An equivalence study of interview platform: Does videoconference technology impact medical school acceptance rates of different groups?

Web-based interviewing may be an effective element of a medical school's larger approach to promotion of holistic review, as recommended by the Association of American Medical Colleges, by facilitating the feasibility of including rural and community physicians in the interview process. Only 10% of medical schools offer videoconference interviews to applicants and little is known about the impact of this interview modality on the admissions process. This study investigated the impact of overall acceptance rates using videoconference interviews and face-to-face interviews in the medical school selection process using an equivalence trial design. The University of New Mexico School of Medicine integrated a videoconferencing interview option for community and rural physician interviewers in a pseudo-random fashion during the 2014-2016 admissions cycles. Logistic regression was conducted to examine whether videoconference interviews impacted acceptance rates or the characteristics of accepted students. Demographic, admissions and diversity factors were analyzed that included applicant age, MCAT score, cumulative GPA, gender, underrepresented in medicine, socioeconomic status and geographic residency. Data from 752 interviews were analyzed. Adjusted rates of acceptance for face-to-face (37.0%; 95% CI 28.2, 46.7%) and videoconference (36.1%; 95% CI 17.8, 59.5%) interviews were within an a priori ± 5% margin of equivalence. Both interview conditions yielded highly diverse groups of admitted students. Having a higher medical college admission test score, grade point average, and self-identifying as disadvantaged increased odds of admission in both interview modalities. Integration of the videoconference interview did not impact the overall acceptance of a highly diverse and qualified group of applicants, and allowed rural and community physicians to participate in the medical school interview process as well as allowed campus faculty and medical student committee members to interview remotely.

Increasing the relative weight of noncognitive admission criteria improves underrepresented minority admission rates to medical school.

UNLABELLED: CONSTRUCT: The objective of this study was to evaluate the impact of varying the relative weights of cognitive versus noncognitive admission criteria on the proportion of underrepresented minorities admitted to medical school. It answers the question, "Can medical schools increase the admission rates of underrepresented minority (URM) students by balancing cognitive criteria with the experiences, attributes, and metrics of noncognitive data in the admission process?" BACKGROUND: U.S. demographics are shifting, and by 2042 ethnic minority groups will make up approximately 50% of the population. Increasing diversity of the U.S. population foreshadows the need to increase the number of physicians from underrepresented minorities to help address healthcare disparities that are on the rise. APPROACH: A cohort of three medical school applicant classes (2007-2009) was used to model the impact on URM admission rates as the relative weights of cognitive and noncognitive admission criteria were varied. This study used the minimum admission standards established for the actual incoming classes. The URM rate of admission to medical school was the outcome. Cognitive criteria included Medical College Admission Test scores and grade point averages. Noncognitive criteria included four categories: background and diversity, interest and suitability for a career in medicine, problem-solving and communication skills, and letters of recommendation. RESULTS: A cohort of 480 applicants from the three applicant classes were enrolled in the study. As the weighting scheme was varied from 50% cognitive/50% noncognitive weights to 35%/65%, the proportion of URM students accepted to medical school increased from 24% (42/177) to 30% (57/193; p < .001). Hispanic and Native American acceptance rates increased by 5.1% and 0.7%, respectively. CONCLUSIONS: Admission rates of URM students can be increased by weighting noncognitive higher relative to cognitive criteria without compromising admission standards. Challenging conventional practice in the admissions process may improve health disparities and diversify the physician workforce.

Predicting Medical Student Performance With a Situational Judgment Test in Admissions.

PURPOSE: To explore correlations between AAMC situational judgment test (SJT) scores, other admissions data, and learners' medical school performance. METHOD: First- and second-year medical students from 8 U.S. MD-granting medical schools completed a prototype version of the AAMC SJT in 2017. Outcomes included research-only faculty ratings of student performance, final course grades, and faculty evaluations of student performance, 2017-2018 and 2018-2019 academic years. Bivariate correlations were used to investigate the relationship between SJT scores and student performance outcomes and hierarchical regressions to investigate whether SJT scores provided incremental validity over MCAT total scores and cumulative undergraduate grade point averages (UGPAs) for predicting student performance outcomes. RESULTS: In general, there were small positive correlations with research-only faculty ratings from the first year of medical school, with the highest for social skills/service orientation ( rcorrected = .33, P < .05). Correlations were higher, with the highest for social skills/service orientation and cultural competence ( rcorrected = .33 and .36, respectively, P < .05) in the second year in medical school. SJT scores improved prediction of research-only faculty ratings over MCAT total scores and UGPAs for reliability and dependability/capacity for improvement, cultural competence, social skills/service orientation, and the overall composite score in the first year and for resilience and adaptability, social skills/service orientation, cultural competence, and the overall composite score in the second year. SJT scores demonstrated small correlations with course grades ( rsample-weighted = .10, P = ns) and faculty evaluations related to professionalism skills ( rsample-weighted = .14, P < .05); however, MCAT total scores explained most of the variance associated with course outcomes. CONCLUSIONS: These studies provide initial evidence that SJT scores may add value to the medical school admissions process because scores were related to faculty ratings of professional behaviors and provided unique information relative to MCAT scores and UGPAs.

Applying holistic review practices to a Combined Baccalaureate/Medical Degree Program: Reflections on lessons learned.

PROBLEM: Despite the implementation of holistic review in the medical school application process, there is little information about how this can be utilized in Combined Baccalaureate/Medical Degree pipeline programs, especially since many programs offer reserved spots to their students in the medical school. Implementing holistic review in a Combined Baccalaureate/Medical Degree program and intentionally structuring it to align with the medical school mission and admissions practices and processes, can improve the diversification of the physician workforce, contribute to more primary care doctors, and promote in-state practice. INTERVENTION: Utilizing the medical school admissions by-laws, committee structure, shared training, and educational processes, we successfully engrained in our committee members the values and mission alignment to select the best applicants to fulfill the medical school mission using holistic review. To our knowledge, no other program has written about how holistic review is used in Combined Baccalaureate/Medical Degree programs and how it contributes to program outcomes. CONTEXT: The Combined Baccalaureate/Medical Degree Program is a partnership between the undergraduate College of Arts and Sciences and the School of Medicine. The Combined Baccalaureate/Medical Degree admissions committee is a subcommittee of the School of Medicine admissions committee but has a separate membership. Hence, the holistic admissions process for the program mirrors the School of Medicine admissions process. To determine the outcome of this process, we analyzed practice specialty, practice location, gender, race and ethnicity of program alumni. IMPACT: To date, the Combined Baccalaureate/Medical Degree holistic admissions processes have supported the medical school mission, "…To meet the physician workforce needs of the state by selection of students who are likely to train in specialty areas of need and to remain in or return to the areas of our state needing physicians." This implementation has resulted in 75% (37/49) of our practicing alumni selecting a primary care specialty, and 69% (34/49) practicing in the state. In addition, 55% (27/49) identify as Underrepresented in Medicine. LESSONS LEARNED: We observed that having an intentional structured alignment in place allowed for implementation of holistic practices in the Combined Baccalaureate/Medical Degree admissions process. The high retention rates and specialty of graduates from the Combined Baccalaureate/Medical Degree Program support our intentional efforts to diversify our admissions committees and align the Combined Baccalaureate/Medical Degree program's holistic review admissions process with our School of Medicine mission and admissions practices and processes, as key strategies to reach our diversity-related goals.

Postapplication Advisement for U.S. Medical School Reapplicants: One School's Program.

PROBLEM: Reapplicants make up over one-quarter of U.S. medical school applicants. Postapplication advisement (PAA) can provide potential reapplicants with concrete strategies for improvement, a contextualized basis for their scores, and a realistic idea of their chances for success. However, more data showing the effectiveness of PAA and an analysis of best practices are needed for PAA programs to be more widely adopted. APPROACH: In 2010, the University of New Mexico School of Medicine (UNM SOM) created a PAA program that involves a postapplication seminar (PAS), mandatory self-assessment and action plan development, and an individual consult with an admissions dean to prepare participants for reapplication. OUTCOMES: From 2010 to 2016, 892 applicants who interviewed and were rejected at UNM SOM were eligible to participate in PAA. Of these, 478 (53.6%) chose to participate in PAA over the seven-year period. Males had a higher participation rate (246/430; 57.2%) compared with females (232/461; 50.3%; P = .04). African Americans had a higher participation rate (12/17; 70.6%) and American Indian/Alaska Natives had a lower participation rate (17/64; 26.6%) than any other race/ethnicity. Of reapplicants who were subsequently accepted, 140/178 (78.7%) attended PAS and a consult, and 7/178 (3.9%) attended PAS only, compared with 31/178 (17.4%) of subsequently accepted reapplicants who did not participate in any PAA (P < .001). NEXT STEPS: Additional research should focus on the best approach for assisting reapplicants with prioritizing areas for improvement in their application. Demographic data may be used to target outreach to specific populations.

Combined Baccalaureate/Medical Degree Students Match Into Family Medicine Residencies More Than Similar Peers: A Matched Case-Control Study.

BACKGROUND AND OBJECTIVES: We sought to evaluate whether the University of New Mexico (UNM) Combined Baccalaureate/Medical Degree (BA/MD) program increases the likelihood that students match into family medicine residencies. METHODS: We used binary logistic regression to predict interest and actual residency match in family medicine. We compared BA/MD participants to similar peers (one-to-one match subject design) and all other students for the nine cohorts of medical students who have matriculated into UNM School of Medicine since the inception of the BA/MD program (medical school matriculation years 2009-2017). We also investigated whether BA/MD students were more likely to select family medicine as their specialty choice at the time of matriculation using survey responses. RESULTS: At the time of matriculation, the differences in identifying family medicine as a first specialty choice between BA/MD, similar peers, and all other students were small and not statistically significant. However, upon graduation, 33% of BA/MD students matched into family medicine compared to 17% of similar peers, a statistically significant difference even after controlling for United States Medical Licensing Examination (USMLE) test scores and several demographic factors. CONCLUSIONS: The University of New Mexico Combined Baccalaureate/Medical Degree students match into family medicine at nearly twice the rate of traditional medical degree students, suggesting that the UNM BA/MD program serves to increase the growth rate of the family medicine workforce.

Recruiting American Indian/Alaska Native Students to Medical School: A Multi-Institutional Alliance in the U.S. Southwest.

PROBLEM: Despite national efforts to diversify the physician workforce, American Indian/Alaska Native (AI/AN) individuals have the least representation of all major racial and ethnic groups. Limited resources at state medical schools present institution-level recruitment challenges. Unified efforts to engage AI/AN students in premedical education activities are needed. APPROACH: The medical schools at the Universities of Arizona (Phoenix and Tucson), Colorado, New Mexico, and Utah identified a collective need to increase student diversity, particularly with regard to AI/AN students. The schools partnered with the Association of American Indian Physicians to support AI/AN students applying to medical school and to grow the overall AI/AN applicant pool. Each year from 2011 to 2016, these institutions hosted a two-day preadmissions workshop (PAW) to prepare participants for applying to medical school. OUTCOMES: From 2011 to 2016, 130 AI/AN students participated in the PAWs. Of these, 113 were first-time attendees, 15 participated on two separate occasions, and 1 participated on three separate occasions. Nineteen (21%) of the 90 first-time participants from 2011 to 2015 matriculated to a U.S. medical school in the past five years. Twenty-two of 23 participants (96% response rate) in 2016 responded to the postworkshop survey. Results indicated that interview preparation, individual consultation, and writing preparation ranked as the three most beneficial sessions/activities. NEXT STEPS: Standardized evaluation of future PAWs will identify best practices for recruiting AI/AN students to medical school, and future initiatives will include more robust measures of success.