Med School Admissions Process = Load of Crap

[RxnMan]

Based solely on admissions practices in this country, one must conclude that those selected by foreign methods are felt to be somehow lacking as compared to their US counterparts.

I've worked with docs from all over the world (Japan, Germany, Scotland, etc.) that trained under a number of systems and I can't see any difference in their clinical skills, reasoning/intelligence, or bedside manner, when compared to their US coworkers. Granted, I don't have direct experience with their residency programs. But I would have to disagree that foreign admissions practices are lax, given that their products, foreign physicians, are not lacking in any measure.

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[Law2Doc]

I've worked with docs from all over the world (Japan, Germany, Scotland, etc.) that trained under a number of systems and I can't see any difference in their clinical skills, reasoning/intelligence, or bedside manner, when compared to their US coworkers. Granted, I don't have direct experience with their residency programs. But I would have to disagree that foreign admissions practices are lax, given that their products, foreign physicians, are not lacking in any measure.

First, bear in mind that this is not my conclusion -- I said that US admissions intentionally go out of their way not to do it the way that the foreign countries do it, at great cost. Thus they must be seeing something you aren't. They didn't get up one day and say, let's just make it harder on ourselves for no good reason.
Second, I don't know how many foreign docs you have dealt with, but your sample size is going to be absurdly small, the problem with basing viewpoints on anecdotal evidence. And perhaps the typical foreign doc isn't going to be the one you've come across (especially the case if your perspective is limited to foreign docs who come to work in the US, a smaller and more selective group). There will be exemplary folks in every system, bad or good. The goal (at least here) is to maximize selection for them. Whether they achieve that is subject to debate, but since efforts have continued here in the same general direction for quite a while now, with no hint at changing to a more objective test driven form, somebody is clearly happy with the general trend.

 

[gostudy]

I've worked with docs from all over the world (Japan, Germany, Scotland, etc.) that trained under a number of systems and I can't see any difference in their clinical skills, reasoning/intelligence, or bedside manner, when compared to their US coworkers. Granted, I don't have direct experience with their residency programs. But I would have to disagree that foreign admissions practices are lax, given that their products, foreign physicians, are not lacking in any measure.

Keep in mind that foreign docs working in the US are the best of the best from their respective countries and may in fact be superior to the lower rung of American docs. Sample size is key.

 

[LizzyM]

Just for comparison's sake - how med admissions work abroad where my cousin is going to school:

1. You take a national test. 2. Each school has its own test which is part oral/part written/part practical. 3. They put both scores together and make a big list of applicants and pick from the top down until the class is full.

No ECs, No GPA, nothing.

You could do this with the MCAT. With twice as many applicants as seats, the cut point would be at the 50th percentile. There would have to be some sort of match so that you would get your 1st, 2nd, 3rd, etc choice if the school hadn't already filled with students who had higher scores.

Would this result in better doctors than we get under the current system? Would excellent candidates be shut out of the system because they were not good at standardized tests? Would psychos who would never get past an interviewer get admission to medical school? Would people who don't want to go to medical school but who are pressured by family end up in medical school?

 

[Orthodoc40]

You could do this with the MCAT.
Would this result in better doctors than we get under the current system? Would excellent candidates be shut out of the system because they were not good at standardized tests? Would psychos who would never get past an interviewer get admission to medical school? Would people who don't want to go to medical school but who are pressured by family end up in medical school?

No, yes, yes, yes.....!

 

[LizzyM]

Yes, yes, yes, yes.....!

I'm not sure how yes to question #3 (would psychos be admitted?) results in a yes to question #1 (would we have better doctors with a new system?). Would psychopaths who are weeded out in the interview process make better doctors than those who are currently being admitted. This is not logical.

 

[Law2Doc]

Would psychopaths who are weeded out in the interview process make better doctors than those who are currently being admitted. This is not logical.

I'm not sure logic applies to psychopaths.

 

[Orthodoc40]

I'm not sure how yes to question #3 (would psychos be admitted?) results in a yes to question #1 (would we have better doctors with a new system?). Would psychopaths who are weeded out in the interview process make better doctors than those who are currently being admitted. This is not logical.

Right - WHOOPS! I meant to agree with your points...

No, yes, yes, yes!

 

[Shredder]

the current process is expensive and would have been switched to your proposed system (much cheaper by the way). The only problem is that Adcoms know the system you proposed is not a very good one and are willing to shed the big bucks to keep doing what they are doing (at least until they find something better).

thats putting a lot of faith in ppl in power. power resides as much in adcom members' hands as it does in politicians' hands, just in a more specific context. are you as trusting of the actions and motives of politicians?

basically this is saying more costly is better. just like american education, and the american healthcare system as a whole? (cost as a proportion of gdp vs stats like life expectancy and infant mortality; and in education, cost vs stats like test scores and literacy--to be explicit about it, the USA sucks in these two expensive areas compared to other 1st world countries). by your logic costs are guaranteed to spiral upwards over time...and thats exactly whats happening not only in medicine but in the entire us economy. good thing? im shocked that your premise is: the more expensive then, ipso facto, the better.

for the sake of the united states, americans should start to question whether the usa is the undisputed champion in every aspect of society. its not unpatriotic--its quite the contrary. i know people in india who maintain, through this and that rationalization, that india is somehow number one. clearly its gotten them far. really, what is being said here in so many words is "this is the way the USA does it right now (bear in mind, not even throughout history) and thus it is the best way to do it".

 

[uvce]

Would psychos who would never get past an interviewer get admission to medical school? Would people who don't want to go to medical school but who are pressured by family end up in medical school?

Many companies administer personality profile tests to prospective employees and screen out any with a potential for a future problem. Perhaps that should be a pre-requisite for med school admissions?

 

[Shredder]

surely youre kidding, imagine how easy it would be to pick out the "right" answers to get the ideal personality. it wouldnt weed out psychos but it would weed out dunderheads who cant see through personality tests like an open window

also whats the huge deal about accidentally admitting somebody who doesnt belong by mistake. simple solution is to reduce the ridiculously high graduation rates and start kicking more ppl out, preferably in the early stages when problems should manifest themselves. an axe murderer who is smart will get into med school no matter what silly barriers are erected. really, expulsion is a much underused med school tool

 

[Law2Doc]

also whats the huge deal about accidentally admitting somebody who doesnt belong by mistake. simple solution is to reduce the ridiculously high graduation rates and start kicking more ppl out, preferably in the early stages when problems should manifest themselves. an axe murderer who is smart will get into med school no matter what silly barriers are erected. really, expulsion is a much underused med school tool

It depends where you want to put the gatekeeper, but the result proves the same. You either don't let a lot of folks into med school but once in most everybody graduates, or you let everybody in, but not everybody gets to practice. The latter is used in law and other professions, and it's problematic, because by the time you find out you won't succeed, you are already several years and many tens of thousands of dollars into the hole. Why should folks pay 100k to find out they don't cut it, when you can give them a decent read after a few thousand in application costs?

As for your question of not trusting politicians, I think you can trust them to serve their own interests. Here the adcoms could save THEMSELVES a lot of time and effort by using a formulaic numerical approach, so the fact that they aren't -- i.e. they are not doing what is easiest for them suggests there must be a real benefit in doing it otherwise. We definitely don't see eye to eye on this one. Fortunately, the med school world is on my side on this one.

 

[Will Ferrell]

Would psychopaths who are weeded out in the interview process make better doctors than those who are currently being admitted.

Have you met any of these "psychopaths"? I have never met a pyschopath who intended to apply to medical school. I've met some extremely nutty grade-grubbers, but no psychopaths. Could ADCOMs just be falsely labeling people psychopaths?

 

[ND2005]

surely youre kidding, imagine how easy it would be to pick out the "right" answers to get the ideal personality. it wouldnt weed out psychos but it would weed out dunderheads who cant see through personality tests like an open window

Have you ever taken the MMPI?

Try picking out the "right" answers on that...

 

[Gut Shot]

This is from a thread discussing residency interviews, but what my man Koko states is applicable here:

"If an applicant goes into the interview day unprepared and naive, then yes, it will be a low yield experience. Of course the faculty and others will put their best foot forward on an interview day - so will you, but an intelligent interviewer can get something from a relatively brief discussion with an applicant. That said, people have personalities and these do show through, even when people do the dog and pony show routine. Pay attention and ask thoughtful questions, and you will learn something about most of the people you come across.

Even more helpful are the residents. Most are pretty open and honest, especially if you talk with them out of ear shot of faculty. In addition, most are less adept at the dog and pony show act. The dinners/lunches are helpful, too, if you pay attention and are engaged.

On the tours, watch how people talk with one another and treat each other - that goes for everyone, not just residents/attendings.

There's more, but part of this process involves figuring out for yourself what matters and using your head."

 

[Gut Shot]

Have you ever taken the MMPI?

My dad used to joke that when they administered the MMPI to his engineering students the results all came back the same: negative.

 

[LizzyM]

Have you met any of these "psychopaths"?

Yes. Interviewed at least one this cycle.

Could ADCOMs just be falsely labeling people psychopaths?

No.

 

[ClearDay]

Yes. Interviewed at least one this cycle.



No.

Please elaborate?

 

[happydays]

A "psycho path" doesn't have to be a complete lunatic. That's just someone who doesn't know how to behave in an interview, like getting angry (for a nonlegit reason) or taking their shoes off.

 

[deuist]

disagree--thats why there are objective measures that separate the men from the boys. gpa and even more so mcat should take priority. if american business made decisions based on a random factor this country would be in shambles. get some actuaries in adcoms, thats what needed. hey, i really like that actuary idea. theres no such thing as 200 people being equal. there is always something that can be used to distinguish between them.

Huh? Have you seen the GPA's that America's business leaders are pulling? Just look at the stats for an MBA program. Further, the random factor is very important in the hiring process. People who interview well and get along with others are far more likely to get employed compared to the loner who had stellar grades in college and is an amazing engineer.

 

[deuist]

don't waste time and money applying to schools you wouldn't go to if you got into (or even interviews from) any other school on your list.

Given that everyone has only one top choice, and given that people would choose to go to this top choice over other schools that they were accepted to, then according to your logic, people should only apply to one university.

I say apply to the 15. I have no problem admitting the UMiami was not my first choice when I applied. Had I been accepted to Vandy or Baylor, I would have dropped UM in a second. However, I got in, it's a good school, and I'm glad that I came here.

 

[happydays]

Shredder,


Numbers (MCAT and GPA) do take priority, but a good applicant must also prove him/herself worthy at random subjective measures.


There is NO such thing as complete objectivism on this planet. That's because it's run by PEOPLE and human beings are inherently subjective. All our perseptions of this world are subjective, including your opinion on how the admissions process should be run. Heck, even the standardized tests are based on biased ideas on what makes good doctor (do doctors actually have to understand physics to practice medicine?). GPA is even more dependent on what school it was from, with whom was the class taken, and one's personal status when it was taken. You can't get away from subjectivity.


With that said, the current system does have its flaws, but it's the best one we got. It think it does a good job 90%+ of the time. (if it didn't, our hospitals would be filled with horrible doctors and no one will ever get treated.)

 

[fewchewrmd]

Sounds like the tuba playing paid off.

Ok, I need some advice. I dropped my tuba class this semester. Do I have to contact all schools to tell them? Do you think it will hurt my chances of getting into an ivy? I'm already got an acceptance... can they rescind my acceptance?

 

[deuist]

I'll reply to a few of your comments en mass:

are you as trusting of the actions and motives of politicians?

There are many medical schools, each with a different method of selecting applicants. You can choose where to apply and can look at the personality of each university. There is only one government. Even with voting, you cannot choose it.

i know people in india who maintain, through this and that rationalization, that india is somehow number one. clearly its gotten them far.

India may have a fast growing economy, but it is hardly moved into the realm of "developed nation" status. There is a large gap between the rich and poor. There is limited access to health care in rural areas. Witch doctors are still employed in high numbers. And no major innovations have come out of India. You can point to high numbers of engineers that India produces, and I'll point to a group of people that is good at memorizing material to keep the status quo going, but are of no use at coming up with innovative ideas.

also whats the huge deal about accidentally admitting somebody who doesnt belong by mistake.

Because it keeps out the person who should really be there instead.

really, expulsion is a much underused med school tool

The United States already has a physician shortage---based in part upon the weed-out methods of long ago. Are you suggesting that we kick out even more capable doctors?

 

[deuist]

I, for one, will give someone who worked as a nursing assistant in a nursing home as much credit as someone who volunteered with the elderly, maybe more for the nurse's aide, because it is very hard, often unpleasant work.

Lizzy,

I should have applied to your school instead. The University of Florida blasted my work as a CNA and told me that it was worthless since I was paid for it. I was told by an adcom member that I would need to gain clinical skills before re-applying to medical school. When I pointed out my CNA experience, she said that it wasn't good enough.

 

[Shredder]

Numbers (MCAT and GPA) do take priority, but a good applicant must also prove him/herself worthy at random subjective measures.

this is a gray area and it begs the question, where do you draw the line for these random subjective measures. also numbers do not take priority when schools (some explicitly stating as much) set minimum cutoffs for interviews and then consider interviewees equal

All our perseptions of this world are subjective, including your opinion on how the admissions process should be run. Heck, even the standardized tests are based on biased ideas on what makes good doctor

tempting argument, but objectivity is based on correlations showing what makes good docs. studies are conducted to take account of data and determine what abilities produce high quality healthcare providers. thats the scientific way to do things. thats how standardized tests are crafted--by professionals who create such relatively nonrandom objective measures for a living. adcoms way of shooting the breeze and rolling dice to see who gets in is the artistic way of making admissions decisions. this isnt about my opinions on how things should work, its about the apparent lack of a systematic approach to evaluating applicants. (antonym of systematic=haphazard, aka random)

With that said, the current system does have its flaws, but it's the best one we got. It think it does a good job 90%+ of the time. (if it didn't, our hospitals would be filled with horrible doctors and no one will ever get treated.)

is it the best? why are avg healthcare stats like ones i mentioned earlier not so spectacular in the usa, and why are costs so sky high in spite of that fact? also, even though adcoms are supposedly so skilled at weeding out unsociable and unlikeable docs, are docs not still sued like no other profession? the USA has the worlds top docs, which is why saudi princes come here for their bypasses, but do we really have the best docs on average, which is what adcoms are in the business of selecting in the early stages?

i guess most of you guys are just not the types to question authority. many of you figure if things are done a certain way then that must be optimal based on the opinions of higher ups. its not a paradigm shifting attitude. time and again many of you are parroting "the Man says this is the way it should be done, so thats that"

law2doc adcoms would save a ton of resources by loosening the gates and lowering graduation rates, rather than keeping the ridiculously tight gates they have now and devoting a full time, year round adcom to chatting about thousands of applicants. its a sensitivity/specificity thing. whether the med school world/adcoms are on your side or not is irrelevant to the validity of your stance, since im working on the premise that adcoms are bogus in the first place

US admissions intentionally go out of their way not to do it the way that the foreign countries do it, at great cost. Thus they must be seeing something you aren't. They didn't get up one day and say, let's just make it harder on ourselves for no good reason.

again, too much faith in the USA/US admissions. is it just not even remotely feasible that they are mistaken/misled, flat out? i guess the Man must have been seeing something as well when things like Prohibition were in place--and some ppl would say vietnam and iraq as well

will ferrell you would think that med students/docs would be a little stricter with slapping the label of psychopath on everyone they dislike, but no thats not the case

 

[happydays]

this is a gray area and it begs the question, where do you draw the line for these random subjective measures. also numbers do not take priority when schools (some explicitly stating as much) set minimum cutoffs for interviews and then consider interviewees equal

The interviewers usually aren't drooling 5-yr-olds pulled from the street. These are professionals who are trained to be able to read people. They want to see a DOCTOR in front of them, not a test-taking machine.

tempting argument, but objectivity is based on correlations showing what makes good docs. studies are conducted to take account of data and determine what abilities produce high quality healthcare providers. thats the scientific way to do things. thats how standardized tests are crafted--by professionals who create such relatively nonrandom objective measures for a living. adcoms way of shooting the breeze and rolling dice to see who gets in is the artistic way of making admissions decisions. this isnt about my opinions on how things should work, its about the apparent lack of a systematic approach to evaluating applicants. (antonym of systematic=haphazard, aka random)

Again, I emphasize that there is no such thing as objectivity. All these are measurements that PEOPLE have designed, and they are riddled with flaws. I don't think you understand the goal of the interview. Your "systematic approach" is also designed based on YOUR own subjectivities, your own biases.

is it the best? why are avg healthcare stats like ones i mentioned earlier not so spectacular in the usa, and why are costs so sky high in spite of that fact? also, even though adcoms are supposedly so skilled at weeding out unsociable and unlikeable docs, are docs not still sued like no other profession? the USA has the worlds top docs, which is why saudi princes come here for their bypasses, but do we really have the best docs on average, which is what adcoms are in the business of selecting in the early stages?

healthcare is high b/c:
1. Doctors need to get paid
2. All healthcare staff need to get paid.
3. Insurance, drug, instrument companies are all FOR profit. They drive up the cost like crazy.
Docs are sued for more than one reason. Sometimes the ones sueing just need some extra cash or trying to feel special. Yes, there are unsociable, incompetent docs, but they are the minority.

i guess most of you guys are just not the types to question authority. many of you figure if things are done a certain way then that must be optimal based on the opinions of higher ups. its not a paradigm shifting attitude. time and again many of you are parroting "the Man says this is the way it should be done, so thats that"

We've questioned, but we've arrived at the same answer. Other methods have been employed, but at the end, the best one is this; plus, it's improved every year with more experience and feedback.

law2doc adcoms would save a ton of resources by loosening the gates and lowering graduation rates, rather than keeping the ridiculously tight gates they have now and devoting a full time, year round adcom to chatting about thousands of applicants. its a sensitivity/specificity thing. whether the med school world/adcoms are on your side or not is irrelevant to the validity of your stance, since im working on the premise that adcoms are bogus in the first placeagain, too much faith in the USA/US admissions. is it just not even remotely feasible that they are mistaken/misled, flat out? i guess the Man must have been seeing something as well when things like Prohibition were in place--and some ppl would say vietnam and iraq as well

The gates aren't even that high. 50% of those applying get accepted. Plus, if the screening process was loosened, wouldn't there be MORE unqualified applicants getting in (statiscally speaking)?

Look, the process is constantly being monitored and improved. Didn't prohibition get repealed? Didn't we pull out of Vietnam (kinda late, but we did anyway)? Didn't we admit that there are no WMD's in Iraq (but we still need to give them freedom, so we need to kill more people, but this is another topic)? If there's something GRAVELY wrong about the admissions process, it would have been noticed and changed. This is just like any other administration.

 

[j8131]

Look, the process is constantly being monitored and improved. Didn't prohibition get repealed? Didn't we pull out of Vietnam (kinda late, but we did anyway)? Didn't we admit that there are no WMD's in Iraq (but we still need to give them freedom, so we need to kill more people, but this is another topic)? If there's something GRAVELY wrong about the admissions process, it would have been noticed and changed. This is just like any other administration.[/QUOTE]

I don't know why you assume this. A lot of professional behavior happens just because of tradition. Also, this logic has a circular quality that can lead to a result where nothing changes because nothing changes.

 

[happydays]

I don't know why you assume this. A lot of professional behavior happens just because of tradition. Also, this logic has a circular quality that can lead to a result where nothing changes because nothing changes.

So you think nothing changes about the admissions process in medicine? If you don't believe me, why don't you talk to some adcoms?

 

[Law2Doc]

I don't know why you assume this. A lot of professional behavior happens just because of tradition. Also, this logic has a circular quality that can lead to a result where nothing changes because nothing changes.

No - tradition can keep things going that don't have a cost. But very few traditions that are extremely costly continue without some other validation. Some of us think there is a benefit to having more well rounded individuals. Adcoms certainly think this. So much so that they refuse to take the easier and cheaper path of just using the MCAT over all else. Some of the premise of you and shredder is that the system is somehow "broken". This is the part where you lose me. While there are problems in healthcare, I don't think there is any good evidence that the US medical admissions process is not churning out good doctors. Some would argue that with the increase in well rounded candidates, they are churning out doctors with additional interpersonal and communicative skillsets lacking in a prior generation, but the jury is still out on this.
Don't forget that this is a SERVICE INDUSTRY, and by and large a doctors job involves dealing with patients and co-workers far more than use of basic science. Thus selection for high MCAT or other such objective criteria totally misses the boat on selection of many of the skills most necessary in this job. The ideal candidate clearly needs both.
My personal view is that while tweaks can and will be made to identify the optimal future physician, the tweaks required will not involve a move toward more objective criteria and instead will actually involve identifying other personality traits and skills to select for. These will most likely need to be sought through the interview, which is the strongest "personality" component of the application thus far.

 

[Shredder]

The interviewers usually aren't drooling 5-yr-olds pulled from the street. These are professionals who are trained to be able to read people. They want to see a DOCTOR in front of them, not a test-taking machine.

is that really what theyre trained for, i thought they were trained for medicine? seeing as adcoms dont consist of pro interviewers and "readers" and instead are made up of avg faculty and students who feel the need to be gatekeepers, i can hardly agree here. also, what they see in front of them are mostly young and naive premeds who dont know a thing about medicine no matter what theyve experienced, bc they have not in fact experienced the process of going through medicine and being a doctor. so no, theyre not seeing doctors in front of them or ppl who have a major clue about what its like to be one. why do 90% of premeds go in wanting to do primary care and 50% come out as specialists? a little change of mind?

Again, I emphasize that there is no such thing as objectivity.

ah, just like the arguments that theres no such thing as truth so why bother even pursuing it? there is at least such a thing as more objective (as humans have defined objectivity, if you will cede that much), and less objective.

healthcare is high b/c:
1. Doctors need to get paid
2. All healthcare staff need to get paid.

docs and healthcare staff in other countries work for free?

3. Insurance, drug, instrument companies are all FOR profit. They drive up the cost like crazy.

its always been my understanding that markets and corporations are in the business (literally) of driving costs down, unless there are monopolies or meddlesome public sector intrusions into markets

Docs are sued for more than one reason. Sometimes the ones sueing just need some extra cash or trying to feel special. Yes, there are unsociable, incompetent docs, but they are the minority.

all docs are sued at some point in their careers, most get sued many times. looks like adcoms are doing a great job of screening out the malpractice-proof docs.

if the screening process was loosened, wouldn't there be MORE unqualified applicants getting in

thats the idea--admit more and expel more by keeping a closer eye on matriculants. or let them quit of their own accord. it may well be worth lessening or eradicating the bureaucratic nightmare that offices of admission/adcoms are. as i mentioned with specificity/sensitivity, in the process of strictly filtering out every possible troublemaker, many good applicants are turned away. this is just a minor issue as it relates to the OP though. sensitivity/specificity is another story

Look, the process is constantly being monitored and improved. Didn't prohibition get repealed? Didn't we pull out of Vietnam (kinda late, but we did anyway)? Didn't we admit that there are no WMD's in Iraq (but we still need to give them freedom, so we need to kill more people, but this is another topic)? If there's something GRAVELY wrong about the admissions process, it would have been noticed and changed. This is just like any other administration.

its rare for things to appear gravely wrong. they start out with good intentions and snowball into more and more gray area. some ppl see the snowballs before others. Social Security is an example of this--started with good intentions but was fundamentally flawed and we are now seeing ramifications of that.

law2doc every govt program and department is a tradition that is continuing at large cost. most of the cost just is not borne by those in charge of the programs. in the case of adcoms, its borne by premeds, while adcom members enjoy their power and infinite wisdom that being on the adcom gives them the impression they have.

 

[Law2Doc]

in the case of adcoms, its borne by premeds, while adcom members enjoy their power and infinite wisdom that being on the adcom gives them the impression they have.

This is so embarrassingly absurd -- you've outdone yourself. Are you sure you really want to enter this field when you think so little of the gatekeepers?

 

[funshine]

"The interviewers usually aren't drooling 5-yr-olds pulled from the street. These are professionals who are trained to be able to read people. They want to see a DOCTOR in front of them, not a test-taking machine."

you never know...drooling 5-yr olds might have a better sense of who's really "compassionate" and who's not. You really think our interviewers are professionally trained to "read people"? No way. They're just faculty taking time out of their busy day to interview a couple of kids. You can totally put on a fake show for them and they'll eat it right up. Every interviewee I've talked to about this has agreed that interviews are the most unfair part of admissions. It's true that some applicants will always interview well, and some will always interview poorly but the majority of us are in between and our fate just depends on whether our interviewer found us appealing or not.

 

[Law2Doc]

You really think our interviewers are professionally trained to "read people"? No way. They're just faculty taking time out of their busy day to interview a couple of kids.

Most of the interviewers I've had have been clinicians who spend most of their time dealing with patients and other doctors. You are interviewing for a career where you will spend your time dealing with patients and other doctors. Erego there is no one better qualified to tell if you have the knack, maturity or temperment to do this job. I also think that folks with people-intense jobs tend to get pretty good at reading people.

 

[Shredder]

This is so embarrassingly absurd -- you've outdone yourself. Are you sure you really want to enter this field when you think so little of the gatekeepers?

ok maybe it was a stretch, but i do think it there are some subconscious power effects and that even if adcom members do have good intentions, intentions are often misdirected. lowly secretaries and clerks often love to flex their muscles as gatekeepers. adcom members arent lowly but they share the same human desires for power and importance, which its natural to crave and relish. im sure adcom members do feel like they have lots of insight into which students are suitable and which not, but tests do a better job of this unless its for a very specific position like a fortune 500 CEO--and even here objective past performance speaks loudest

becoming a good doc with a strong reputation is less about becoming buddies with patients and more about showing them results. in fact a doc who is too cordial risks broaching the traditional doc-patient relationship, which is not one of friendship but more of authority--at least traditionally

 

[Law2Doc]

ok maybe it was a stretch, but i do think it there are some subconscious power effects and that even if adcom members do have good intentions, intentions are often misdirected. lowly secretaries and clerks often love to flex their muscles as gatekeepers. adcom members arent lowly but they share the same human desires for power and importance, which its natural to crave and relish. im sure adcom members do feel like they have lots of insight into which students are suitable and which not, but tests do a better job of this unless its for a very specific position like a fortune 500 CEO--and even here objective past performance speaks loudest

becoming a good doc with a strong reputation is less about becoming buddies with patients and more about showing them results. in fact a doc who is too cordial risks broaching the traditional doc-patient relationship, which is not one of friendship but more of authority--at least traditionally

Lots of adcom members are chairmen, department heads and deans. I assure you that their need for power and importance is more than satisfied elsewhere, and they tend to only do adcom out of pride for the school. As for results oriented patient care, you are going to be really bumming when you get to med school. Quite a few of the patients you will have there is nothing you can do for them other than perhaps make them more comfortable. This won't be just a few patients, it will be many. In med school they will emphasize empathy and listening skills, and expect you to learn and heed these. You simply don't get to brush this aside as unimportant if you plan to do well. It's sort of surprising that you hold these attitudes yet use Donald Trump as your icon -- this is a majorly personality driven, people skills emphasizing, person.

 

[funshine]

Most of the interviewers I've had have been clinicians who spend most of their time dealing with patients and other doctors. You are interviewing for a career where you will spend your time dealing with patients and other doctors. Erego there is no one better qualified to tell if you have the knack, maturity or temperment to do this job. I also think that folks with people-intense jobs tend to get pretty good at reading people.

I've had three interviewers that were outstanding. The rest have been so-so and a few have completely misunderstood parts of my personal statement, which I find rather alarming...if med schools wanted to set up the ideal interview situation, I'd recruit teachers and humanities professors to do the job, b/c in general they are the most awesome people-readers and they can sniff out BS better than anyone else. They are also the best at getting shy people to come out under their modesty shells. But I'm not complaining with the current admissions situation much. I just think it sucks for the deserving few out there who are really screwed over and have to reapply.

 

[Law2Doc]

I just think it sucks for the deserving few out there who are really screwed over and have to reapply.

This is true. But as is apparent from this thread, there are very different viewpoints out there as to who the "deserving few" are.

 

[Shredder]

noteworthy snippets:

The selection of candidates who possess the appropriate personal qualities is important. However, it may be more difficult than expected to adequately assess these qualities.

The results of this study clearly indicate that the admissions criteria used to select medical students are less than perfect predictors of licencing examination performance. Further, the results strongly indicate that the
traditional cognitive predictors have the most utility in predicting future academic and clinical performance. The fact that these two measures were consistently positively correlated with both cognitive and non-cognitive
measures as measured by the licencing examinations, despite the restriction of range, indicates that these are sound predictors. The finding that these traditional academic measures significantly predict LMCC Part II performance, a measure of clinical skill, is contrary to the conventional wisdom that cognitive measures predict performance in the pre-clinical years, but not clinical performance. One explanation may be that, in contrast to this study, previous studies relied on unreliable criterion measures of clinical performance. Our outcome measure, the LMCC Part II, is a sound
measure of clinical skill.

Similarly, although the personal interview was shown to have some utility in predicting LMCC Part II communication skills performance as found by the simple correlations, the hierarchical analysis found no significant relation between personal interview and LMCC Part II communication skills performance. These findings are of great significance since both measures are designed to assess non-cognitive factors such as communication
skills. As the LMCC Part II Examination is an explicit, reliable and valid assessment of communication and problem-exploration skills, it provides an excellent criterion on which to assess the admissions measures of these qualities.

A particularly useful finding of our study is that performance on the communication skills component of the LMCC Part II is predicted by the MCAT Verbal Reasoning score. Since the MCAT Verbal Reasoning score accounted for a much greater portion of the variance than the personal interview, it may be more reasonable to ask applicants to submit MCAT Verbal Reasoning scores rather than to conduct resource-intensive tutorials or interviews. Although the use of MCAT scores may seem inconsistent with the philosophy and policy of schools such as McMaster which encourage applicants from all academic backgrounds, it is important to note that only the Verbal Reasoning component may be used in the selection process. Admissions committees may also want to examine other standardized measures of verbal ability such as the Graduate Record Examination (GRE) Verbal Reasoning component.

...the results clearly indicate that validity studies can inform the admissions process. As medical schools adopt problem-based curricula, there is an increasing trend toward selecting candidates based on non-academic factors based on brief personal interviews. Since decisions based on such admissions measures have profound personal implications, medical schools must ensure that these measures are reliable and valid. As is evidenced by this study, face validity is not sufficient.

 

[happydays]

why do you think that those that you choose under your "method" will be better than those choosen by adcoms?

Show me a doctor who's infallible and I will worship him/her. The current system is already selecting for the best that we've got.

 

[Shredder]

why do you think that those that you choose under your "method" will be better than those choosen by adcoms?

Show me a doctor who's infallible and I will worship him/her. The current system is already selecting for the best that we've got.

http://www.springerlink.com/(3q1y5i...nal,7,32;linkingpublicationresults,1:102840,1

Abstract
Purpose: Determining the valid andfair use of the interview for medical schooladmissions is contingent upon a demonstrationof the reproducibility of interview scores. This study seeks to establish thegeneralizability of interview scores, firstassessing the existing research evidence, andthen analyzing data from a non-experimentalindependent replications research design.

Methods: Multivariate andunivariate generalizability analyses areconducted using data from a structuredinterview obtained from a population of medicalschool applicants over two years.

Results: The existing literaturedoes not provide sufficient evidence regardinginterview reliability. In this study,interview scores derived from a standardizedinterview were found to display low to moderatelevels of reliability. Interview scores do notappear to possess the level of precision foundwith other measures commonly used to facilitateadmissions decisions.

Discussion/Conclusion: Given theresults obtained, the fairness of using theinterview as a highly influential component ofthe admission process is called into question. Methods for using interview data in apsychometrically defensible fashion arediscussed. Specifically, attention to decisionreliability provides guidance on how interviewscores can best be integrated into theadmissions process.

 

[happydays]

Interviews are subjective. Yes, they vary from person to person. Again, there is NO such thing as objectivity. No matter how you select med students, there will ALWAYS be ones that do very well in the system and those who don't. And with any admissions process, there will always be a couple bad apples that get through. That's life. It doesn't matter how you slice this pie, it's always going to taste the same.

 

[kirexhana]

hey people,
maybe we've been going at it all wrong. maybe it's not just the med school admissions we should be thinking of, but the way past students reacted to changes as well? take a look at this:

The problem of choosing the right student for a medical education has befuddled the profession for a long time. Preparation for medical school in the 19th century was guided by the old saw that...a boy too dumb to study classics, too immoral for the pulpit, or too dishonest for the bar, should study medicine (28). The Flexner report (29) and the Council on Medical Education of the American Medical Association (30) changed all that but, by the late 20th century, preparatory qualifications for medical school had become so extraordinary that more and more applicants were showing signs of a "pre-med" syndrome (31). This much maligned syndrome describes a personality where fixation on grades and aggressive anxiety paints the dogged pursuit of a medical school acceptance. The origins of this self-absorption and social insensitivity are not clear, but one could attribute its breeding to the changing values of college students (32) and the competitiveness of professional education (27, 33). We should worry that we have not corrected this behavior (34-36) or even made it worse (37) by the time students leave medical school. In any case, educators twenty years ago felt we could remedy the situation by selecting a different kind of student (28, 38).

Consequently, in the early 1980s just before the time medical students began showing less interest in research (16), we entered a period where admitting matriculants with an education broader in the humanities was thought to be a good way of developing more compassionate physicians (38-40). Admissions committees began taking this notion seriously (41), and medical schools added training in humanistic values to their curricula (42). The implications of this approach for students who wanted to study medicine for the love of the science was not all that favorable (40, 43, 44). I suspect admissions committees fell into a trap of confusing this love of science with the risk of educating someone who would become too enamored with the impersonal aspects of technology (33, 44, 45). If true, committees have misjudged the character of physician-scientists and failed to recognize that scientific progress is what leads to more humane treatment (33, 46). There is a Good Samaritan tradition in the work ethic of physician-scientists that reflects an authentic compassion for human health (47). A life in science offers the hope of helping many more patients beyond the few we assist individually in the clinic (48, 49). Such values need more praise by those responsible for student selection. In any event, we have trained several generations of technocrats (44, 50) and most of them are not physician-scientists. If finding college students who majored in the humanities was the answer to more professionalism from physicians, why then did we need social curriculum reform? The modern message about training in the humanities did not consider Mencken’s prescient observation that...there is always an easy solution to every human problem — neat, plausible, and wrong (51).

More at: http://www.jci.org/cgi/content/full/111/6/765%20

Changes have definitely occurred such as the MCAT 80 years ago and interviews 20 years ago (?), so I don't think that we can blame tradition for any oversighted faults in this process. The problem might just be the opposite, too many specific changes for the wrong reasons, like trying to put a bandage on a gunshot? (if this doesn't make sense, i'm sorry it's late). My point is, maybe 40 years from now, they feel that students might not be interested in contributing knowledge to their field and have a publication requirement to become even more specific on who they're looking for. Perhaps, we're just expecting too much out of our doctors? Dunno, just a thought I wanted to share.

 

[Shredder]

happydays by that reasoning we really should select applicants by setting minimum cutoffs and then rolling dice, since apparently it makes no difference either way, right? i mean, everything is imperfect and cest la vie, so why bother trying to improve anything?

every research paper i have ever read cites objectivity as a goal of the research, especially in social sciences and outcomes research. if you dismiss the notion of objectivity, or the strive for it, you should remain strictly in the realm of the clinic and far from anything involving studies and correlations. in fact i would fear any doctor who claims objectivity does not exist. basically you are completely casting aside the concept of correlations and what they mean. i think youre really flailing now, you might do best to throw in the towel. im stunned. i hate turning discussions at all personal, but i cannot believe the implications you are making. trying to increase objectivity is pointless, wow.

 

[happydays]

That's because everything is based on economics: doctors make more money, more people want to enter the field, so adcoms have to look for more EC's in the applicants' profiles to weed out those who didn't completely dedicate themselves to entering med school.

 

[happydays]

correlation is found based on our limited ability to interpret things. Give 5 doctors the same symptoms and you might just get 5 different diagnoses.

It's an artificial world. Love it or hate it. It's your call.

You think the interview is completely random, but it's not. Those who possess good communication skills WILL get accepted more than those who aren't. Some people feel the process is very random because they're over-confident about their own communication skills (and hate it when someone tells them that it ain't so hot). Med school is half brains (MCAT/GPA) and half heart (communication). Can't have one without the other (now sing that Married with Children theme song with me).

 

[Shredder]

studies show that its talent--demonstrated talent via psychometric constructs, and grades to a lesser extent--that makes the most effective docs, not some vague idea of "dedication" that is not quantifiable except in the number of useless volunteering hours. i dont see fortune 500 companies hiring leaders based on who wants it really bad--they base it on demonstrated past performance as i stated earlier in the thread.

ECs as criteria did not come about in this country until after ww2 and it was for political reasons, not sound ones. so, you exalt "dedication" as a concept but belittle objectivity...interesting. dedication sans talent is meaningless, sports are the best example. dedication in the end doesnt save lives, skills and abilities do

 

[happydays]

When you look for a job in the business world, charisma and the ability to kiss ass will contribute 70% to your position as CEO (or some other top job). The first thing a top business firm screens for in an interview is someone with ambition, charm, and the ability to schmooze (sp?). Talk about objectivity there.

how do adcoms screen for drive: they look at how dedicated you are at getting to med school (this includes doing research, volunteering, shadowing, etc.). Not everyone is will to do all those, so they are eliminated. How do adcoms screen for intelligence? Grades. Over all, your grades take you to the interview, which is where they look for communication skills. (Good docs need to be able to "market" trust to their patients.)

Face it. You can't get away from subjectivity. No matter how hard you want to try. It's everywhere!

 

[Shredder]

correlation is found based on our limited ability to interpret things. Give 5 doctors the same symptoms and you might just get 5 different diagnoses.

It's an artificial world. Love it or hate it. It's your call.

You think the interview is completely random, but it's not. Those who possess good communication skills WILL get accepted more than those who aren't. Some people feel the process is very random because they're over-confident about their own communication skills (and hate it when someone tells them that it ain't so hot). Med school is half brains (MCAT/GPA) and half heart (communication). Can't have one without the other (now sing that Married with Children theme song with me).

i posted a table above that patently refutes your argument on the strengths of the interview. i dont think the interview is completely random (meaning a correlation of 0 versus the correlation of .26 or so shown). but also shown is the superiority of the verbal portion of the mcat in predicting communication skills, calling into question the need for interviews at all in the face of a superior criterion, verbal mcat scores. the artificial world bit shows a very resigned attitude. learned helplessness is a state i want to avoid in my life. theres something called changing things, moving and shaking, taking the bull by the horns

giving 5 docs the same symptoms and getting 5 different diagnoses is a weakness in medicine. standardization is seen as a good thing--this is a big problem in medical records and insurance. im reading a well known book called "blink" where the guy talks about some hotshot doc who cooked up an algorithm for diagnosing questionable heart attack cases. when it was compared to the diagnoses of individual docs (who all thought they could beat the algorithm) it had a much higher accuracy. so much for the merits of subjectivity.

 

[Shredder]

When you look for a job in the business world, charisma and the ability to kiss ass will contribute 70% to your position as CEO (or some other top job). The first thing a top business firm screens for in an interview is someone with ambition, charm, and the ability to schmooze (sp?). Talk about objectivity there.

CEOs like carly fiorina of HP can in fact schmooze their way into top positions. only to be very publicly canned soon afterward after showing dismal performance in objective measures--earnings, profits, stock price. nobody cares about how the CEO looks or talks, people want money. in the end objectivity wins. fiorina only got there in the first place bc the had some fortuitous successes in prior endeavors--meaning good numbers, not how many friends she had or how her voice sounded

many businesses would administer intelligence/iq tests if the govt didnt prohibit it, which it does, for dubious reasons. studies consistently show the superiority of objective measures in predictive value vs subjective measures. when microsoft interviews candidates they ask questions like "how many windows are in the city of san francisco" to assess wits and the thinking process of interviewees. its a clever way of getting around explicit administration of iq tests, which im sure they would prefer if uncle sam allowed it.