Revamp Medical School Admissions to Mimic Residency Application Process

[Greenberg702]

Hello fellow SDNers. I wanted to spark a discussion regarding an issue that I've been thinking extensively about since the beginning of last summer and that is the goals, nature of, and success of the current medical school admissions process. I ran several of these ideas and suggestions past the Dean for Medical Education at the school I'm currently doing research at and was surprised to receive positive feedback and genuine interest in some of these points. Was curious to hear what people (especially current and former applicants) thought.

It appears to me and many of my pre-med friends and acquaintances that the current system of med school admissions feels extremely contrived, with artificial hoops set-up for no discernible purpose than to please some bigwigs or administrators sitting on admissions committees. Schools are often extremely vague about what they're looking for. It seems that much of the process is "fake" and rewards mindless box-checking/conforming to certain requirements than really preparing oneself for a career in medicine. If we're really honest with ourselves, we would admit that this process has at least somewhat affected how we structure or schedules/ECs/summers and the thought of medical school is always looming in the back of our minds as we go through undergrad.

Applications for residency/post-graduate training differ significantly from those for medical school. As is well known, residency directors look at 1. USMLE Step I score (in order to have a standard for comparing all applicants) 2. Clerkship grades (are you a strong clinician? can you work with other residents/attendings?) 3. Letters of recommendation from physicians (very field dependent but writers are often from the specialty you're applying to) 4. Research (are you committed to academics/advancing the field? More so at top programs). They care very little about anything else. Some cool ECs and volunteering may be good talking points but they never make or break an application. People want to know a) Are you smart? b) Can you be a good physician with whom we can work with for the next 3-7 years? The whole process seems much more intuitive, almost like applying for any normal job.

Now, what if we can extend some of these principles in order to make medical school admissions look more like residency applications? I've heard of some people advocating for a match system in order to minimize waitlisting, which is an interesting but slightly different discussion. First, we must establish "the point" of the whole system. How can we find people who will make excellent physicians and advance the field we're so passionately about? I think the crucial questions that we must ask are 1) Are you a smart individual? Will you be able to successfully graduate from medical school and become licensed? 2) Are you interested in medicine?What makes you passionate about the field? 3) Are you somebody with whom people can work?
In order to better answer these questions, I'd like to propose the following modifications:

1. MCAT + GPA: These should be very heavily favored a la Step I.
2. Eliminate ridiculous cut-offs that some committees have in terms of box checking. A personal anecdote: My SO who is on the committee of a top 5 med school at my undergrad told me that a 3.9+ from Princeton with good research, no red flags, worked through college to support themselves, and who spent 2 years in Colombia streamlining healthcare delivery systems got dinged because of insufficient shadowing. "How do we know he's really interested in medicine, they asked." These kinds of attitudes from members who aren't even physicians (see point 4) are ridiculous and archaic. There should be no cutoffs for clinical experience/shadowing, volunteering, or other requirements. The resume padding that occurs among pre-meds is wildly rampant (I myself am guilty of this) and really isn't productive for anybody or makes a good use of students' time. I've seen posts on SDN that boast getting 100000 hours of hospital volunteering just to one-up somebody else.
3. Make requirements for letters of recommendation more flexible. In a college environment, interacting with professors (particularly science professors) is fairly difficult without some major outside involvement like performing research with your science professor or having him/her as an adviser for your student organization. When applying this cycle, I felt that the people who really knew best were NOT my science professors who lectured from power-point slides but were physicians who I shadowed, my PIs, and EC/student org advisers. Personally, I think this point needs to be discussed/addressed. I chose to present an abstract (on a topic I was not remotely interested in) with one of my science profs in order to better get to know them for a rec letter. This "playing the game" shouldn't be necessary.
4. Make admissions committees MD only (except for screeners). I personally believe that you should not be permitted to assess students' suitability to pursue a degree which you yourself do not possess. Some of the administrators/PhDs on these committees have no idea what real medicine is like (I'm not claiming I do either) and have no idea how out of touch this process is with the reality of pre-medical preparation. Some of them genuinely believe that people who spend a couple hours a week tutoring or going on 2 week trips to Guatemala (never to be seen again) are somehow more compassionate than those who don't.
5. Repeal MMI interviewing in favor of traditional interviews. The whole notion that setting up a bunch of contrived scenarios is somehow better than speaking with and getting to know an actual person is ridiculous. REAL patient interactions occur in the traditional fashion. Residency interviews occur in the same 1 v 1 way. You need to learn how to present your thoughts/ideas/story in a cogent manner to any person who is sitting in front of you. That is real life and nobody will be asking you what you would do if you crashed into a BMW in the parking lot. The most natural solution to this in my view would be to have residency application style "speed-dating" interviews with multiple people.
6. Convert affirmative action utilizing race into an affirmative action system that takes into account socioeconomic status. The latter method would incorporate indigent individuals of ALL races. At several of my interviews/second looks, the vast majority of URM students were super rich and attended private schools. There is absolutely no way that they were more disadvantaged than an Asian or Caucasian growing up in coal country or more likely to serve URM groups in the future. They all admitted to wanting to pursue derm/plastics and open up private practices. Obviously, this is highly controversial and anecdotal but an affirmative action system utilizing socioeconomic status intuitively seems more fair and may better differentiate those who are more likely to practice in underserved areas. Asking individuals who checked the URM box additional questions regarding their ties to certain groups during interviews can also help address this.

Full disclosure: I was very fortunate to be successful this past cycle. This does not, however, mean that I support all of the aspects of medical school admissions or believe that there should not be serious changes to the system. I'd love to hear what other people think.

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[gettheleadout]

I like suggestions 1-5 quite a lot. I might amend #6 to instead heavily favor URM applicants (both racial minorities and, separately, underrepresented SES) with cultural ties and a history of involvement with their group, in an effort to select for future URM physicians that will actually serve underserved URM communities and SES-disadvantaged physicians that will actually serve low-SES underserved communities.

 

[dbeast]

I saw the long post and immediately thought, oh man this is gonna be a bunch of sour grapes, but you actually raise a lot of good points. Some schools do operate closer to the fashion that you propose, and the ones that don't are surely missing out on some strong applicants.

For the record, plenty of residencies do have cutoffs as well in regards to research and step 1 scores. Also I'm not a fan of the MMI either.

 

[mrh125]

All of them are good except for 1 which is horrible and a huge portion of what's wrong with the process. By making a number such as the mcat THE factor that makes you a doctor you indadvertedly screw over a lot of great future doctors, regardless of "statistical relevance" (if you ask me someone should release the full set of data that correlated the mcat and step 1 because even in a statistical context, data can be interpreted in many diff ways. Let more people see all the data and make their own decisions). Elevated Standardized test scores importance also screws over a lot of people from non-trad backgrounds and diverse circumstances, if anything most of the time they're better off used as a way to indicate one's socioeconomic background (can you pay for 9 bajillion resources and expensive $350/hr private tutoring or upteen thousand prep course? this is considering the fact that many people don't know about sdn)

If anything med school admissions should be like college admissions as colleges take the highest standardized test scores in each section. Applicants should be given the benefit of the doubt, instead of held to superfluous competition-induced admissions standards regarding standardized tests.

 

[Aerus]

1 sounds nice, but in reality, so many people have the numbers. How else are we to filter people out?

Love 2 and 3.

No opinion on 4.

I like 5, although there have been studies that show MMI's are more effective than traditional interviews.

You're missing the main point in 6 - it's not give a boost for being disadvantaged. It's to recruit applicants who are more likely to serve underserved communities.

 

[Greenberg702]

I like suggestions 1-5 quite a lot. I might amend #6 to instead heavily favor URM applicants (both racial minorities and, separately, underrepresented SES) with cultural ties and a history of involvement with their group, in an effort to select for future URM physicians that will actually serve underserved URM communities and SES-disadvantaged physicians that will actually serve low-SES underserved communities.

I can buy that. The main point I was trying to raise is that the current system of blindly checking the URM box ---> instant advantage does NOT differentiate between applicants who are most likely to return to underserved URM communities. I think that exploring this further (perhaps questioning applicants who checked this box at the interview about their involvement) could better achieve this.

 

[gettheleadout]

I can buy that. The main point I was trying to raise is that the current system of blindly checking the URM box ---> instant advantage does NOT differentiate between applicants who are most likely to return to underserved URM communities. I think that exploring this further (perhaps questioning applicants who checked this box at the interview about their involvement) could better achieve this.

Oh I completely agree.

 

[Greenberg702]

All of them are good except for 1 which is horrible and a huge portion of what's wrong with the process. By making a number such as the mcat THE factor that makes you a doctor you indadvertedly screw over a lot of great future doctors, regardless of "statistical relevance" (if you ask me someone should release the full set of data that correlated the mcat and step 1 because even in a statistical context, data can be interpreted in many diff ways. Let more people see all the data and make their own decisions).

If anything med school admissions should be like college admissions as colleges take the highest standardized test scores in each section. Applicants should be given the benefit of the doubt, instead of held to superfluous competition-induced admissions standards regarding standardized tests.

Like it or not, numbers are a huge part of medicine. It is simply the most objective "fair" way to distinguish the academic strength of applicants and those who took the time and made the sacrifices to master the content. Now, we can have the discussion about the MCAT being a skills test kind of like the SAT, as opposed to a knowledge test like Step I (which is more studyable) and that would be valid. No EC involvement/"interesting" background can make up for a Step I failure.

 

[Greenberg702]

1 sounds nice, but in reality, so many people have the numbers. How else are we to filter people out?

Love 2 and 3.

No opinion on 4.

I like 5, although there have been studies that show MMI's are more effective than traditional interviews.

You're missing the main point in 6 - it's not give a boost for being disadvantaged. It's to recruit applicants who are more likely to serve underserved communities.

I can buy that. The main point I was trying to raise is that the current system of blindly checking the URM box ---> instant advantage does NOT differentiate between applicants who are most likely to return to underserved URM communities. I think that exploring this further (perhaps questioning applicants who checked this box at the interview about their involvement) could better achieve this.

 

[mrh125]

Like it or not, numbers are a huge part of medicine. It is simply the most objective "fair" way to distinguish the academic strength of applicants and those who took the time and made the sacrifices to master the content. Now, we can have the discussion about the MCAT being a skills test kind of like the SAT, as opposed to a knowledge test like Step I (which is more studyable) and that would be valid. No EC involvement/"interesting" background can make up for a Step I failure.

I've taken the mcat and SAT and if you ask me the mcat was nothing like the SAT, which was far more reasonable as you were held accountable for the listed material and the study resources were representative of the real test. the mcat is a breadth slot machine. you develop all this background knowledge and do all these practice problems and you hope you dont get blind-sided by it, but are ultimately left at the mercy of its slot machine pseudo "skill" (note the quotes) based testing. It also seems pretty hard to correlate the step 1 and mcat when they are designed to assess students in two totally diff ways as you mentioned. The step 1 sounds fair more reasonable, meaning you study, learn all you can, and are held accountable for that knowledge.

Also look at the way the cutoffs are done in verbal reasoning. it's not only flawed but nonsensical.

 

[Greenberg702]

1 sounds nice, but in reality, so many people have the numbers. How else are we to filter people out?

Love 2 and 3.

No opinion on 4.

I like 5, although there have been studies that show MMI's are more effective than traditional interviews.

You're missing the main point in 6 - it's not give a boost for being disadvantaged. It's to recruit applicants who are more likely to serve underserved communities.

Now, the issue that most MMIers raise about traditional interviews is the problem of interobserver variability. The most natural solution to this in my view would be to have residency application style "speed-dating" interviews with multiple people. I think that there's something to be said for being able to maintain an interesting conversation with somebody you have never met. Again, this is exactly what occurs in physicians' lives every day, not acting out fake scenarios. Using MMIs to solve the inter-observer variability issue completely destroys this and just sets up more artificial hoops.

 

[Fabio Lanzoni]

I'm not really a fan of MMIs, but I don't like traditional interviews either. Your fate rests on the hand of one or two people who might be highly biased and that is out of your control. I would vote for a hybrid of a panel of normal interviews (not ridiculous scenarios) that are shorter than your traditional interview. Maybe 5 x 10mins.

 

[gettheleadout]

I've taken the mcat and SAT and if you ask me the mcat was nothing like the SAT, which was far more reasonable as you were held accountable for the listed material and the study resources were representative of the real test. the mcat is a breadth slot machine. you develop all this background knowledge and do all these practice problems and you hope you dont get blind-sided by it, but are ultimately left at the mercy of its slot machine pseudo "skill" (note the quotes) based testing. It also seems pretty hard to correlate the step 1 and mcat when they are designed to assess students in two totally diff ways as you mentioned. The step 1 sounds fair more reasonable, meaning you study, learn all you can, and are held accountable for that knowledge.

Also look at the way the cutoffs are done in verbal reasoning. it's not only flawed but nonsensical.

I hope you don't think every Step 1 exam form covers all the testable material.

 

[mrh125]

I hope you don't think every Step 1 exam form covers all the testable material.

I'm not expecting it to. My point still stands though. the mcat is the epitome of a breadth slot machine exam and that's a huge part of the reason why people are stuck with the feeling that they can do better.

 

[Aerus]

Now, the issue that most MMIers raise about traditional interviews is the problem of interobserver variability. The most natural solution to this in my view would be to have residency application style "speed-dating" interviews with multiple people. I think that there's something to be said for being able to maintain an interesting conversation with somebody you have never met. Again, this is exactly what occurs in physicians' lives every day, not acting out fake scenarios. Using MMIs to solve the inter-observer variability issue completely destroys this and just sets up more artificial hoops.

I can agree on this part. While I do like the "multiple" part of MMI's, as it does reduce bias, they need to actually keep the "interview" part! Hiring actors to scream or cry in your face is not what I would consider an interview!

 

[Aerus]

I'm not really a fan of MMIs either, but I don't like traditional interviews either. Your fate rests on the hand of one or two people who might be highly biased and that is out of your control. I would vote for a hybrid of a panel of normal interviews (not ridiculous scenarios) that are shorter than your traditional interview. Maybe 5 x 10mins.

^Yes, this!

 

[Aerus]

I've taken the mcat and SAT and if you ask me the mcat was nothing like the SAT, which was far more reasonable as you were held accountable for the listed material and the study resources were representative of the real test. the mcat is a breadth slot machine. you develop all this background knowledge and do all these practice problems and you hope you dont get blind-sided by it, but are ultimately left at the mercy of its slot machine pseudo "skill" (note the quotes) based testing. It also seems pretty hard to correlate the step 1 and mcat when they are designed to assess students in two totally diff ways as you mentioned. The step 1 sounds fair more reasonable, meaning you study, learn all you can, and are held accountable for that knowledge.

Also look at the way the cutoffs are done in verbal reasoning. it's not only flawed but nonsensical.

It's only a slot machine if you approach the MCAT by trying to memorize everything. Yes, there's content, but there's also a list. Once you master the list, it's all up to your ability to critically think with the content.

 

[gettheleadout]

I'm not expecting it to. My point still stands though. the mcat is the epitome of a breadth slot machine exam and that's a huge part of the reason why people are stuck with the feeling that they can do better.

And if they had prepared for all the content they are responsible for they might have.

 

[mrh125]

And if they had prepared for all the content they are responsible for they might have.

that's silly though and a total copout to tell people that. you can't prepare for an infinite of permutations and trick questions with material unrelated to the topic outline aamcs provides. you can however prepare for an exam that provides you a realistic knowledge based context of what you need to know.

 

[mehc012]

I've taken the mcat and SAT and if you ask me the mcat was nothing like the SAT, which was far more reasonable as you were held accountable for the listed material and the study resources were representative of the real test. the mcat is a breadth slot machine. you develop all this background knowledge and do all these practice problems and you hope you dont get blind-sided by it, but are ultimately left at the mercy of its slot machine pseudo "skill" (note the quotes) based testing. It also seems pretty hard to correlate the step 1 and mcat when they are designed to assess students in two totally diff ways as you mentioned. The step 1 sounds fair more reasonable, meaning you study, learn all you can, and are held accountable for that knowledge.

Also look at the way the cutoffs are done in verbal reasoning. it's not only flawed but nonsensical.

Thank heavens the MCAT isn't like the SAT...the SAT is barely even a test! If we were using THAT to evaluate admissions, everyone would have a 2300+ and you may as well not have a standardized exam (and no opportunity for low-GPA turnarounds to demonstrate that they do, indeed, have some academic skillz).

 

[Greenberg702]

I've taken the mcat and SAT and if you ask me the mcat was nothing like the SAT, which was far more reasonable as you were held accountable for the listed material and the study resources were representative of the real test. the mcat is a breadth slot machine. you develop all this background knowledge and do all these practice problems and you hope you dont get blind-sided by it, but are ultimately left at the mercy of its slot machine pseudo "skill" (note the quotes) based testing. It also seems pretty hard to correlate the step 1 and mcat when they are designed to assess students in two totally diff ways as you mentioned. The step 1 sounds fair more reasonable, meaning you study, learn all you can, and are held accountable for that knowledge.

Also look at the way the cutoffs are done in verbal reasoning. it's not only flawed but nonsensical.

It's tough for me to comment on this but I don't remember anything appearing on my MCAT that wasn't on the AAMC outline or given in the passage. I do recognize, however, that verbal is imperfect (although I do think that <6 is a reasonable screen) and that quickly assessing the information presented in passages does test "skills." Whether or not this is appropriate is a different discussion altogether.

 

[Greenberg702]

I can agree on this part. While I do like the "multiple" part of MMI's, as it does reduce bias, they need to actually keep the "interview" part! Hiring actors to scream or cry in your face is not what I would consider an interview!

I'm not really a fan of MMIs, but I don't like traditional interviews either. Your fate rests on the hand of one or two people who might be highly biased and that is out of your control. I would vote for a hybrid of a panel of normal interviews (not ridiculous scenarios) that are shorter than your traditional interview. Maybe 5 x 10mins.

Yes, this is exactly what I meant by residency-style "speed-dating" interviews. This is what they actually do in the real world.

 

[gettheleadout]

that's silly though and a total copout to tell people that. you can't prepare for an infinite of permutations and trick questions with material unrelated to the topic outline aamcs provides. you can however prepare for an exam that provides you a realistic knowledge based context of what you need to know.

Preparing for "infinite permutations" of question scenarios is unnecessary because you're expected to be able to apply critical thinking ability and background knowledge to adapt to new situations and information. Your assertion that untestable content appears on the exam is unfounded as far as I'm concerned. From my position the MCAT does indeed provide a realistic, relatively detailed list of the content you are responsible for.

 

[mrh125]

Preparing for "infinite permutations" of question scenarios is unnecessary because you're expected to be able to apply critical thinking ability and background knowledge to adapt to new situations and information. Your assertion that untestable content appears on the exam is unfounded as far as I'm concerned. From my position the MCAT does indeed provide a realistic, relatively detailed list of the content you are responsible for.

Just because you've encountered it doesn't make it fair, although it's pretty easy to make generalizations from that perspective. The same goes for your study strategies. Plenty of people may use and expose themselves to the resources you do, but that hardly puts them on the same playing field as yourself. Like I said before about most of those who score well on the mcat and give advice, they start with high scores and score higher. It's a bias sample.

 

[gettheleadout]

Just because you've encountered it doesn't make it fair, although it's pretty easy to make generalizations from that perspective. The same goes for your study strategies. Plenty of people may use and expose themselves to the resources you do, but that hardly puts them on the same playing field as yourself. Like I said before about most of those who score well on the mcat and give advice, they start with high scores and score higher. It's a bias sample.

Yeah, people have different innate aptitudes for different things. Life's not fair. Anyway, this is the last time I'll address the issue in this thread. Back on topic!

 

[mehc012]

Just because you've encountered it doesn't make it fair, although it's pretty easy to make generalizations from that perspective. The same goes for your study strategies. Plenty of people may use and expose themselves to the resources you do, but that hardly puts them on the same playing field as yourself. Like I said before about most of those who score well on the mcat and give advice, they start with high scores and score higher. It's a bias sample.

Even if that is true (I'm not saying its not, I just don't trust your offhand evaluation to be unbiased any more than I trust my own not to be), that is hardly an argument against what gettheleadout is saying...perhaps those who can 'apply critical thinking skills' in the way that the MCAT wants start out high, then get higher with content review. Again, not stating that that is what's happening, but it's a simple, plausible explanation which fits your statement AND gettheleadout's. If you want to contest "MCAT = the content on AAMC + critical thinking", you'll have to come up with something more robust.

 

[Narmerguy]

Just because you've encountered it doesn't make it fair, although it's pretty easy to make generalizations from that perspective. The same goes for your study strategies. Plenty of people may use and expose themselves to the resources you do, but that hardly puts them on the same playing field as yourself. Like I said before about most of those who score well on the mcat and give advice, they start with high scores and score higher. It's a bias sample.

I don't know what my score would have been when I first started, but given my knowledge at the time, probably something 13-15 points lower than what I ended up with. The MCAT is a knowlege + reasoning test. My reasoning never changed, but relearning the knowledge I had forgotten (or never fully understood) from my prereqs is what brought up my score (I took the exam more than 2 years after I took my last prereq).

I see people complain often about exam questions as unfair or requiring "tricks" to solve. For the most part, if you knew the information in the fairly detailed AAMC list you would not need to resort to any of that and the correct answer is evident. The only section of the MCAT that is "tricky" is the Verbal, which I think is a shoddy section that needs to be improved (or scaled differently). But the sciences are pretty cut and dry once you've mastered all the concepts that the MCAT can cover.

Testers' unwillingness to study and master all of those concepts inevitably introduces much more confusion and variance into their test performance that does not reflect ambiguities on the actual test (with the exception of Verbal...which is crap). Just look at the practice tests--every answer can typically be explained quite succintly using a combination of reasoning from the passage and background information that is covered in the topic list. There are no magical leaps and twirls. Most people score quite within a certain range, which is normal for any test. Their scores on the real deal usually reflect that as well.

This post is a long way of saying: preparing for the MCAT is a combination of knowledge and reasoning ability. The latter is harder to change, but true mastery of the former is hard to acquire and accounts for much of why people needlessly struggle on the test.

 

[masaraksh]

I've taken the mcat and SAT and if you ask me the mcat was nothing like the SAT, which was far more reasonable as you were held accountable for the listed material and the study resources were representative of the real test. the mcat is a breadth slot machine. you develop all this background knowledge and do all these practice problems and you hope you dont get blind-sided by it, but are ultimately left at the mercy of its slot machine pseudo "skill" (note the quotes) based testing. It also seems pretty hard to correlate the step 1 and mcat when they are designed to assess students in two totally diff ways as you mentioned. The step 1 sounds fair more reasonable, meaning you study, learn all you can, and are held accountable for that knowledge.

Also look at the way the cutoffs are done in verbal reasoning. it's not only flawed but nonsensical.

... Now you're just talking out of your @$$. Tell the above to any of the kids who hit 37-42 on their FL averages and they'll laugh in your face. I sucked at verbal, but the rest is quite far from a 'slot machine'. The content you need to know is pretty well defined and clear. All questions/passages ultimately don't fall outside the scope of that content. After a solid amount of content review & practice problems (4-6 weeks), I was consistently hitting 12+ in all BS and PS sets.


"The step 1 sounds fair more reasonable, meaning you study, learn all you can, and are held accountable for that knowledge."

Since you haven't studied, learned the content, or taken step 1, none of what you say about it matters. Actually your statement doesn't even make sense since it is just as applicable to MCAT sciences - you study, learn all you can, and are held accountable for the knowledge.


Verbal may seem like a slot machine from hell but actually, if you read more about the setup and structure of it, it is quite a standardized assessment.

 

[masaraksh]

Thank heavens the MCAT isn't like the SAT...the SAT is barely even a test! If we were using THAT to evaluate admissions, everyone would have a 2300+ and you may as well not have a standardized exam (and no opportunity for low-GPA turnarounds to demonstrate that they do, indeed, have some academic skillz).

Actually, replace SAT with GRE and your quote stands. GRE is a joke. Everyone will have 320+

 

[DokterMom]

1 MCAT & GPA

• These are useful and relevant, but imperfect. I'd like to also see Class Rank % within major or university overall on transcripts as a way of controlling for grade inflation/deflation. And for MCAT scores, a more standardized way of handling retakes and verbal scores for English as a second language applicants.

2 ECs

• As opposed to eliminating or reducing requirements, how about simply making them explicit? Simply require 40 hours of shadowing, 100 hours of clinical contact, and 100 hours of community service and require letters or timesheets to substantiate the time.

3 LORs

• I'd agree that more flexibility would be better.

4 MD committee

• Makes sense...

5 MMI

• If MMI results are statistically more accurate, shouldn't we use them more rather than less? The 'What would you do if...' scenarios are valuable and informative, as some applicants do not posses much common sense or resilience and it's important to weed them out where possible. I do agree with the argument that several 15-minute conversations are more reflective of a physician's actual work environment, but 'small talk' is only one measure, and arguably, not the best.

6 URM AA

• In a perfect world, we wouldn't need to do anything here -- but I don't think anyone is arguing that our world is perfect. I would prefer a system that considers both race and SES in admissions to further the legitimate goals of diversity and supplying physicians that better mirror our population. I would agree that it is unfair to offer significant preferences for racial minorities from privileged SES backgrounds who are unlikely to serve underserved populations anyway, but very necessary and appropriate to favor racial minorities from disadvantaged circumstances. I'd also change the way Asian applicants are classified, similar to the way Hispanic applicants are sub-classified. Some Asian populations are severely SES disadvantaged, and treating them all as ORM is unfair.

 

[Goro]

When you start teaching medical students, you'll sing a different tune. I have to teach these people and I want students who I can tell will handle our curriculum. And yes, I can suss that out in a very narrow window of a group interview format. And we're not idiots, we know that mission trips are medical tourism, and we discount them.

People going into residencies are different from people going into medical school.


4. Make admissions committees MD only (except for screeners). I personally believe that you should not be permitted to assess students' suitability to pursue a degree which you yourself do not possess. Some of the administrators/PhDs on these committees have no idea what real medicine is like (I'm not claiming I do either) and have no idea how out of touch this process is with the reality of pre-medical preparation. Some of them genuinely believe that people who spend a couple hours a week tutoring or going on 2 week trips to Guatemala (never to be seen again) are somehow more compassionate than those who don't.


We don't do MMI, but there's decent data ( from U of Edmonton, I think), that shows MMI is a good predictor of a person's compassion.

5. Repeal MMI interviewing in favor of traditional interviews. The whole notion that setting up a bunch of contrived scenarios is somehow better than speaking with and getting to know an actual person is ridiculous. REAL patient interactions occur in the traditional fashion. Residency interviews occur in the same 1 v 1 way. You need to learn how to present your thoughts/ideas/story in a cogent manner to any person who is sitting in front of you. That is real life and nobody will be asking you what you would do if you crashed into a BMW in the parking lot. The most natural solution to this in my view would be to have residency application style "speed-dating" interviews with multiple people.

 

[Mr Interesting]

Interesting.... You do raise some valid points that provokes a good discussion. I particularly do not favor MMI either.

At several of my interviews/second looks, the vast majority of URM students were super rich and attended private schools. There is absolutely no way that they were more disadvantaged than an Asian or Caucasian growing up in coal country or more likely to serve URM groups in the future. They all admitted to wanting to pursue derm/plastics and open up private practices

Are you implying that the only way minorities can get into medical school is if they are disadvantaged? First off, that sounds like complete crap but even if this was true those super rich URM students could have way better stats than you. Unless you actually went up to them one by one to ask them about their stats (which would make you a complete douche btw) this just a blanket statement. Super rich URM students would most likely not check the disadvantaged box because it's so easy to find out they are not. Do you think adcoms will believe a Hispanic student from Beverly Hills with parents who are both doctors is disadvantaged? Give them more credit than that. Also please note URM's are not limited to serving underserved communities in just family medicine. They can serve underserved communities from any specialty of their choice or even while doing academic research.

I like suggestions 1-5 quite a lot. I might amend #6 to instead heavily favor URM applicants (both racial minorities and, separately, underrepresented SES) with cultural ties and a history of involvement with their group, in an effort to select for future URM physicians that will actually serve underserved URM communities and SES-disadvantaged physicians that will actually serve low-SES underserved communities.

I agree but I am highly skeptical this will change much. Some minority students already get accepted on their own merits and others who come from poverty most likely already do show ties to their community and a commitment to serving underserved communities. Think about it, if they live in impoverish areas they are more likely to do extracurriculars and volunteering in those same areas. We could focus more on SES status but if we look at the US poverty rates by races. Which races are more likely to produce students who grew up poor? How would this affect average students who grew up in middle class?

 

[Greenberg702]

Interesting.... You do raise some valid points that provokes a good discussion. I do particularly do not favor MMI either.



Are you implying that the only way minorities can get into medical school is if they are disadvantaged? First off, that sounds like complete crap but even if this was true those super rich URM students could have way better stats than you. Unless you actually went up to them one by one to ask them about their stats (which would make you a complete douche btw) this just a blanket statement. Super rich URM students would most likely not check the disadvantaged box because it's so easy to find out they are not. Do you think adcoms will believe a Hispanic student from Beverly Hills with parents who are both doctors is disadvantaged? Give them more credit than that. Also please note URM's are not limited to serving underserved communities in just family medicine. They can serve underserved communities from any specialty of their choice or even while doing academic research.



I agree but I am highly skeptical this will change much. Some minority students already get accepted on their own merits and others who come from poverty most likely already do show ties to their community and a commitment to serving underserved communities. Think about it, if they live in impoverish areas they are more likely to do extracurriculars and volunteering in those same areas. We could focus more on SES status but if we look at the US poverty rates by races. Which races are more likely to produce students who grew up poor? How would this affect average students who grew up in middle class?

That is not at all what I'm implying. I know several URMs in my class who applied and with whom I'm very friendly (3.7/ 35 MCAT got into every single medical school they applied to including Hopkins/HMS/Stanford). The point I'm trying to make is that right now, NOBODY looks into the background of applicants checking off their race. They wouldn't check off the disadvantaged box but you're naive if you think they will not check off "AA or Hispanic." The way it currently works is that adcoms have a list of all applicants on the computer and they simply sort by race so that people who checked off certain boxes appear at the top of the screen. Simply checking off this box gives an incredible advantage, regardless of their stats (which can be and often may be very strong). The point is that adcoms currently take the path of least resistance and accept the most academically qualified minorities (who are often from 250K + households, but not "Beverly Hills") under the guise that they will go on to serve underrepresented communities. Nobody probes this at the interview, and nobody really cares whether you've had involvement or not. This is a well-known fact and I believe that you can still give preferences to certain groups as long as you actually investigate their background more carefully. Under the current system: checking off race box ---(no questions asked)---> You show up at the top of the screen w/ instant advantage.

 

[Greenberg702]

When you start teaching medical students, you'll sing a different tune. I have to teach these people and I want students who I can tell will handle our curriculum. And yes, I can suss that out in a very narrow window of a group interview format. And we're not idiots, we know that mission trips are medical tourism, and we discount them.

People going into residencies are different from people going into medical school.


4. Make admissions committees MD only (except for screeners). I personally believe that you should not be permitted to assess students' suitability to pursue a degree which you yourself do not possess. Some of the administrators/PhDs on these committees have no idea what real medicine is like (I'm not claiming I do either) and have no idea how out of touch this process is with the reality of pre-medical preparation. Some of them genuinely believe that people who spend a couple hours a week tutoring or going on 2 week trips to Guatemala (never to be seen again) are somehow more compassionate than those who don't.


We don't do MMI, but there's decent data ( from U of Edmonton, I think), that shows MMI is a good predictor of a person's compassion.

5. Repeal MMI interviewing in favor of traditional interviews. The whole notion that setting up a bunch of contrived scenarios is somehow better than speaking with and getting to know an actual person is ridiculous. REAL patient interactions occur in the traditional fashion. Residency interviews occur in the same 1 v 1 way. You need to learn how to present your thoughts/ideas/story in a cogent manner to any person who is sitting in front of you. That is real life and nobody will be asking you what you would do if you crashed into a BMW in the parking lot. The most natural solution to this in my view would be to have residency application style "speed-dating" interviews with multiple people.

I would be extremely skeptical of any study that claims to be able to correlate anything to "compassion." That's something that cannot be reasonably quantified.

 

[Greenberg702]

1 MCAT & GPA

• These are useful and relevant, but imperfect. I'd like to also see Class Rank % within major or university overall on transcripts as a way of controlling for grade inflation/deflation. And for MCAT scores, a more standardized way of handling retakes and verbal scores for English as a second language applicants.

2 ECs

• As opposed to eliminating or reducing requirements, how about simply making them explicit? Simply require 40 hours of shadowing, 100 hours of clinical contact, and 100 hours of community service and require letters or timesheets to substantiate the time.

3 LORs

• I'd agree that more flexibility would be better.

4 MD committee

• Makes sense...

5 MMI

• If MMI results are statistically more accurate, shouldn't we use them more rather than less? The 'What would you do if...' scenarios are valuable and informative, as some applicants do not posses much common sense or resilience and it's important to weed them out where possible. I do agree with the argument that several 15-minute conversations are more reflective of a physician's actual work environment, but 'small talk' is only one measure, and arguably, not the best.

6 URM AA

• In a perfect world, we wouldn't need to do anything here -- but I don't think anyone is arguing that our world is perfect. I would prefer a system that considers both race and SES in admissions to further the legitimate goals of diversity and supplying physicians that better mirror our population. I would agree that it is unfair to offer significant preferences for racial minorities from privileged SES backgrounds who are unlikely to serve underserved populations anyway, but very necessary and appropriate to favor racial minorities from disadvantaged circumstances. I'd also change the way Asian applicants are classified, similar to the way Hispanic applicants are sub-classified. Some Asian populations are severely SES disadvantaged, and treating them all as ORM is unfair.

There's a lot more to the traditional interview than small talk. For example, at my HMS interview I was asked questions like "should college athletes be payed?" and then she followed up to play devil's advocate against me. I believe that you can learn much more about how a person approaches things/their demeanor this way than attempting to test "ethics" in acting situations which almost any attending will admit to being impossible.


I actually really like the idea of including class rank (perhaps for people within your major).

 

[Mr Interesting]

That is not at all what I'm implying. I know several URMs in my class who applied and with whom I'm very friendly (3.7/ 35 MCAT got into every single medical school they applied to including Hopkins/HMS/Stanford). The point I'm trying to make is that right now, NOBODY looks into the background of applicants checking off their race. They wouldn't check off the disadvantaged box but you're naive if you think they will not check off "AA or Hispanic." The way it currently works is that adcoms have a list of all applicants on the computer and they simply sort by race so that people who checked off certain boxes appear at the top of the screen. Simply checking off this box gives an incredible advantage, regardless of their stats (which can be and often may be very strong). The point is that adcoms currently take the path of least resistance and accept the most academically qualified minorities (who are often from 250K + households, but not "Beverly Hills") under the guise that they will go on to serve underrepresented communities. Nobody probes this at the interview, and nobody really cares whether you've had involvement or not. This is a well-known fact and I believe that you can still give preferences to certain groups as long as you actually investigate their background more carefully. Under the current system: checking off race box ---(no questions asked)---> You show up at the top of the screen w/ instant advantage.

They would check that box off because that's what they are lol. Should high performing or wealthy URM students not acknowledge their own race on their apps? How do you know those wealthy students even said they wanted to serve underserve communities in the first place? That isn't a requirement for them to get accepted. Remember, wealthy URM students often do better academically then URM's who grew up poor. Can you show me evidence that they show up at top screened with no questions asked? I'm willing to bet a URM with IA's, a criminal record, or other major red flags will still be screened out just like everyone else. Say we eliminate our current system and focus more on SES. Then those who grew up poor would have a significant advantage, correct? How would students who come from wealthy or middle class households feel about this? Wouldn't they feel discriminated against because they didn't grow up poor? Most ORM students who do become med students come from affluent or middle class households.

 

[Greenberg702]

They would check that box off because that's what they are lol. Should high performing or wealthy URM students not acknowledge their own race on their apps? How do you know those wealthy students even said they wanted to serve underserve communities in the first place? That isn't a requirement for them to get accepted. Remember, wealthy URM students often do better academically then URM's who grew up poor. Can you show me evidence that they show up at top screened with no questions asked? I'm willing to bet a URM with IA's, a criminal record, or other major red flags will still be screened out just like everyone else. Say we eliminate our current system and focus more on SES. Then those who grew up poor would have a significant advantage, correct? How would students who come from wealthy or middle class households feel about this? Wouldn't they feel discriminated against because they didn't grow up poor? Most ORM students who do become med students come from affluent or middle class households.

They would check that box off because that's what they are lol --> Obviously. I thought you were referring to the race box when you wrote "super rich URM students would most likely not check the disadvantaged box."
Should high performing or wealthy URM students not acknowledge their own race on their apps? --> Of course they should. But that doesn't mean they should instantly gain an advantage without further investigation.
How do you know those wealthy students even said they wanted to serve underserve communities in the first place? --> They don't say it. But that's the excuse that most admissions committee members give when justifying their advantages in the admission process.
I'm willing to bet a URM with IA's, a criminal record, or other major red flags will still be screened out just like everyone else. --> No ****. That's an extreme example.
Say we eliminate our current system and focus more on SES. Then those who grew up poor would have a significant advantage, correct? How would students who come from wealthy or middle class households feel about this? Wouldn't they feel discriminated against because they didn't grow up poor? --> The point isn't that some applicant is getting discriminated against. The point I'm making is that students who grew up in poverty, regardless of race, would be more likely to serve the poor of all races.
Can you show me evidence that they show up at top screened with no questions asked? --> Of course not. Schools don't release this as it wouldn't look good for them. My SO is on the admissions committee of a top 5 and I know for a fact that's how they do it. LizzyM mentioned at some point that she uses the "sort" function in relation to race at her institution. Currently, nobody looks further into it. I'd be more willing to accept this system if adcoms at least questioned applicants about this at the interview. If you check off Native American and you reveal that you're 1/8 NA at the interview with no connection to any tribe, you shouldn't gain any advantage, plain and simple.

 

[kyamh]

I actually really like the idea of including class rank (perhaps for people within your major).

I don't know, class rank is difficult. It's hard to compare class rank/percentile when you're at a top private school with a class size of 500 vs a large university with a class of 10k. In medical school, the demands at different institutions are much more equal than the demands at different undergraduate institutions.

 

[Mr Interesting]

Currently, nobody looks further into it. I'd be more willing to accept this system if adcoms at least questioned applicants about this at the interview. If you check off Native American and you reveal that you're 1/8 NA at the interview with no connection to any tribe, you shouldn't gain any advantage, plain and simple.

If you are talking about a system that looks into whether a student actually grew up poor or actually has ties to certain communities, I could get behind this. I suppose the reason why this doesn't happen now because this probably isn't as big an issue as most people probably make it out to be. I doubt that a large number of wealthy minorities pretend to be poor to get into medical school and large number of white people pretend to be Native American. I'm not saying it doesn't happen, I'm just saying people probably hate it more than it actually happens. If there was a system where committees would look into this further and give applicants who flat out lie the boot, I would fully support it.

The thing is, I realize white students and Asian students can grow up poor. I hate that some of them slip through the cracks with the current system and I do want SES to be considered more. However, I feel like even that will have repercussions. Middle class and wealthy students will eventually start to feel discriminated against as well. What would we do to fix that?

 

[juliuspepperwood]

1 MCAT & GPA

• These are useful and relevant, but imperfect. I'd like to also see Class Rank % within major or university overall on transcripts as a way of controlling for grade inflation/deflation. And for MCAT scores, a more standardized way of handling retakes and verbal scores for English as a second language applicants.

This is a very good point. GPAs are not standardized by any means, class rank within major would be a much better way of evaluating that. I would love it, in my second major I had a 4.0 but my overall is significantly lower from 10 year old grades.

 

[over2012]

[QUOTE="The point is that adcoms currently take the path of least resistance and accept the most academically qualified minorities (who are often from 250K + households, but not "Beverly Hills") under the guise that they will go on to serve underrepresented communities. Nobody probes this at the interview, and nobody really cares whether you've had involvement or not. This is a well-known fact and I believe that you can still give preferences to certain groups as long as you actually investigate their background more carefully. Under the current system: checking off race box ---(no questions asked)---> You show up at the top of the screen w/ instant advantage.[/QUOTE]

How do you know that they don't ask for this during the interview; were you allowed a special corner seat in interviews with URMs ?!
As a SES disadvantaged URM, they do probe.

 

[Ser_Pounce]

There's a lot more to the traditional interview than small talk. For example, at my HMS interview I was asked questions like "should college athletes be payed?" and then she followed up to play devil's advocate against me. I believe that you can learn much more about how a person approaches things/their demeanor this way than attempting to test "ethics" in acting situations which almost any attending will admit to being impossible.

My MMI experience was great, but that might be because it was devoid of actors and irrelevant questions. Before the interview started, we were informed that each each station/interview had a specific theme and we would be sitting with either a student, administrator, or faculty member. The question/situation was posted on the door of the interview room (we were in a hallway and moved from room to room) and we were given 2 minutes to read over and collect our thoughts before starting. We then had 8 minutes to discuss the question/situation, and while not necessarily clinically relevant i.e. a specific patient encounter, the questions/situations were thought provoking and broached topics that were relevant professionally (I can expound on the actual topics, but I want to keep this post somewhat short). In addition, we also had a "double" station that was a full 20 minutes which was basically a traditional interview with the exception that it was closed file.

I thought this was a rather effective way of interviewing without making the MMI silly. It still had the "speed dating" feel, but I felt that I had ample time to show how I approach things. It was also nice to have the ability to shake off a poor interview (if you felt that way), and get to start fresh with a new topic and new interviewer. Overall, I just felt it was a better interviewing model that the traditional interview.

 

[Omppu27]

Hello fellow SDNers. I wanted to spark a discussion regarding an issue that I've been thinking extensively about since the beginning of last summer and that is the goals, nature of, and success of the current medical school admissions process. I ran several of these ideas and suggestions past the Dean for Medical Education at the school I'm currently doing research at and was surprised to receive positive feedback and genuine interest in some of these points. Was curious to hear what people (especially current and former applicants) thought.

It appears to me and many of my pre-med friends and acquaintances that the current system of med school admissions feels extremely contrived, with artificial hoops set-up for no discernible purpose than to please some bigwigs or administrators sitting on admissions committees. Schools are often extremely vague about what they're looking for. It seems that much of the process is "fake" and rewards mindless box-checking/conforming to certain requirements than really preparing oneself for a career in medicine. If we're really honest with ourselves, we would admit that this process has at least somewhat affected how we structure or schedules/ECs/summers and the thought of medical school is always looming in the back of our minds as we go through undergrad.

Applications for residency/post-graduate training differ significantly from those for medical school. As is well known, residency directors look at 1. USMLE Step I score (in order to have a standard for comparing all applicants) 2. Clerkship grades (are you a strong clinician? can you work with other residents/attendings?) 3. Letters of recommendation from physicians (very field dependent but writers are often from the specialty you're applying to) 4. Research (are you committed to academics/advancing the field? More so at top programs). They care very little about anything else. Some cool ECs and volunteering may be good talking points but they never make or break an application. People want to know a) Are you smart? b) Can you be a good physician with whom we can work with for the next 3-7 years? The whole process seems much more intuitive, almost like applying for any normal job.

Now, what if we can extend some of these principles in order to make medical school admissions look more like residency applications? I've heard of some people advocating for a match system in order to minimize waitlisting, which is an interesting but slightly different discussion. First, we must establish "the point" of the whole system. How can we find people who will make excellent physicians and advance the field we're so passionately about? I think the crucial questions that we must ask are 1) Are you a smart individual? Will you be able to successfully graduate from medical school and become licensed? 2) Are you interested in medicine?What makes you passionate about the field? 3) Are you somebody with whom people can work?
In order to better answer these questions, I'd like to propose the following modifications:

1. MCAT + GPA: These should be very heavily favored a la Step I.
2. Eliminate ridiculous cut-offs that some committees have in terms of box checking. A personal anecdote: My SO who is on the committee of a top 5 med school at my undergrad told me that a 3.9+ from Princeton with good research, no red flags, worked through college to support themselves, and who spent 2 years in Colombia streamlining healthcare delivery systems got dinged because of insufficient shadowing. "How do we know he's really interested in medicine, they asked." These kinds of attitudes from members who aren't even physicians (see point 4) are ridiculous and archaic. There should be no cutoffs for clinical experience/shadowing, volunteering, or other requirements. The resume padding that occurs among pre-meds is wildly rampant (I myself am guilty of this) and really isn't productive for anybody or makes a good use of students' time. I've seen posts on SDN that boast getting 100000 hours of hospital volunteering just to one-up somebody else.
3. Make requirements for letters of recommendation more flexible. In a college environment, interacting with professors (particularly science professors) is fairly difficult without some major outside involvement like performing research with your science professor or having him/her as an adviser for your student organization. When applying this cycle, I felt that the people who really knew best were NOT my science professors who lectured from power-point slides but were physicians who I shadowed, my PIs, and EC/student org advisers. Personally, I think this point needs to be discussed/addressed. I chose to present an abstract (on a topic I was not remotely interested in) with one of my science profs in order to better get to know them for a rec letter. This "playing the game" shouldn't be necessary.
4. Make admissions committees MD only (except for screeners). I personally believe that you should not be permitted to assess students' suitability to pursue a degree which you yourself do not possess. Some of the administrators/PhDs on these committees have no idea what real medicine is like (I'm not claiming I do either) and have no idea how out of touch this process is with the reality of pre-medical preparation. Some of them genuinely believe that people who spend a couple hours a week tutoring or going on 2 week trips to Guatemala (never to be seen again) are somehow more compassionate than those who don't.
5. Repeal MMI interviewing in favor of traditional interviews. The whole notion that setting up a bunch of contrived scenarios is somehow better than speaking with and getting to know an actual person is ridiculous. REAL patient interactions occur in the traditional fashion. Residency interviews occur in the same 1 v 1 way. You need to learn how to present your thoughts/ideas/story in a cogent manner to any person who is sitting in front of you. That is real life and nobody will be asking you what you would do if you crashed into a BMW in the parking lot. The most natural solution to this in my view would be to have residency application style "speed-dating" interviews with multiple people.
6. Convert affirmative action utilizing race into an affirmative action system that takes into account socioeconomic status. The latter method would incorporate indigent individuals of ALL races. At several of my interviews/second looks, the vast majority of URM students were super rich and attended private schools. There is absolutely no way that they were more disadvantaged than an Asian or Caucasian growing up in coal country or more likely to serve URM groups in the future. They all admitted to wanting to pursue derm/plastics and open up private practices. Obviously, this is highly controversial and anecdotal but an affirmative action system utilizing socioeconomic status intuitively seems more fair and may better differentiate those who are more likely to practice in underserved areas. Asking individuals who checked the URM box additional questions regarding their ties to certain groups during interviews can also help address this.

Full disclosure: I was very fortunate to be successful this past cycle. This does not, however, mean that I support all of the aspects of medical school admissions or believe that there should not be serious changes to the system. I'd love to hear what other people think.

Read the first paragraph, thought it was gonna be a bogus rant, was wrong... Pretty good points here.

1. I agree GPA and MCAT are important. However, I don't think they necessarily address "the point" you were referring to (does high GPA and MCAT really = great physician/smart person??). I think if these numbers were brought together like a LizzyM score that might help (perhaps many schools already do this...). Also, I agree with what others have said that schools should be more open to superscoring or just taking the highest score. Although the MCAT is considered the "ultimate equalizer," the topics on one MCAT can differ quite a lot to another MCAT (lots of ochem vs. very little ochem, heavy physics vs. heavy chem, etc.).

2. What is considered "insufficient shadowing?" I think shadowing or experience around medical doctors (PCA, medical assistant, patient liaison, etc.) is vitally important. If the applicant had no hours of these types of experiences, how does he/she know that he/she actually wants to be an MD/DO and treat patients???? Now, if the person OP mentioned had only like 20ish hours I don't think that would be an issue. If this was the case, then yes, that's ridiculous.

3. ABSOLUTELY agree. I think this should be applied to some class requirements as well. Some schools I have specific requirements for certain social/behavioral science courses ("must take a sociology course, no exceptions"). It's pretty ridiculous that despite an all around solid application, an applicant lacking a certain letter or course would not be considered at certain schools.

4. Good point. Never really thought about this. I also think that senior medical students should be allowed here as well.

5. I can't really comment on this considered I haven't interviewed yet.

6. I agree that SES should play a much bigger role than it does for the exact reasons you mentioned.

 

[Fabio Lanzoni]

If you are talking about a system that looks into whether a student actually grew up poor or actually has ties to certain communities, I could get behind this. I suppose the reason why this doesn't happen now because this probably isn't as big an issue as most people probably make it out to be. I doubt that a large number of wealthy minorities pretend to be poor to get into medical school and large number of white people pretend to be Native American. I'm not saying it doesn't happen, I'm just saying people probably hate it more than it actually happens. If there was a system where committees would look into this further and give applicants who flat out lie the boot, I would fully support it.

They might not do heavy cross-checking and probing because it's very cumbersome. That seems to make sense to me. And then people could make up incomes and stuff since the school won't really know your income until financial aid offers, and by then, who's gonna go check whether you lied or not? Or who's to say your family didn't suddenly make a lot of money. I'm a proponent of this theoretically, but in reality is sounds like way more effort for most likely similar outcomes.

The thing is, I realize white students and Asian students can grow up poor. I hate that some of them slip through the cracks with the current system and I do want SES to be considered more. However, I feel like even that will have repercussions. Middle class and wealthy students will eventually start to feel discriminated against as well. What would we do to fix that?

There's no good way to go about these inequalities, I agree!

 

[Mr Interesting]

They might not do heavy cross-checking and probing because it's very cumbersome. That seems to make sense to me. And then people could make up incomes and stuff since the school won't really know your income until financial aid offers, and by then, who's gonna go check whether you lied or not? Or who's to say your family didn't suddenly make a lot of money. I'm a proponent of this theoretically, but in reality is sounds like way more effort for most likely similar outcomes.



There's no good way to go about these inequalities, I agree!

hmm... amcas could start making people upload their income tax information as part of the verification process?

This sucks because I do want ORM students who have lived a life of poverty but yet have managed to overcome obstacles to be considered more. I know some and they are bad asses. However, I feel orm students who were lucky enough to be born into wealthy families will inadvertently be punished. No easy solution at this moment.

 

[amvet70]

mrh125 doesn’t like added weight of modification 1 because of his struggles with MCAT

juliuspepperwood, DokterMom want to add importance to a class rank

kyamph has problems with idea of class rank

Aerus, Goro, DokterMom speak to the pluses of MMIs v traditional.

Residency program directors apparently use 35-40 factors in making decisions so why not just have an application with a list of 35-40 factors and let each of the 45-50K med school applicants pick and choose which factors they want adcoms to use in evaluating an individual applicant?

 

[mrh125]

... Now you're just talking out of your @$$. Tell the above to any of the kids who hit 37-42 on their FL averages and they'll laugh in your face. I sucked at verbal, but the rest is quite far from a 'slot machine'. The content you need to know is pretty well defined and clear. All questions/passages ultimately don't fall outside the scope of that content. After a solid amount of content review & practice problems (4-6 weeks), I was consistently hitting 12+ in all BS and PS sets.


"The step 1 sounds fair more reasonable, meaning you study, learn all you can, and are held accountable for that knowledge."

Since you haven't studied, learned the content, or taken step 1, none of what you say about it matters. Actually your statement doesn't even make sense since it is just as applicable to MCAT sciences - you study, learn all you can, and are held accountable for the knowledge.


Verbal may seem like a slot machine from hell but actually, if you read more about the setup and structure of it, it is quite a standardized assessment.

bolded part = lol no. check the mcat 30+ scorers thread for 35+ scorers they started high and scored higher most of the time. if they were laughing at my face, they'd need to seriously recheck their numbers. Also, of course they'd have favor the setup, considering they succeeded on it.

Also elaborate on verbal because it's cheap as hell, poorly optimized, and flawed.

mrh125 doesn’t like added weight of modification 1 because of his struggles with MCAT

juliuspepperwood, DokterMom want to add importance to a class rank

kyamph has problems with idea of class rank

Aerus, Goro, DokterMom speak to the pluses of MMIs v traditional.

Residency program directors apparently use 35-40 factors in making decisions so why not just have an application with a list of 35-40 factors and let each of the 45-50K med school applicants pick and choose which factors they want adcoms to use in evaluating an individual applicant?

correction: I don't like the mcat because sections, such as verbal are flawed.

 

[AlbinoHawk DO]

The way the system is set up is to show how resourceful you are and how much BS you're willing to put up with. This guarantees that the applicant will make it through the entire process.

Point 1 is already being used. I understand the spirit of point 2, but maybe we can create more clear guidelines instead of necessarily saying that someone shouldn't have to do shadowing. Schools can compromise at being direct saying "we require 50 hours of shadowing" and not penalizing for having below that. Points 3-5 I would agree with. I find it ridiculous these PhDs think they can evaluate us. Point 6 misses the point that URM is not about giving poor people a chance. It's about representation in healthcare because we know that minority populations are impacted by not having enough physicians that represent them. The present system is good.

 

[basketcase0a0]

bolded part = lol no. check the mcat 30+ scorers thread for 35+ scorers they started high and scored higher most of the time. if they were laughing at my face, they'd need to seriously recheck their numbers. Also, of course they'd have favor the setup, considering they succeeded on it.

Also elaborate on verbal because it's cheap as hell, poorly optimized, and flawed.




correction: I don't like the mcat because sections, such as verbal are flawed.

Not to take this further off topic (I like most of your suggestions outside of the MD requirement for adcoms, OP) but how exactly is verbal flawed?

 

[Greenberg702]

mrh125 doesn’t like added weight of modification 1 because of his struggles with MCAT

juliuspepperwood, DokterMom want to add importance to a class rank

kyamph has problems with idea of class rank

Aerus, Goro, DokterMom speak to the pluses of MMIs v traditional.

Residency program directors apparently use 35-40 factors in making decisions so why not just have an application with a list of 35-40 factors and let each of the 45-50K med school applicants pick and choose which factors they want adcoms to use in evaluating an individual applicant?

Residency directors don't *actually* use 45 factors. After step I, clerkship grades, letters, research, and interview they couldn't care less what else you do.