Are med school admission policies in for a change?

Jordan Cohen, MD, the Assn. of American Medical Colleges' top official, wants schools to use subjective criteria along with test scores to both attract and select students.

By Jay Greene, amednews staff. Dec. 24/31, 2001.

Calling for a more balanced method of selecting medical students, Jordan Cohen, MD, president of the Assn. of American Medical Colleges, said standardized test scores and grades should be used only as part of an overall admission assessment that would also include personal characteristics, leadership abilities, past experiences and maturity.

"My concern here is the imbalance that currently exists in how we convey to applicants the selection criteria we use," said Dr. Cohen in a speech at the AAMC's recent annual meeting. "I'm referring, of course, to our tendency to underemphasize, because they are harder to measure, the personal characteristics we are seeking in our applicants, and to overemphasize the more easily measured indices of academic achievement."

Dr. Cohen said he believes focusing on scores discourages some undergraduates from applying to medical school, which may be one reason applications are down the past five years. For the 2001-2002 school year, the AAMC said there were 34,859 applications to the nation's 125 allopathic medical schools, a 6% decline from the previous year.

"If more such intelligent and dedicated idealists were to perceive that we would give as much weight to what's in their hearts as to what's in their heads, a career in medicine would no doubt attract them strongly," Dr. Cohen said. "As it is, I'm persuaded that many don't perceive this balance in our selection criteria, and turn away convinced that medicine is for grade-grubbing Philistines but not for them."

Application declines also have been attributed to undergraduates selecting business or other careers in the booming economy of the last decade, the loss of physician autonomy over their practices due to managed care and government regulations and the high cost of medical education that now averages about $100,000.

"While we can't pinpoint exactly why the numbers continue to decline, we are investigating new ways of communicating to potential doctors why medicine is still among the most noble and gratifying professions," Dr. Cohen said.

In what appears to a be a more troubling trend, applications also are down 4.5% for underrepresented minority applicants -- black, Native American, Mexican American/Chicano and Mainland Puerto Rican -- dropping to 4,091 from 4,284. Fewer males also applied to medical school this year, an 8.4% decline to 18,142 from 19,816. Female applicants dropped 3.2% to 16,717 from 17,273.

Dr. Cohen also called on schools to review how they prepare students for practice. "No matter how successful we are in attracting idealistic, properly motivated students to medicine now or in the future, we have little hope of delivering the same number of idealistic, properly motivated doctors to society unless we can close the gap between rhetoric and reality," he said.