several adverse effects. Although minority families are more likely to be among the poorest Americans than the richest, socioeconomic hardship is an inefficient route to integration if racial and ethnic diversity is the ultimate goal. Middle-class and upper class minorities who have not had significant economic disadvantages would not be considered under this approach, yet they may be among the strongest candidates for success in medical school. Ultimately, these models are flawed in that they depend on the effects of disparities in educational opportunities, the core objective of which is ostensibly to end such disparity.

A preferred admissions approach is to use standardized test results as a dichotomous variable and to decide on a threshold value below which a student is not believed to be competitive for admission to medical school and above which factors other than the test scores will determine eligibility for school. With such an approach, the initial screen will be strongly weighted by standardized test scores, but the ultimate decision will rest on other measures of knowledge, skills, and personal qualities. Students who have performed well in college and have acquired the skills and attitudes that will serve them well in medicine will have a strong chance of acceptance to medical school, even in the presence of less than stellar MCAT scores.

Schools that have adopted this approach find and accept candidates whose performance in college is exceptional and have a track record of activities that reflect the expectations derived from the mission of the school, even though the MCAT scores of those students are not in the highest percentile. Because many URM students may find themselves in this group, an environment that recognizes their strengths and supports them through the future testing requirements by teaching test-taking and other skills is most likely to help students succeed.

Recommendation: Ensure that careful assessment of personal qualities is a priority consideration for each candidate.

Evaluating students on their personal qualities and their acquisition of skills useful in the medical profession necessitates a method to categorize these variables and determine their relative value. This method should be consistent with the mission of the school and the expectations derived from that mission. Research-intensive medical schools should look for a track record of and a desire to continue productive and creative scholarly activities. Public-service-oriented schools will look for evidence of participation in activities intended to improve the health of needy communities and an indication of leadership and innovative approaches to service. Schools with missions to serve specific communities—described in religious, geographic, or racial/ethnic terms—will look for evidence of prior and future service to these communities. The decision by the University of California-Irvine Col-



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