Analysis of the Admission

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DOCUMENT. NESIME
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BE 010.119
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Cucai Janet Asiei
4HTLiOR
in Analysis of the Admission Prc4ess to u.s..:Medical
TITLE
Scheel's,. 1973 and 1976.---Pinal Report.
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Associatiqn of -Imeric.an Medical' Colleges,. Nashing
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plitO/PaS)., Bethe das
Health .Reso
SPOILS AGENCY
f.Health Manpower.
Md. Bureau
PUB was
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231-76-0011
CONTRACT"
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101p.; Lard may be marginally legible due,tg.,printi
NOTE
quality
Association of American Medical Colleges; Cne.D,upont
AVAILABLE PRON.
Circle, Washington's D. C. '20036
,
MP-30,43 Hc-56.01 Plus Postage.
BDRS PRICE
*Admission (School); *Admission Criteria; Competitive
DESCRIPTORS,"
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-Selection; ,/ducational,Change;-tigher Education;
*Medical' Schools,; *Medical Students; *Professional
Education; *Student Charactetiitics
f
lgigatf'
The- wedical school admission process is a 'majoz
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d'etzerminant of various "attributes and characteristics of the,American
analysis' investigated the
Rhysician of
manpower pool.
criteria
national aid institutional consequience An :selecting s.tndents, for
medical schogl, the changes in th4- relative importance of these
criteria from 1973 to 1976, the relatienhip of elements- of the
admission process, to the admission. of students with characteristics
presently of societal interest, and factors distinguishing accepters
who Matriculated in medical school frem those who did not.
(Author/MSE)
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AN ANALYSIS OF THE
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ADMISSIONS PROCESS TO U.S. MEDICAL SCHOOLS,
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1973 AND19'76
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.SERS E
FINAL REPORT
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DEnt-ruE.4, OF t*Ei.LT)*
EDUCATiOrt t WELFART
45TiTtgE OF
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Associaiion of American Medical Colleges
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20636
One Diipont Circle, N.W., Washington,
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U.S. Department of Health, Education, and Welfare
Public Health Service
Health Resources Administration
Bureau of Health Manpower,
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Contract No. 231776-0011
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AssociatioA of Am rican Medical Colleges, 1978
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The Government retains, the right to use, dupli-*
"cate or disclose the contents of this report
and to haves or permit' others to do so.'
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AN ANALYSIS OF THE
ADMISSION PROCESS-TOTS. M ICAL SCHOOLS, 1973 AND 1976
t--
A
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Janet ?aid Coca
Division of Student Stafses
Association of AnieriCan ?ladies' Colleges
ft/
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Jane 1978
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The wail. upOo which this publication is bpsd was supported in part by the Baran of Health Manpower,
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DePartment of HSalik EduRation, and Welfare pprsuant to contract number 231-.F6-Til. flowesir, any,
expressed ha* do not necessan7; P;oresc, khe rqws dr& supporting
coerncnlas i oas anWor
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-Table 'of rodents
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List of Tablefs
Lgt cif Aaon-
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Exectitive Summary
L INTRODUCTION
1
Caracteristier
The Admissica Process and Mirka' n Manpower
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of
pr
esent sthdy
Parposes
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2.
Previous studies
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'Problems in Ascertaining National Adis'
B.
Criteria
The admission process is not a national monorail
1.
Lack of national data ka applicants' t'peraceptlity
1.
characteristics"
Why, then, a national stody or-admism- :of)
3.
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MEITIODOLOGY
Pala Soorces.._,
A.
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Content arIlysis of pubrashed statements of medical ,book
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2:
Admission criteria and changes from 1973 to 1976
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National analyses
Examination or IAD:renew
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R4ression analyses
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lastinnioral analysis
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c.
y analysis.
Case-stod
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Nonmatriculation factori..............._,---..-9
3.
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III.
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RESULTS Mit DISCUSSIMi
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is of Medical Selz*
Gomez Analyisr. of Mashed State:
A.
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Admission Criteria and alma From 1T73 to 1976
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National
1.
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Examina6ce of &itemizes
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Regression analyses--:
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Ingitinional analysis
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Case-swirly matlyaiiy...._
3.
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Noandtricalstion Faceoci '
.C.
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i ty. SUMMARY
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A.
Content Analysis of Pubtobed Statements of Medical Schoch
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B.
Admissica Criteria and Crmozes From 1973 to 1976
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Natioril inalyses:___,
1.
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L
snarysis
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Noranatikuiation Factors
C.
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BIBLIOGRAPHY
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APPENDIX k Objectives and-Goals of Metrical S4lools as Stated
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in Medical &boo! Adazisaca' Requarroents, 1973-79
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APPENDIX B:
Scaling Of Variables in the Statistical_Anthyses
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APPENDIX C: A MI-SU*. of the 1976-'77 Admission Process
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Report,.
1.
Questionnaire'
2.
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APPENDIX' D: Percentages of Selected.Chafactaistics of Applicants
'apt! Accepte& to the 1973 and 1976 Entering
Classes of 117 US. Medical
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Medical Schools' 'Stating Non-D' crimitiation,
Table if
Number- *tif
Preferences for and Prefererices Against. Indicated- Applicant -
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Characteristics
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Peecerilage Distifttions of Character4stics of Accepted' and
Table
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Rejected- Applicants to the 1973 anctto the .1976 National
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Entering Classes
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,.:..».,.:.,.:..»..r....
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Means and Standard .,Deriitiioni for Acqepted and Rejected
Table 3:
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Applicants to the 1973,alid tothe 1976 klational Entering Classes
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'he
R;sults of Forward Stepwise Regression Analysis of the
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"Acceptability- and Number of Acceptances Received by
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1976-77 Entering Clasi .......
Applicants to
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Resifts of Tors;ard Stepwise Regressiqn, Analysi; of the
Table 5: -
r Acceptability- and Number of Acceptances Received by
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Acceptees to the 1976-77 Entering Class._
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Number of Schools Which Overselected, ,Reproduced or
Table 6:
Underselected Their Applicant Pools by WKIjcated Percentage of
Applicant Characteristics and Clreer Plans ...............---................24
Percentage DistnIsurions of Characteristics 'of .Matriculant and
Table7:
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Nouraktricularit Acceptees to the 1976 National EnteringClass
and
Means and
Matriculant
for
Deviations
Standard
-Table 8:
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NonmatriculantrAcceptees to the 1976 National Entering
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Scaling of Variables in the Statistical Analyses
Table B:
Pi:rrazittages of Selected diaraaerisrics Regarding ACCeptance
Table D-I:
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and-Demographic Attributes of Applicants and Acceprees to the
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1973 a n d 1976 Entering glasses 0617 US. Medical Schools
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Placentages of Selected Chaiacicristics, Regarding Geographic
table D-2:
Location and Carter Plans of Applicants and Acciptees to the
93
1973 and 1976 Entering Classes of 117 U.S. Medical Schools......
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List' of Actosyms
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AAMC
Asittiation or-American Medical Collegei
AMCAS
American Medical College Appricaticzo Service
COTRANS.
Coordinated TransferApplication System.
Grade Point Average
GPA
MCAT
Medical Colic& Admission Test
'Med-MAR
Medical Minority Applicant Registry
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MSAR
Medical School Admission Requiirmcnts
MSIS
Medical Student Informatabn -System
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'SUM UMARY
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As the principaf gateway to the medical pwfession in the 13., the spedic;i1,schOol admission pio'' cess is a
m*rdeterminant of various attributes and characteristics of the American physician manpower pool. This
study, AiAnalysis oftb Admission Process tc; US. Medical Schools 1973.3nd 1976, investigated the criteria of
national and institutional consequent in selecting students for medical school, the changes in the relative
importance of the criteria fruit} 1973 to 1976, the relationship of elements of the admission process to the
admission of students with characteristiiss presently of societal interest, and factorsAstinguishing acceptees who
matriculated in medical school from thdsg 'Who didsibt: ;
The analyses conducted to addriss these severalsissues included (1) a content analysis of Published
statements of the medical schools relative to selection criteria, (2) statistical comparisons of the national
1973 and 1976, 43) regression analyses of the."acceptability" and
characteriStics. of icceptees and rejectees
number of acceptances received by applicants and ar.x.cptees to,the 1976 entering class, (4) ar,t.kstitutional level
analysis of the differenciS in the characteristic* of applicants and acceptees in 1973'and 1976, (5) a case-study of
admissions at 8 selecied schools, and. (6) statistical 'comparisons of the charaaeristics of nonmatriciilant and
tliatricutint acceptees to the 1976-77 entering class.
Data for the_ content analysis (item 1 abbve) were derived from individual school entries in the 1976-77
edition of Medical School .4.1mksion Requirements. For the national and institutional statistical analyses of
applicants, aciteptees, rejecteis, matriculants, and nonmatrik.ulants (i
" 3, 4 and 6 above ) data were obtained
quei.tionnaireollected the data
from the AAMC's Medical Student Information System. A specially
for-the case-study analysis (item 5
e).
Results of the content
shov;ed (4) a high degree of sensitivity that neither sex, race nor religion
in n.
should be the basis for disc
(2) the "encouragement" of applications from applicants with ..ertain
so
demographic characteristics, (3)
relative inattention to the intended careers and practice locations of appIrcants
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as criteria for admission; and(4) a
"gli degree of concern with state-residency.
The picture which seemed
emerge from the obtained acceptee-rejectee differences and 1973-1976
in .response, to more entering positions being available in medical,iih291s in 1976 and the
changes.. etas
necessity of choosing rabic students to fill those positions from an applicant pool .withimproved academic
credentials, continued emphasis was placed.on academic .credentials (GPA and MCAT s+res) and on factors
related to them (age, educational level, socioeconomidc. baclground, etc.). The result wasihat applicants -with
career and location plans si.hich might correct present imbalances in the physician manpower pool, but plans
which are also negatively related to desired academic credentials, continued to be screened out, though not at. the
levels of 1973..
Rigression analyses based on two indices reflecting medical school evaluation of applicants, i.e., applicant
"acceptability" 'and number of acceptances received, showed that only one-fourth to one-third of the variance in
the two indicts was explained by a total of 27 variables concerned with academic qualificauons, demographic
plans, and admissions-process pragmatics. Information regarding
characteristics,
career
"personality
cliatacteristics," motivation for a medical career, etc., the "soft data" not collected
cm a uniform national basis, is
among the information not included in these analyses.
The variables which 'tog
accounted for most of the explained variance were undergraduate college
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selectivity, GPA, and MCAT scores.
ese results demonstrate that academic. aptittide and achievement are the
necessary, thriugh not sufficient, conditions for admission to and success in medical school. Together with the
abovementioned academic variables, other variables concerned with repeat-appliapt status, underrepresented
minor
racial/ethnic identity, age, and ratio of instate applicants to openings added in
a minor way to the
explaadtion of acceptability and number of acceptances. Career-type, location and speaaliFation plans,
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socioeconomic background, and all remaining variables added essentially nothing in the
way of explanation,
confirming infofmal intelligence that admissions personnel perceive ;violent plans expressed at application to
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mediCal school as uninforrried, therefore,.nnstAle an d-unworthy. Of much consideration. ruitlferinure, since the
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`data on student plans in all of the analyses in this study. had been collected solely for research purposeand were:
not Available to the schools, to use them to,ascribe implicit or explicit policies on these matters to the schools
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would be to do so on extrenrly tenu9usgrotutds.
Analysis at the'in`stiiinional-looldso demonstrated the disappearance in 1976.0t trends which were evident.
in 1973-to overselect (Or give preferenCe to) women applicants and black applicants. The, ovetselection of
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backgrounds and of applicants- planning to locate in rural ara.S
applicants from low-int:crust and rural;small to
blacks and also 'disappeared by 1976. The characteristics showing the greatest
was less than that for.women and
"diffeiences between applicants and acceptees concerned the related issues of career Type plans and specialty plans.
Mae majority of schools underselected (a) those aPplicant.1 who planned to devote their careers to general practice
activities(as opposed to research; teaching, etc.) and (b) those applicants &So planned to specialize in general
_practice medieine,(as,opposed to internal medicine, surgery, etc.). At a few schools the-percentage of applicants
planning a general practice type of career was more than 2,0 points greater than that uracceptees with such plans.
With regard to applicants who planned to specialize in Primary care specialties other than that of general practice,
numbers.or schooLs nvertelected and underselected them in 1973, however; in 1976, more
. approximately equal
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schools ender elected than overselected these applicants.
,
and specialty plans of"
The case-study analysis also indicited a relative lack of attention to the career-an.
applicants in comparison to that paid to other applicant cbataderistics. Admission _ policies, committee
chliactensui:s, and procedures directed towards increasing the probability of acceptance of women and nCnurity
Tor
grpup applicants seemed successful, while the decreased probability of acceptance of applicants with plans
generabTaraily and," rural ptacticiseerbed due to the lack of s'peciar attention to such applicants in policies and
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procedufes.
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Only 3 percent of the applicants accepted to the 1976-77 entering class did not matriculate and, in
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socioeconomic.bacigrounds, of
comparison to matriculants, included higher percentaggs of acceptees from lower
pothesizecithat
women, and of students who at application were iruerested in research,'teaching careers. it is by
bvomen being unsure of
Career indecision may be the crucial factor in nonmatriculation
the appropriateness of the physician role for themselves and research-oriented students
deciding for careers wholly devoted to iesearch/t,Fachingiy enrolling for graduate study in
the disciplines of their interest;
The economically-poorer background of nonmatriculants may have been the precipitating
given their uncertty regarding a'career in medicine
factor in their nonmatriculatioh
;
and the rising cost of medical education.
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L -INTROtItiCTION
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A. The Adtnission'Process and
school based on changeable prefet.e, nets or propensities
Physician Manpower Characteristics
is also capable of influencing in desired directions the
characteristics of the new cohorts of phyThsisians
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produced annually. This capability is groun. -a0 in the
Thi proceSsy which students are selected for
demonstration that careerpreierences at admission ire,
admission to U.S. mecifeal schools* is the major
not- unrelated to later career decisions (2) and that
gateway to the medical profession,in the United States
.
later career choices are not unrelated to baekgroimd
today. WO increasing restrictions on the immigration
and personal characteristics whicl are present at
of foreign-national physicians, heretofore a sizeable
admission and which do not change (3).
addition to medical manpower in the U.S., entrance
. and graduation from a U.S. medical school will
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NI-Poses 'of PresentStudjc
become virtually the only gateway to U.S. medicine.
Thus, the admission process is a majordeterrainant of
The question then becomes one of whether the
various attributes of the physician manpower pool.
medical §chool .admissions process is perceived. and
Organizations and individuals monitoring Medical
*
used (whether implicitly or explicitly) as a mechanism
manpower characteristics, ait,
'rightly
tiherefore,
uencing the chkaeteristics of the physician
for
concerned with the impact of the medical 'school
tics presently of special societal
'pool.
-admission process on physician characteristics. --
interest-- ..a.e those of sex,
racial/ethnic identity,
Students are admitted both on the basis of
income-leyeb and medical specialization and practice
attrikutes which do not change (e.g., sex-and race) and
primary*
location
The
intentions /probabilities.
on the basis of attributes which maY--elfange (e.g.
purpose of the presint study is to determine what
career, specialty, and geographic location plans).
criteria have been used to evaluate candidates for
-'here the process selectively admits students on the
admission to medical-gc.hook including whether the'
basis of attributes which do not change, even attrition
five aforementioned characteristics of special interest
though it may be selective
from medical
are among those criteria, and what the relative
adording to th
e attributes, will do little to alter
importance of the various criteria are.
the collective images of the annual pools 'of new
A second" purpose "is to identify the criteria
physicians from the images of the essentially identical
which have assumed greater (or lesser) importance in
pool of persons admitted to medical school 3 to 5 years.
recent years as a means of discovering whether the
earlier. Logically, therefore, there is little quarrel with
priorities of the medical schools have changed. The
the pragmatic appropriateness of using the admission
identification and description b1 admission process
process to modify the characteristics of the medical
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features which are uniquely an/or especially tailored
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manpower pool and to increase the,-
minim° ui-,
to increase the selectton of particular groups of
medicine of groups of persons whapreyiously have
students, i.e. women, underrepresented minorities, low
been underrepresented. (However, whether there is
income, and those apt to become primary care
any quarrel with the legal appropriateness of doing so
practitioners and/or locate in underserved
,areas, is a
is presently under consideraticin by the U.S. Supreme
third Purpose of thastudy. Discovery and examination _,
Court
-theca., se of Allan Bakke vs The Regents of the
%
of differences in the characteristics' 6f students who
Univ
ty of California el)).
to medical school but did not
Were accepted
the admission process to _influence
matriculate as compared to those who did matriculate
characteristics of the physician pail which can change
was*the final purpose of the study.
from the time a studetiPapplies to medical school until
he or she enters practice (and even after) is obvidusly
results than is use of
subject to More uneaten-
to
immutable demographic
admission
influence
,
characteristics. Nevertheless, selection for medical