Medical Education and Societal Needs A Planning Report for Health Professions (1983) / Chapter Skim
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7. Medical School Admissions
7. Medical School Admissions
Pages 175-197
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From page 175... ...
It is projected that medical students will greatly increase their borrowing, do it at substantially higher interest rates, and run a greater risk of having cash-flow problems in residency and starting practice. It is anticipated that higher costs of medical education will adversely affect the medical school application rate over the long run.
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From page 176... ...
Therefore, some admissions committees are becoming concerned about the likely effects of the diminishing applicant pool on the caliber, and eventually size, of their entering classes. Maintenance of class size is a major concern among admissions officers.4 As the popular ion of college graduates declines, some medical school administrators will eventually be faced with the choice 176
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From page 177... ...
TABLE 1 Medical School Applicant Data, 1961/62 to 1980/81 First-year Number of Accepted Percentage of Total Class Applicants Applicants Applicants Accepted 1961/62 14,381 8,682 60.4 1962/63 15,847 8,959 56.6 1963/64 17,668 9,063 51.3 1964/65 19,168 9,043 47.2 1965/66 18,703 9,012 48.2 1966/67 18,250 9,123 50.0 1967/68 18,724 9~702 51.8 1968/69 21,118 10,092 47.8 1969/70 24,465 10,547 43.1 1970/71 24,987 11,500 46.0 1971/72 29,172 12,335 42.3 1972/73 36,135 13,757 38.1 1973/74 40,506 14,335 35.4 1974/75 42,624 15,066 35.3 1975/76 42,303 15,365 36.3 1976/77 42,155 15,774 37.4 1977/78 40,569 15,977 39.4 1978/79 36,636 16,527 45.1 1979/80 36,141 16,886 46.7 1980/81 36,100 17,146 47.5 1981/82 36,727 11, 286 47.1 SOURCES: Medical education in the United States, 1980-1981 and 1981-82. Journal of the American Medical Association 246:2893-3044, 1981 and 248:3223-3328, 1982.
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From page 178... ...
SOURCES: Medical education in the United States, 1980-81.
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From page 179... ...
However, projections indicate that the number of applicants will continue diminishing ~ ~ ~ ~ while entering class size will increase slightly, so that average GPAs and New MCAT scores will likely decline.1 TABLE 3 Premedical Grade Point Average Distribution Among First-year Medical Students, 1966/68 to 1981/82 Academic Year Aa B ~ OtherC 1966/67 13.6% 77.8% 8.6% 1967/68 14.1 76.8 9.1 1968/69 16.8 75.9 7.3 1969/70 17.9 76.6 5.5 1970/71 19.7 73.3 7.0 1971/72 24.0 70.0 6.0 1972/73 28.9 60.1 11.0 1973/74 33.9 54.7 11.4 1974/75 39.3 50.8 9.9 1975/76 44.2 47.4 8.4 1976/77 46.0 47.3 6.7 1977/78 50.4 43.0 6.6 1978/79 49.6 46.9 3.5 1979/80 49.2 47.2 3.6 1980/81 47.S 48.5 4.0 1981/82 45.8 50.2 4.0 l a3.6-4.0 GPA on a four-point scale b2.6-3.5 GPA CLe ss than 2.6 GPA or unknown SOURCES: Medical education in the United States. Journal of the American Medical Association 236:2692, 1976; 246:2919, 1981; 248:3251, 1982.
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From page 180... ...
A second factor in selection decisions involves traditional indicators of academic competence -- previous grades and New MCAT scores are relied upon heavily in medical school admissions decisions. The ability of these measures to predict medical school success has been studied extensively.
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From page 181... ...
Unfortunately, little has been published regarding admissions committee procedures in making selections.3 Reports on the decision processes and specific criteria at this stage are particularly elusive, though available evidence indicates that the particular process seems to vary greatly among admissions committees. However, in making final selection decisions, most committees appear to use 181
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From page 182... ...
The actual role of admissions measures in final selection decisions has seldom been documented, but the characteristics, appropriate uses, and limitations of each type of measure are discussed in the next section. Evaluation of Admissions Measures Technical Considerations in Interpreting Measures If it is to be useful in selection, an admissions measure should provide an accurate assessment of a pertinent trait or quality.
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From page 183... ...
Areas of knowledge tested have been rated by medical school faculty as important prerequisites for entering medical students.9 Scores in the latter three categories (Science Problems, Reading, and Quantitative) "indicate skills in analyzing and using inf ormation including an assessment of problem solving ability.'']
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From page 184... ...
Many medical schools also use the National Board of Medical Examiners, Part I-Basic Sciences and Part [I-Clinical, which are multiple choice, as external reference points. Numerous studies have been done using admissions measures to predict medical school grades, National Board scores, and other factors.3 Yet, it is uncertain whether individual medical schools have adjusted admissions criteria on the basis of such evidence.
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From page 185... ...
That is, the addition of a noncognitive measure in combination with academic measures should better predict success in medical education and in practice than do academic measures used alone. Following is a discussion of the limited available research on the efficacy of each type of measure for selection purposes.
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From page 186... ...
The emphasis placed on the interview in the final selection decision varies considerably from heavy weighting to the other extreme of contributing to selection decisions only if it seems that the applicant has gross deficiencies in personality or emotional stability.
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From page 187... ...
The research cited above suggests clues for improving reliability and validity of the use of interview data, but further evidence of the utility of these data in the medical school admissions context is needed. Study is needed of both the interview process and the use of results in selection decisions.
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From page 188... ...
Other Considerations in Selection Decisions Medical school admissions committees often take into account other factors in selection decisions to meet particular goals of the school or society. For example, an attempt may be made to select individuals likely to both provide quality care, and to practice in underserved geographic areas and in primary care specialties.
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From page 189... ...
Numerous undergraduate colleges and 44 medical schools sponsor special summer programs for aspiring medical students . 27, 28 The Harvard Health Summer Program, begun in 1969, was the first large, national, slimmer program established to prepare "disadvantaged" college students for medical or dental school.
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From page 190... ...
Its utility as a predictive tool can be evaluated by a longitudinal research study. That is, the relationships would be analyzed between scores on an admissions measure and diverse performance criteria throughout medical education and into practice.
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From page 191... ...
30 Wingard and Williamson, in summarizing the literature on predicting physician performance by medical school grades, pointed out that "there was no general agreement in the studies reviewed as to what constituted quality career performance. Some investigators emphasized the dimensions of performance and others stressed performance standards, while some concentrated on instruments of measurement.
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From page 192... ...
The ability to assess personal characteristics reliably for selection decisions is a long way off, and much farther off is the ability to use these data to predict who will become a good physician. Even though evaluation of a physician' s clinical competence is complicated, existing techniques could be refined and evaluations carried out.
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From page 193... ...
The interview and academic criteria were studied at two medical schools. The usefulness as predictors of success in each of four years of medical school at Tulane was studied, using the following admissions criteria: overall interview rating; MCAT scores in Science, Modern Society, Verbal Ability, and Quantitative Ability; overall grade average and age.36 The science grade average and SCAT Science score best predicted basic science achievement in the f irst two years of medical school, but the predictive ability of overall grade average and the interview were greater ~ though low)
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From page 194... ...
The effects of rising medical school costs on class mix should be monitored, and financing alternatives considered. Another concern is the effect of the declining numbers of college graduates on the applicant pool and entering medical school classes.
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From page 195... ...
M., and Arthur, R J., Medical education institutions.
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From page 196... ...
British Journal of Medical Education 7: 225-229, 1973.
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From page 197... ...
F The General Practitioner: A Study of Medical Education and Practice in Ontario and Nova Scotia.
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