

To our allies, within and outside of the adcom: we're aware the call is coming from inside the house. Hope you hang in there long enough for us to join you.

 

[LizzyM]

I was reading through old SDN threads, mostly from people who served on admissions committees. A common theme kept coming up: applications are often run through a scoring algorithm—a mix of GPA, MCAT, research, etc.—and only those with a high enough score have their application actually reviewed by a human.

If your algorithm score is too low, your application is automatically filtered out. No one ever reads it.

So someone could win a Nobel Peace Prize, rescue a hospital full of babies during a disaster, and log 10,000 hours of leadership—but if they’re one point below the cutoff, it doesn’t matter. No one ever sees that application. It’s filtered out.

How can a process ever be considered holistic if this is how the process works?

The cut-off can be set very low -- Schools facing thousands of highly qualified applicants might set aside for just a quick look by one individual any application with an MCAT < 281 or an sGPA of 2.49 or lower making the argument that such applicants are unlikely to succeed in the first 2 years of medical school. A school might play with those numbers based on their own experience. (Maybe CARS < 120 could be a deal breaker for some schools, etc). This is not to say that no one will review the application but it is unlikely to get the full-court press that can take 20-60 minutes.

 

[notEinstein]

The cut-off can be set very low -- Schools facing thousands of highly qualified applicants might set aside for just a quick look by one individual any application with an MCAT < 281 or an sGPA of 2.49 or lower making the argument that such applicants are unlikely to succeed in the first 2 years of medical school. A school might play with those numbers based on their own experience. (Maybe CARS < 120 could be a deal breaker for some schools, etc). This is not to say that no one will review the application but it is unlikely to get the full-court press that can take 20-60 minutes.

Ahh... so a 3.5sgpa and 505 MCAT (125+ in every section) likely wont be low enough to be auto-filtered (without human review)?

 

[LizzyM]

Ahh... so a 3.5sgpa and 505 MCAT (125+ in every section) likely wont be low enough to be auto-filtered (without human review)?

Not likely. I'd think it would need to be below 3.3 and 500 even at the top schools. But still understand that at many school the proportion of applicants who can be interviewed is <10% so whether they have one set of eyeballs on them or three, it is unlikely that most applicants will get an interview.

 

[Mr.Smile12]

Ahh... so a 3.5sgpa and 505 MCAT (125+ in every section) likely wont be low enough to be auto-filtered (without human review)?

A 3.5 sGPA would be too high for a formal cutoff set by a UNIVERSITY for its graduate programs, IMO. I am aware of institutional cutoffs of 2.5 for all graduate programs.

 

[Goro]

Holistic review doesn't mean that every crappy application gets a forma review. It's impossible when your school, like mine, gets some 6000 apps for only ~100 seats. Now imagine Drexel's plight when they get 15,000 apps!

 

[notEinstein]

A 3.5 sGPA would be too high for a formal cutoff set by a UNIVERSITY for its graduate programs, IMO. I am aware of institutional cutoffs of 2.5 for all graduate programs.

Thank you.

Holistic review doesn't mean that every crappy application gets a forma review. It's impossible when your school, like mine, gets some 6000 apps for only ~100 seats. Now imagine Drexel's plight when they get 15,000 apps!

Its just interesting to me that a random person in an adcom office decides whether you get a II or not. I mean, that same person - depending on the type of day they're having or their mindset - may give a II one day, but not to the same type of applicant a different day.

 

[Mr.Smile12]

Its just interesting to me that a random person in an adcom office decides whether you get a II or not. I mean, that same person - depending on the type of day they're having or their mindset - may give a II one day, but not to the same type of applicant a different day.

It depends. For medical school admissions, our screeners have to use a rubric, so a subjective decision still has to be made based on some standard. That's why we train screeners and faculty.

 

[LizzyM]

Thank you.



Its just interesting to me that a random person in an adcom office decides whether you get a II or not. I mean, that same person - depending on the type of day they're having or their mindset - may give a II one day, but not to the same type of applicant a different day.

The "random person" in our office who decides whether you get an interview is a medical school professor/physician with years of experience as an academic, a physician, and a dean of admissions. That person also takes a quick look at the "screened out" files to be sure we haven't missed a gem.

This person depends on the written review of faculty members who read applications and score them in categories such as academics, research, mission fit, etc.

 

[eigen]

Its just interesting to me that a random person in an adcom office decides whether you get a II or not. I mean, that same person - depending on the type of day they're having or their mindset - may give a II one day, but not to the same type of applicant a different day.

That's kinda like saying it's interesting that a "random person in a doctors office" decides what medicine to prescribe to you.

Assuming that the people reviewing your admissions aren't experienced and trained and have no criteria they use to minimize bias or provide consistency seems odd.

So someone could win a Nobel Peace Prize, rescue a hospital full of babies during a disaster, and log 10,000 hours of leadership—but if they’re one point below the cutoff, it doesn’t matter. No one ever sees that application. It’s filtered out.

For some cutoffs, there are reasons. There is data to show that MCAT scores below a certain point correlate strongly with failure rates in medical school courses and increased difficulty in passing exams. While all of the other stuff is important, you also have to show that you are capable of making it through an academically rigorous curriculum and subsequent exams successfully.

 

[notEinstein]

That's kinda like saying it's interesting that a "random person in a doctors office" decides what medicine to prescribe to you.

I worked in corporate finance for over a decade. Some days we declined loans that would have been approved the day before. We were professionals, but human beings are human beings. Mood, annoyance level, time of day, urgency, etc all went into decision making.

If adcom are not affected by any of those human factors, I give them major kudos.

 

[LunaOri]

I worked in corporate finance for over a decade. Some days we declined loans that would have been approved the day before. We were professionals, but human beings are human beings. Mood, annoyance level, time of day, urgency, etc all went into decision making.

If adcom are not affected by any of those human factors, I give them major kudos.

That’s why there’s usually more than one person seeing your file, and at many schools there is a committee vote on which applicants to accept.