Two Articles that Challenge the Validity of Medical School Admissions

[Mt Kilimanjaro]

---

Members do not see this ad.

Ran across these on PubMED while searching for something else.

Cliffs: None of your application means anything, except maybe your MCAT/GPA combination.

Does self-reported clinical experience predict performance in medical school and internship?
http://www.ncbi.nlm.nih.gov/pubmed/22239331

Application essays and future performance in medical school: are they related?
http://www.ncbi.nlm.nih.gov/pubmed/23330895

EDIT: Fixed.

Here's a bonus article about the unreliability of the interview (although, other studies indicate that the MMI is more reliable than the traditional, unstructured interview):

Investigating the reliability of the medical school admissions interview.
http://www.ncbi.nlm.nih.gov/pubmed/15141132

 

[joshyabs]

We can't see them because they require logons.

Sigh, darn GPA following me around...

 

[jeghaber]

We can't see them because they require logons.

Sigh, darn GPA following me around...

Here are the normal links:
http://www.ncbi.nlm.nih.gov/pubmed/22239331
http://www.ncbi.nlm.nih.gov/pubmed/23330895

 

[Spinach Dip]

Sometimes I wonder: if a school got rid of their admissions committee and picked the 100 applicants with the best MCAT scores, would the overall quality of the student body really go down?

 

[Mt Kilimanjaro]

Sometimes I wonder: if a school got rid of their admissions committee and picked the 100 applicants with the best MCAT scores, would the overall quality of the student body really go down?

No.

See page 7.

"In recent evaluations at four of the universities using selection, three universities found that selected students did not achieve better outcomes (academic achievement) than students allocated places through the lottery systems."

 

[jdfamily]

Ha this is great! Love it! Thanks for posting. I just read the clinical experience article from USUHS.

So now that I know that clinical experience doesn't help me perform better in medical school now I don't have to do it. JK

Obviously the abstract doesn't mention the reasons for shadowing that aren't necessarily representative by scores on the board exams or performance academically in medical school. I think clinical experience is expected from applicants to make sure they know what they are getting themselves into as physicians, develop early on a sense of empathy and compassion towards patients (hopefully), and other factors that are hard to measure in a study like the one mentioned.

I just laugh at the possibly of an interview going like this...

Interviewer: So I see here you have no clinical experience...

Student; That's right. I decided it was be detrimental to my potential performance in medical so I avoided it at all costs.

Ha!

 

[Mt Kilimanjaro]

As long as you have that article ready in your black leather portfolio, you'll be solid.

 

[jdfamily]

As long as you have that article ready in your black leather portfolio, you'll be solid.

Ha! And the second article about how essays basically doesn't indicate anything about performance in medical school neither. Obviously essays say more to the medical school about what the intentions are of applicants, who they are, how well they communicate (on paper), and whether or not they would make a good match.

Thanks again for sharing these.

 

[joshyabs]

Too bad we can't post these with our applications and some highlighted notes

 

[Spinach Dip]

<Enter room>


"Hello, admission committee. I would like to start this interview by saying that I may have no shadowing and no job experience. I have no publications and limited research. I left my ECs blank not by accident, but because I really have done nothing of interest in my free time. I have not built any orphanages in Africa or worked at a soup kitchen here at home. I have never applied to volunteer at a hospital. I have never played sports. I am not a URM. I have a 3.2 GPA and scored a 30 on the MCAT.

But, on the other hand, I have these studies which show none of that matters anyway.

Thank you."


<Leave room>

 

[jdfamily]

Ha great stuff! Obviously we are writing great essays and doing these things so that we GET ACCEPTED to the schools of our dreams, not necessarily to show how well we will perform in medical school. This refers to high quality essays, clinical experiences, etc. Maybe these studies would start affecting the schools and how much emphasis they put on these areas though. But then again great and successful physicians aren't always the ones who score the highest on the boards or the highest ranked in medical school neither.

 

[joshyabs]

<enter room>


"hello, admission committee. I would like to start this interview by saying that i may have no shadowing and no job experience. I have no publications and limited research. I left my ecs blank not by accident, but because i really have done nothing of interest in my free time. I have not built any orphanages in africa or worked at a soup kitchen here at home. I have never applied to volunteer at a hospital. I have never played sports. I am not a urm. I have a 3.2 gpa and scored a 30 on the mcat.

But, on the other hand, i have these studies which show none of that matters anyway.

Thank you."


<leave room>

lol!!

 

[Status Sciaticus]

Sometimes I wonder: if a school got rid of their admissions committee and picked the 100 applicants with the best MCAT scores, would the overall quality of the student body really go down?

the likelihood that those 100 applicants coming from wealthy white families who can afford the best education, resources, and education would be astronomically high.

 

[gimghoul]

The article about the essays is interesting, but it is a classic case of why intermediate outcomes can be dangerous as a research endpoint.

No one should be surprised that applicants whose strengths were their essays rather than their GPA didn't do as well on GPA in medical school as applicants whose strength was their GPA.

The outcome of interest would be whether or not those with dynamic and interesting essays ended up being dynamic and interesting physicians (since that is the underlying assumption behind application essays), but that is much more difficult to measure.

 

[Mt Kilimanjaro]

the likelihood that those 100 applicants coming from wealthy white families who can afford the best education, resources, and education would be astronomically high.

Is that all that different from the current state of matriculating medical students?

Median household income of ~$113,000.

Also, this problem is easy to fix with a lottery. Set quotas that achieve a mix of students that mirrors the income distribution of the United States. Require tax returns as part of the application.

 

[The Kraken]

What makes a good doctor? The doctor who scores highest on the step? Mcat? Boards? Arguably no. The MCAT shows how well you can remember and utilize simple undergraduate coursework in one or two step problems.

The minutia of a majority of pre clinical curriculum does not make a good physician. The simple, closely defined material on the mcat does not predict a good physician. The best care received is by the physician who knows their stuff while making a connection with the patient. Any physician worth their snuff provides positive outcomes. The best make an impact on their patients while doing so. No standardized test predicts this.

 

[catzzz88]

I would like to see a more thorough analysis of these variables. If they did PCA, maybe schools would actually change the system!

 

[ritatud]

This refers to high quality essays, clinical experiences, etc.

 

[Status Sciaticus]

Is that all that different from the current state of matriculating medical students?

Median household income of ~$113,000.

Also, this problem is easy to fix with a lottery. Set quotas that achieve a mix of students that mirrors the income distribution of the United States. Require tax returns as part of the application.

The problem with that is that you assume everyone is truthful on their tax returns

 

[serendipity007]

Is that all that different from the current state of matriculating medical students?

Median household income of ~$113,000.

Also, this problem is easy to fix with a lottery. Set quotas that achieve a mix of students that mirrors the income distribution of the United States. Require tax returns as part of the application.

The problem with that is that you assume everyone is truthful on their tax returns

Hunh interesting. Where are you getting the $113K number from?

 

[GoPelicans]

Medical school admissions is:

40% MCAT
40% GPA
20% writing ability

 

[OCDOCDOCD]

While I think that much of what med schools look for in choosing applicants is irrelevant and thus love these studies at face value, I have to admit they have a big problem. Namely, they're trying to see if all these things are good predictors in matriculated students.

The issue here is obvious: Med schools are very good at picking out students who will be successful in med school, as evidenced by the 5% drop-out rate for med schools (contrast that to the 50% drop-out rate for undergrad colleges). It goes with reason that any accepted student will be capable of performing at least acceptably in med school. As a result, you hit both a floor and ceiling effect: Most med students are not going to fail, and there's a hard maximum grade they can achieve.

It should come as no surprise then that there's not much difference between students on any predictive measure of performance, because the real pool of subjects has already been filtered substantially to select for students who can do well. When you look at the predictive measures for med students, you're almost certainly getting a very homogenous and unrepresentative sample of the population. GPAs are mostly going to be 3.5+, and many will be 3.7+. MCAT scores are going to be 28+, with many being 31+. Essays are going to be well written. LORs are going to be all positive. Almost all students will have had clinical experience in undergrad. Most will have had community service and research experience as well.

If you want to see how predictive these measures really are, you have to use a random sample of applicants. You would need to see how applicants that are typically rejected would perform.

 

[StephanieZ]

You mean the application process is BS? Groundbreaking stuff!

 

[Mr Avante]

<Enter room>


"Hello, admission committee. I would like to start this interview by saying that I may have no shadowing and no job experience. I have no publications and limited research. I left my ECs blank not by accident, but because I really have done nothing of interest in my free time. I have not built any orphanages in Africa or worked at a soup kitchen here at home. I have never applied to volunteer at a hospital. I have never played sports. I am not a URM. I have a 3.2 GPA and scored a 30 on the MCAT.

But, on the other hand, I have these studies which show none of that matters anyway.

Thank you."


<Leave room>

<Acceptance gets sent within 24 hrs. Reason: Honesty>

 

[chillaxbro]

I really wish all it took was a good GPA and MCAT
I had good numbers but the ECs and interviews ****ed me over 🙁

 

[slopes23]

Same thing happened when I met some girl off jdate. Numbers said everything looked good, in real life she was a troll.

 

[Doudline]

This might sound very novel to you, OP, but... maybe there's more to being a "successful" physician than pre-clinical grades and rotation evaluations? 😱

 

[Goro]

I never look the essay to tell me anything about performance...that's what GPA, transcripts and the MCAT are for.

The essays are to let us know who you are and "why Medicine?"

Clinical experience, as I posted many times in these forums for the naive, are to show us you know what you're getting into and that you like being around sick people, especially for the next 30-40 years.

I'm sure you hav heard of the guy who finished residency and found a position because he hated touching patients...that's the guy I really don't want as a student.

The whole idea of the process is to find people who will make good doctors, not merely good students.

I haven't read the paper, but have been told that the MMI is a good predictor of empathy in a clinician.

Ran across these on PubMED while searching for something else.

Cliffs: None of your application means anything, except maybe your MCAT/GPA combination.

Does self-reported clinical experience predict performance in medical school and internship?
http://www.ncbi.nlm.nih.gov/pubmed/22239331

Application essays and future performance in medical school: are they related?
http://www.ncbi.nlm.nih.gov/pubmed/23330895

EDIT: Fixed.

Here's a bonus article about the unreliability of the interview (although, other studies indicate that the MMI is more reliable than the traditional, unstructured interview):

Investigating the reliability of the medical school admissions interview.
http://www.ncbi.nlm.nih.gov/pubmed/15141132

 

[SunsFun]

As others pointed out we need to look at the performance after school more to make any conclusions.

 

[mimelim]

This might sound very novel to you, OP, but... maybe there's more to being a "successful" physician than pre-clinical grades and rotation evaluations? 😱

Pretty much this. Also most schools aren't hurting their average GPAs and/or MCATs with who they select.

 

[Status Sciaticus]

I never look the essay to tell me anything about performance...that's what GPA, transcripts and the MCAT are for.

The essays are to let us know who you are and "why Medicine?"

Clinical experience, as I posted many times in these forums for the naive, are to show us you know what you're getting into and that you like being around sick people, especially for the next 30-40 years.

I'm sure you hav heard of the guy who finished residency and found a position because he hated touching patients...that's the guy I really don't want as a student.

The whole idea of the process is to find people who will make good doctors, not merely good students.

I haven't read the paper, but have been told that the MMI is a good predictor of empathy in a clinician.

So if a person doesnt like patients, he doesn't deserve to be a doctor?

I'm sure pathologists, radiologists, and MSTPs dont touch patients or even interact with them much.

 

[slopes23]

So if a person doesnt like patients, he doesn't deserve to be a doctor?

I'm sure pathologists, radiologists, and MSTPs dont touch patients or even interact with them much.

IVR bro.

 

[circulus vitios]

The issue here is obvious: Med schools are very good at picking out students who will be successful in med school, as evidenced by the 5% drop-out rate for med schools (contrast that to the 50% drop-out rate for undergrad colleges).

I don't see it like that. It's not because they're good at choosing hard-working and determined students, it's because they set arbitrarily high standards and require ridiculous hoop-jumping that just happens to filter out lazy applicants. Compare Ivy league undergrad drop-out rates with all undergrad drop out rates and you'll see the same phenomena, because putting together an Ivy league application package is so much more difficult slinging out mediocre applications to non-selective schools.

 

[The Bunk]

So if a person doesnt like patients, he doesn't deserve to be a doctor?

I'm sure pathologists, radiologists, and MSTPs dont touch patients or even interact with them much.

I don't understand how a person can want to be a doctor if they don't like patients. 😕

 

[Mt Kilimanjaro]

This might sound very novel to you, OP, but... maybe there's more to being a "successful" physician than pre-clinical grades and rotation evaluations? 😱

No need for the condescending attitude, chief.

What's your metric for a "successful" physician? Press Ganey scores? Lack of malpractice claims?

Let's compare essays, clinical experience, and interview performance to those too. 😱

 

[Radon XP]

So if a person doesnt like patients, he doesn't deserve to be a doctor?

I'm sure pathologists, radiologists, and MSTPs dont touch patients or even interact with them much.

You have to at least be comfortable working with patients, since that's the whole point of medicine.

"Liking" patients is unnecessary. I'm sure Goro doesn't mean that you have to become best friends with each and every patient you treat.

 

[circulus vitios]

I don't understand how a person can want to be a doctor if they don't like patients. 😕

You only need to get through a couple years of patient contact if you're dead-set on something like pathology or radiology.

 

[Status Sciaticus]

IVR bro.

I was giving examples. You know what I mean!

I don't understand how a person can want to be a doctor if they don't like patients. 😕

Because they want to treat disease?
Because they want to further medical science for which they need an MD?
Many doctors in fact dont like their patients, especially the non-compliant ones and the frequent liars.

You have to at least be comfortable working with patients, since that's the whole point of medicine.

"Liking" patients is unnecessary. I'm sure Goro doesn't mean that you have to become best friends with each and every patient you treat.

I agree. Being OK with a patient is imperative, but liking them is unnecessary.
However, there are options that have very low patient contact as it is, so to say that one doesn't deserve to be a student simply because of that is a bit presumptuous.

 

[The Bunk]

You only need to get through a couple years of patient contact if you're dead-set on something like pathology or radiology.

I was under the impression that it's not a good idea to be so narrowly focused on one branch of medicine if you're going to med school. What if you don't get to be a radiologist?

What patient wants a doctor (in any specialty) who just holds their nose and tolerates their patients for the bare minimum amount of time? I've never trusted doctors who I can sense don't care about me.

 

[Radon XP]

I agree. Being OK with a patient is imperative, but liking them is unnecessary.
However, there are options that have very low patient contact as it is, so to say that one doesn't deserve to be a student simply because of that is a bit presumptuous.

Having an MD is not imperative to doing medical research. You can get a Ph.D

 

[Jennyfishy]

Hunh interesting. Where are you getting the $113K number from?

Also curious where the 113K came from - this is also new information to me. I mean, I know most people who were able to do well academically *tend* to come from slightly better socioeconomic backgrounds, but that number still seems pretty...high?

Esp. since I knew of so many people who had parents who kind of played the income loophole game, like letting the divorced parent with the lower income claim them as a dependent, ahaha

 

[Jennyfishy]

Also, I recall on older threads and other people once posting articles that argued after a certain "threshold," your GPA/MCAT scores became worthless in terms of predicting future "success" as a physician/med student. For those with extraordinary stats, you might be able to power through medical school, but it provides no information on if you're a decent human being and/or can actually relate to your patients.

Of course, you could also counter-argue that "success" is relative and that you don't need anyone to like you to correctly diagnose a patient.

 

[The Bunk]

Because they want to treat disease?
Because they want to further medical science for which they need an MD?
Many doctors in fact dont like their patients, especially the non-compliant ones and the frequent liars.

You don't have to have an MD/DO to do those things. There are so many qualified people who want to go to med school. If only some of them genuinely like patients, I think it makes obvious sense for adcoms to try to pick out those people because they're going to be better doctors.

 

[circulus vitios]

Also curious where the 113K came from - this is also new information to me. I mean, I know most people who were able to do well academically *tend* to come from slightly better socioeconomic backgrounds, but that number still seems pretty...high?

Esp. since I knew of so many people who had parents who kind of played the income loophole game, like letting the divorced parent with the lower income claim them as a dependent, ahaha

https://www.aamc.org/download/165992/data/msq2010.pdf.pdf

Page 21, question #30.

 

[Radon XP]

Do adcoms have contempt for people of lower SES but not from races you'd expect that from?

 

[Status Sciaticus]

I was under the impression that it's not a good idea to be so narrowly focused on one branch of medicine if you're going to med school. What if you don't get to be a radiologist?

What patient wants a doctor (in any specialty) who just holds their nose and tolerates their patients for the bare minimum amount of time? I've never trusted doctors who I can sense don't care about me.

so you will opt for an average doctor who holds your hand versus a superior doctor who spends less time with you?

I pay my doctors to do their job, and to do it well, not to hold my hand and tell me everything will be OK.

Having an MD is not imperative to doing medical research. You can get a Ph.D

There is a reason that medical schools accept students in MD/PhD programs that dont have a lot of volunteering or community service on their applications.... Because they know that these students will go into academic medicine or research.

And medical school offers 4 years of knowledge about the human body that graduate programs dont...

And if you want to teach medical school, then its always better to have an MD then to not.

 

[Jennyfishy]

https://www.aamc.org/download/165992/data/msq2010.pdf.pdf

Page 21, question #30.

Thanks!

I could spin this number around and take pride in being part of the "4%." It feels more exclusive that way 😛

 

[The Bunk]

so you will opt for an average doctor who holds your hand versus a superior doctor who spends less time with you?

I pay my doctors to do their job, and to do it well, not to hold my hand and tell me everything will be OK.

I don't think a doctor can be considered "superior" just because they are good at school but their bedside manner sucks. The relationship between doctor and patient has an effect on the patient's well-being. It's not about hand-holding and saying they'll be ok. It's about listening and trust and honesty. Like I said, there are plenty of brilliant people who want to be doctors who also care about patients, so people who are trying to avoid clinical experience and volunteering but still feel entitled to a spot in medical school should be weeded out.

 

[anbuitachi]

This in a way is very similar to college admission. I think most people know that things like essays are BS. Even interviews to a great extent is BS. Just b/c you can fake a good 40 min interview doesn't mean you will be a good doctor.

Problem is if you only base it on MCAT/GPA, med school will be flooded by Asians [compared to their population % in the country], and then the entire country will be complaining about how they are just robots who only study and do nothing else etc etc etc.

 

[Radon XP]

This in a way is very similar to college admission. I think most people know that things like essays are BS. Even interviews to a great extent is BS. Just b/c you can fake a good 40 min interview doesn't mean you will be a good doctor.

Problem is if you only base it on MCAT/GPA, med school will be flooded by Asians [compared to their population % in the country], and then the entire country will be complaining about how they are just robots who only study and do nothing else etc etc etc.

I think essays matter, but they matter just as much because adcoms need to see that you're capable of stringing together a coherent sentence as because of their content.