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Who gets into med school?

How Medical School Applicant Race, Ethnicity, and Socioeconomic Status Relate to Multiple Mini-Interview-Based Admissions Outcomes: Findings From One Medical School. Jerant A et al.  Academic Medicine 2015 e-pub ahead of print.

Reviewed by Angela Punnett

What was the study question?
Greater diversity among physicians is recognized as essential for our health care system to be reflective of and responsive to marginalized populations. Medical school admissions processes admit disproportionately few underrepresented racial/ethnic minority (URM) and lower socioeconomic status (SES) applicants. The authors evaluated associations of URM and SES of applicants on the probability of invitation to and performance on the Multiple Mini-Interview (MMI) and final acceptance recommendation at one medical school.

How was the study done?
This was a correlative study based on admission processes over 3 years at one medical school. A subset of all applicants was invited to submit a secondary application based on GPA/MCAT scores. Additional screening identified the final subset invited to complete the 10-station, structured MMI. URM status was determined by self-report on the initial application. Socioeconomic disadvantage was determined using a validated composite measure of SES derived from eight self-report measures on the initial application.

What are the results?
Lower SES, female gender, older age and higher GPA/MCAT scores were correlated with MMI invitation. Female gender, older age and lower GPA were correlated with higher MMI score; lower SES was associated with slightly lower scores. Higher MMI was most highly correlated with acceptance recommendation but lower SES, female gender, older age, and higher GPA/MCAT scores were also significant. URM was associated with neither MMI invitation or score nor acceptance recommendation.

What are the implications?
MMI-based admissions processes do not appear to adversely affect admission for URM applicants at this medical school, perhaps reflecting less vulnerability to the effects of individual evaluator biases. The cause for lower MMI scores with lower SES is unclear but offset by higher MMI invitation and acceptance recommendation rates. This is an area for further study. If validated, this study provides some reassurance that URM and lower SES applicants are not disadvantaged. The next step is to increase their numbers in the applicant pool.


Editor’s comment: This is an interesting study that provides some initial reassurance about the MMI process. The fact that this study was conducted in only one medical school, though, raises the question of whether the culture of that institution is similar to that of others and whether these findings would be replicated if the study was conducted across a variety of schools. This is definitely an area that warrants further study (LL).

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