Gender Gaps In Medicine

[MountainAmoeba]

Just because it's subjective doesn't mean it's not accurate. You fail to recognize that. You're arguments are so biased and single perspective that it's impossible to talk reasonably with you.

 

Let me explain.

 

You fail to provide answers as to why a subjective process has no merit. You fail to defend your assertion that males underperform in interviews secondary to discriminatory selection biases, rather then lack of capacity. Both are reasonably defendable arguments. You might be right, but I can offer a very reasonable explanation for why you are wrong, that you brush aside. It can't be!!!! Of course men can do as well on women on anything!!!! It has to be discrimination!!!! It can't be lack of capacity.

 

That's what your lack of response on that question states. As though it isn't a relevant postulation, even worthy of attention. You also fail to adequately defend your response that medical schools don't evaluate the outcomes of their students. And have in place an evaluative process to ensure that they use selection criteria that select med students who will experience success. You point out u of c, so let's use that as an example. The director of admissions had several podcasts you can listen to, that discuss how each criteria is determined, and demonstrate how they track their students. Are you saying he's lying? That would be an interesting position. Or does it just not matter that these choices are justifiable? I just find your arguments to be unsupported.

 

Again. You have a lot of opinions.

[Clapton]

Just because it's subjective doesn't mean it's not accurate. You fail to recognize that. You're arguments are so biased and single perspective that it's impossible to talk reasonably with you.

 

Let me explain.

 

You fail to provide answers as to why a subjective process has no merit. You fail to defend your assertion that males underperform in interviews secondary to discriminatory selection biases, rather then lack of capacity. Both are reasonably defendable arguments. You might be right, but I can offer a very reasonable explanation for why you are wrong, that you brush aside. It can't be!!!! Of course men can do as well on women on anything!!!! It has to be discrimination!!!! It can't be lack of capacity.

 

That's what your lack of response on that question states. As though it isn't a relevant postulation, even worthy of attention. You also fail to adequately defend your response that medical schools don't evaluate the outcomes of their students. And have in place an evaluative process to ensure that they use selection criteria that select med students who will experience success. You point out u of c, so let's use that as an example. The director of admissions had several podcasts you can listen to, that discuss how each criteria is determined, and demonstrate how they track their students. Are you saying he's lying? That would be an interesting position. Or does it just not matter that these choices are justifiable? I just find your arguments to be unsupported.

 

Again. You have a lot of opinions.

 

 

For someone with 0 background in psychology, sociology, and psychometrics, you sure have a lot of opinions.

 

This is great. So you feel that males are disadvantaged, because lesser numbers get into medicine. And you think the disadvantage is a discriminatory selection process. Rather than asking why men aren't able to compete against women in interviews and other non acedemic aspects of the application?

 

That maybe the disadvantage has to do with the ways males are socialized, and thus lose opportunities to gain the skills required to be competative.

 

And the idea that there are distinct differences genetically in the way males and females behave is only supported if you accept binary gender categories. Other non western cultures have as many as 7 distinct genders.

 

You have a lot of opinions.

 

Ok...

 

 

IMO, the under-representation of men (not only in medical school) is concerning and too often written off as either a "non-issue" or "rectifying an historical injustice".

[Harvestpro]

Worthwhile debate related to this, with citations.

 

https://www.edge.org/event/the-science-of-gender-and-science-pinker-vs-spelke-a-debate

[MountainAmoeba]

For someone with 0 background in psychology, sociology, and psychometrics, you sure have a lot of opinions.

 

 

 

IMO, the under-representation of men (not only in medical school) is concerning and too often written off as either a "non-issue" or "rectifying an historical injustice".

 

0 background? How do you quantify that?

[MountainAmoeba]

Also, I am not saying it isn't an important observation, worthy of consideration. It absolutely is. Disparities in gender are always worth looking at.

 

I would ask, why don't men have the skills necessary to do well in equal numbers compared to women. Rather then saying that the selection process is discriminatory, I would say how do we ensure than men have the qualities and attributes required for successful admission to medical school? What barriers are there that prevent men from having these skills? What is required to overcome this? I would also ask, why don't women do as well on standardized tests? What barriers exist? How do we over some them? Medical schools are entitled to choose the criteria that they have determined is relevant to their statistical analysis for predictors of long term success.

[fastrunningfish]

As with most changes, the pendulum will over swing before it comes back to a middle ground equilibrium point. 

 

Stats that I think would be interesting to have are a breakdown by year of acceptance (2, 3, 4+), number of attempts, age, and gender. Are women being accepted earlier, or applying more times before switching career paths than men? Or applying at an older age which may help them in interviews with maturity etc.? For instance are 90% of the applicants in the 2/3 year pool females? or maybe 3rd year applicants who are applying for a second time are more often women, who may have received an interview last year and then are better prepared for the next cycle?

 

I don't know any of these things but it'd be interesting to know

[uwopremed]

Just because it's subjective doesn't mean it's not accurate. You fail to recognize that. You're arguments are so biased and single perspective that it's impossible to talk reasonably with you.

 

Let me explain.

 

You fail to provide answers as to why a subjective process has no merit. You fail to defend your assertion that males underperform in interviews secondary to discriminatory selection biases, rather then lack of capacity. Both are reasonably defendable arguments. You might be right, but I can offer a very reasonable explanation for why you are wrong, that you brush aside. It can't be!!!! Of course men can do as well on women on anything!!!! It has to be discrimination!!!! It can't be lack of capacity.

 

That's what your lack of response on that question states. As though it isn't a relevant postulation, even worthy of attention. You also fail to adequately defend your response that medical schools don't evaluate the outcomes of their students. And have in place an evaluative process to ensure that they use selection criteria that select med students who will experience success. You point out u of c, so let's use that as an example. The director of admissions had several podcasts you can listen to, that discuss how each criteria is determined, and demonstrate how they track their students. Are you saying he's lying? That would be an interesting position. Or does it just not matter that these choices are justifiable? I just find your arguments to be unsupported.

 

Again. You have a lot of opinions.

 

Subjective criteria have been used for years to justify why women or blacks don't get higher level jobs or higher pay.  All the time.  Do you think that is legitimate?  I think that is BS.  So when a subjective criteria is found to very much benefit women, I also call BS.  Subjective criteria that produces unequal outcomes should always be evaluated for bias - or replaced by more objective criteria.   I'm not necessarily looking for equal outcomes either - rather equal opportunities.  If subjective interviews are found to routinely favour 'feminine' qualities, that is certainly something worth discussing.

[MountainAmoeba]

Subjective criteria have been used for years to justify why women or blacks don't get higher level jobs or higher pay.  All the time.  Do you think that is legitimate?  I think that is BS.  So when a subjective criteria is found to very much benefit women, I also call BS.  Subjective criteria that produces unequal outcomes should always be evaluated for bias - or replaced by more objective criteria.   I'm not necessarily looking for equal outcomes either - rather equal opportunities.  If subjective interviews are found to routinely favour 'feminine' qualities, that is certainly something worth discussing.

I completely agree, it deserves discussion. And! It should be evaluated for bias. Absolutely. We need to ascknowledge that males, nor females, nor anyone of another gender, nor people of colour, should be discriminated against, or face a biased system. We also need a system that is capable of testing for qualities, or attributes that are considered desirable in the position we are looking to recruit into (I hope we can agree on that). And when a process that is in place is found to favor a particular people for reasons other than ability to demonstrate the qualities, then absolutely, we should examine how it is used, revamp it, or reject it completely. What is so hard about considering that the tools they use to measure specific attributes don't select females preferentially by virtue of their sex organs, but rather their ability to demonstrate the qualities they have? Why doesn't that enrage you more? Why are you so defensive of the idea that men may not be as well suited (on average) to interview well (etc)?

 

What if men are truly limited in these areas because they don't have equal opportunity to become proficient in them, in the same way that women experience limitations because of their gender (as imposed on them)? What if that's true? Doesn't that make you angry? Isn't that worth considering?

 

You talk about objective measures, so let's discuss those too. The MCAT for example. Doing very bad on the MCAT obviously says you either didn't prepare, or don't have the capacity to do well. Doing very well on the MCAT obviously means you were really prepared, and have the capacity to perform well. What about the difference between someone with a 90 vs a 91 percentile ranking. Does that difference equate nicely to summing up capacity? Or does it perhaps reflect opportunity? Doing well on the MCAT definitely demonstrates capacity, but not doing as well as someone else doesn't mean you have less, especially when we are splitting hairs (comparing very close ranking). As for GPA it's largely the same, for the same reason.

 

Also consider that as time goes on applicants are pushing the mean higher and higher, and the differences between top applicants is very little. So how else do you suggest we evaluate these top tier applicants?

 

Let us also consider the intent and purpose of training a physician? What should that person be like? Consider that family medicine and internal medicine are the residencies with the greatest positions, and involve a practice where you arguably interact with the greatest numbers of people. What type of person would be effective in that role? What qualities would they have? How would you test for it? Or measure it?

 

If you alienate your patients and they stop coming to you, they will show up in emerge with DKA, hypertensive crisis, pneumospesis, urosepsis, or worse for things like refills on prescriptions because they don't trust you.

 

So how then, if you think interviews are garbage, EC's are garbage etc, do you propose to test for the kinds of qualities that ensure you have not only admitted a smart person, but also an exceptionally talented person who possess the types of capacities that are meaningful to the long term goals of medicine as a profession, and fulfill the needs of the public? Im curious.

[SunAndMoon]

Can we stop assuming that the MCAT is actually objective? Saying that men perform better without analysing how and why that happens is useless, and could be a source of bias/unfairness if a school heavily emphasizing on those scores ends up picking more men than women as a result of gender differences in the test itself. 

 

Parallel to some ethnic groups performing lower on IQ tests due to bias within the test itself. 

 

The objective > subjective argument is thrown too easily - make sure your objective measure IS actually objective first.

[uwopremed]

Can we stop assuming that the MCAT is actually objective? Saying that men perform better without analysing how and why that happens is useless, and could be a source of bias/unfairness if a school heavily emphasizing on those scores ends up picking more men than women as a result of gender differences in the test itself. 

 

Parallel to some ethnic groups performing lower on IQ tests due to bias within the test itself. 

 

The objective > subjective argument is thrown too easily - make sure your objective measure IS actually objective first.

 

You have ZERO understanding about what Objective means.  Objective evaluations are those which will always have the same result with the same actions with any evaluator.  That is all objective means.  I a man instead of a woman answered every question the same on the MCAT, his score would be the same.  In an attempt to remove questions that have bias - the MCAT and SAT writers are now majority female, and have removed many of the language type questions (SAT) that in theory would burden the working class or minorities.  There was zero difference in outcome, even with those changes.

 

Now I will agree that Objective does not necessarily mean Fair.  A possible Objective test for admission to medical school could be a hand grip strength test administered under ideal conditions.  While Objective, it's not necessarily relevant to medical school admissions, would unfairly bias women, and is hence unfair.  But it is Objective.

 

The only Objective measurement for medical school in Canada is the MCAT. One can argue, much like the SAT, whether it is fair or not.  But both scores correlate very well with success.  While not studied for the MCAT, as most MCAT writers are relatively bright, the SAT correlates with virtually all attributes of success - including likelihood of not going to jail to income to marks in university.  Whether people are unprepared for these tests prior to writing them is another issue - and a very valid one.  But it does not mean that the test itself is invalid.

 

The evidence for subjective evaluations is of course much shakier.

[uwopremed]

I completely agree, it deserves discussion. And! It should be evaluated for bias. Absolutely. We need to ascknowledge that males, nor females, nor anyone of another gender, nor people of colour, should be discriminated against, or face a biased system. We also need a system that is capable of testing for qualities, or attributes that are considered desirable in the position we are looking to recruit into (I hope we can agree on that). And when a process that is in place is found to favor a particular people for reasons other than ability to demonstrate the qualities, then absolutely, we should examine how it is used, revamp it, or reject it completely. What is so hard about considering that the tools they use to measure specific attributes don't select females preferentially by virtue of their sex organs, but rather their ability to demonstrate the qualities they have? Why doesn't that enrage you more? Why are you so defensive of the idea that men may not be as well suited (on average) to interview well (etc)?

 

What if men are truly limited in these areas because they don't have equal opportunity to become proficient in them, in the same way that women experience limitations because of their gender (as imposed on them)? What if that's true? Doesn't that make you angry? Isn't that worth considering?

 

You talk about objective measures, so let's discuss those too. The MCAT for example. Doing very bad on the MCAT obviously says you either didn't prepare, or don't have the capacity to do well. Doing very well on the MCAT obviously means you were really prepared, and have the capacity to perform well. What about the difference between someone with a 90 vs a 91 percentile ranking. Does that difference equate nicely to summing up capacity? Or does it perhaps reflect opportunity? Doing well on the MCAT definitely demonstrates capacity, but not doing as well as someone else doesn't mean you have less, especially when we are splitting hairs (comparing very close ranking). As for GPA it's largely the same, for the same reason.

 

Also consider that as time goes on applicants are pushing the mean higher and higher, and the differences between top applicants is very little. So how else do you suggest we evaluate these top tier applicants?

 

Let us also consider the intent and purpose of training a physician? What should that person be like? Consider that family medicine and internal medicine are the residencies with the greatest positions, and involve a practice where you arguably interact with the greatest numbers of people. What type of person would be effective in that role? What qualities would they have? How would you test for it? Or measure it?

 

If you alienate your patients and they stop coming to you, they will show up in emerge with DKA, hypertensive crisis, pneumospesis, urosepsis, or worse for things like refills on prescriptions because they don't trust you.

 

So how then, if you think interviews are garbage, EC's are garbage etc, do you propose to test for the kinds of qualities that ensure you have not only admitted a smart person, but also an exceptionally talented person who possess the types of capacities that are meaningful to the long term goals of medicine as a profession, and fulfill the needs of the public? Im curious.

 

Your response was much more nuanced than others, and I appreciated that.  I don't think the MCAT is the end all or be all.  It's just an objective score than men do well on - but irrespective still end up being underrepresented in medical school classes.  I use it as a red flag to evaluate possible bias.

 

I think interviews are important.  I also think EC's are important.  I do think that some sort of way of evaluating those things without the evaluator knowing gender, race, and looks would be ideal.  Not very easy - though McMaster and now Ottawa have tried doing that with Casper with some success.  One of the most interesting things about the MCAT was that the only section that women scored higher on regularly was the Writing Sample.  Once the writing sample went to the computer, the averages for both sexes became the same.  Suggesting that the more feminine writing most women have gave them an advantage.  That result fascinated me a lot.

[InstantRamen]

Your response was much more nuanced than others, and I appreciated that.  I don't think the MCAT is the end all or be all.  It's just an objective score than men do well on - but irrespective still end up being underrepresented in medical school classes.  I use it as a red flag to evaluate possible bias.

 

I think interviews are important.  I also think EC's are important.  I do think that some sort of way of evaluating those things without the evaluator knowing gender, race, and looks would be ideal.  Not very easy - though McMaster and now Ottawa have tried doing that with Casper with some success.  One of the most interesting things about the MCAT was that the only section that women scored higher on regularly was the Writing Sample.  Once the writing sample went to the computer, the averages for both sexes became the same.  Suggesting that the more feminine writing most women have gave them an advantage.  That result fascinated me a lot.

Where was this study done? Plz include sauce. I'm curious.

[uwopremed]

Where was this study done? Plz include sauce. I'm curious.

 

The AAMC website has average MCAT scores over the years by race and gender for each component.  Please look at the writing sample data prior to 2008 or so, and compare it to 2013 or so (when they got rid of it).  The average difference between men/women disappeared when computers came into the mix - and handwriting could no longer be evaluated.  To be fair = men might also have worse penmanship to begin with - but still not enough of a reason to punish their scores.

 

Irrespective, pursue the site and look at all the data.  It's all there.

 

ADD:  I reviewed the site - and now for the writing sample they only keep matriculant data, not applicant data.  Probably removing WS stuff as it was removed from the MCAT anyways.  https://www.aamc.org/download/321470/data/factstablea7.pdf and similar pages do show interesting gender data.  Though they really only apply to the USA - a much more conservative and, dare I say, even misogynistic society.  I don't want to emulate them either.

 

Here is average matriculant data by gender for each section of he MCAT: https://www.aamc.org/download/321506/data/factstablea22.pdf

 

Of Note - men have slightly higher Science GPAs, women have slightly higher non-Science GPAs, and the aggregate slightly favours women.

[InstantRamen]

The AAMC website has average MCAT scores over the years by race and gender for each component. Please look at the writing sample data prior to 2008 or so, and compare it to 2013 or so (when they got rid of it). The average difference between men/women disappeared when computers came into the mix - and handwriting could no longer be evaluated. To be fair = men might also have worse penmanship to begin with - but still not enough of a reason to punish their scores.

 

Irrespective, pursue the site and look at all the data. It's all there.

 

ADD: I reviewed the site - and now for the writing sample they only keep matriculant data, not applicant data. Probably removing WS stuff as it was removed from the MCAT anyways. https://www.aamc.org/download/321470/data/factstablea7.pdf and similar pages do show interesting gender data. Though they really only apply to the USA - a much more conservative and, dare I say, even misogynistic society. I don't want to emulate them either.

 

Here is average matriculant data by gender for each section of he MCAT: https://www.aamc.org/download/321506/data/factstablea22.pdf

 

Of Note - men have slightly higher Science GPAs, women have slightly higher non-Science GPAs, and the aggregate slightly favours women.

Isn't VR a better indicator of success in med school? Or do you think that it's a conspiracy to allow more women in med.

 

Also, you speak very definitively, as if there is no room for error. Strong language sounds arrogant. There isn't "Zero" difference. The statistics don't have significant difference to confirm their suspicion.

[uwopremed]

Isn't VR a better indicator of success in med school? Or do you think that it's a conspiracy to allow more women in med.

 

Also, you speak very definitively, as if there is no room for error. Strong language sounds arrogant. There isn't "Zero" difference. The statistics don't have significant difference to confirm their suspicion.

IT is.  Verbal trumps the other two areas.  And in Verbal, men score slightly higher than women - but not by very much.  So in the Applicant pool, men have an average maybe a little bit bigger.  Because I think men and women, on balance, are probably similarly capable for entering medicine and becoming good doctors.  Among matriculants, the verbals scores for both men and women are generally the same.  The US does use the MCAT more in their admissions process anyways...and is why their medical schools are gender balacned (around 52% male, 48% female) as opposed to Canada (63% female, 37% male)

 

The statistics have thousands upon thousands of students per year, over decades.  This isn't like some small study with 100 very disparate patients.  This is statistically significant.  Are you honestly that daft when it comes to understanding basic statistics??

[InstantRamen]

Fair statement. Good luck fighting for your cause.

[ralk]

Glad to see some greater variety of viewpoints being expressed. A few things to clarify, apologies for incoming wall of text

 

1) fastrunningfish made an excellent point about requiring more data before being able to make assured, sweeping conclusions. When their are holes in the data, conclusions are inherently based on assumptions and those assumptions may or may not be true. For example, when looking at MCAT scores, it's clear that among applicants to Canadian medical schools, men have higher MCAT scores than women. Does that mean men do better on the MCAT than women? Not necessarily. The populations being compared are not standardized nor are they necessarily comparable. If men with lower MCAT scores are choosing not to apply to medicine - say because they have better career options elsewhere, or because their GPA precludes them from having a meaningful chance without a high MCAT - that can skew the results. When interpreting data, it's vital that any caveats are kept in mind and that conclusions be made only with mindfulness to any assumptions that lead to that conclusion. To bring that back to the example of MCAT scores, when I see that data, I think the assumptions necessary to turn that data into being gender-neutral or showing that women do better on the MCAT are less likely than any assumptions that would leave men as having a higher overall performance. However, I maintain skepticism about the degree to what men are doing better than women on the MCAT, because any assumptions I would have to make that would lead to a definitive conclusion would be unsupported by the information available.

 

Along those lines, I can't answer fastrunningfish's question about 3rd year/4th year status of applicants by year, but the AFMC data does indicate that male applicants tend to be a bit older than female applicants. That data's in keeping with fastrunningfish's theory, but the only way we could conclude that their idea is correct is with more specific data which I haven't been able to find.

 

However, when information is available, we should look at it. When uwopremed says that Canadian schools are 63% female, that's false. Flatly false. The percentage of women entering medical school in any one year has never been above 59.2%, while the percentage of women graduating has never been above 59.6%. Both those numbers have declined from their maximum values over the past several years.

 

2) The term objective is being thrown around in a way that overstates its meaning. The MCAT is objective, but so is GPA. Regardless of who submits their MCAT score or GPA, or who evaluates it, an applicant's MCAT and GPA are unchangeable. The difference between the MCAT and GPA comes in standardization. The MCAT is standardized, but GPA is not. Both the MCAT and GPA have subjective components within them (MCAT less so that most people's GPA), but the final number is an objective value. Likewise, standardization is frequently used with subjective criteria as well - interviews are typically standardized, but subjective.

 

Yet, the difference between objective and subjective, or standardized vs unstandardized, is really meaningless when it comes to admissions. What matters for admissions is reproducibility, lack of bias, and predictability of future performance. Both objective and subjective criteria, regardless of standardization, can be reproducible if give sufficient time and iterations. Likewise, both tend to be non-reproducible if done in small numbers. A single MCAT question is very unreliable, but the full test has good reproducibility. Likewise, a single interview with a single interviewer for 5 minutes will certainly have poor reproducibility, but several interviews with several people have higher reproducibility. That's the whole idea behind the MMI. Similarly, while Western uses a traditional interview format rather than the MMI, they also use 3 interviewers and do internal testing to ensure reproducibility.

 

Objective vs subjective doesn't speak to bias either. As uwopremed pointed out, objective criteria can be biased, just as subjective criteria can.

 

For predictability of future performance, the best data is for the MCAT and GPA, but there are some big caveats. The MCAT, for example, correlates best with USMLE Step 1 performance - particularly the Bio section - but doesn't do as great a job at predicting, say, GPA in medical school, where undregrad GPA does better. In short, like predicts like. Of course, we don't care particularly how well students do on standardized tests or GPA in medical school as much as we care about their clinical performance, and on that front, MCAT and undergrad GPA both have less evidence behind them last I checked. It'd be great to see more data on that (if anyone knows of studies I might have missed, please share or PM!)

 

In any case, when we say the MCAT is an objective measure, it's a meaningless statement. I like the MCAT, it's what got me into medical school and I think it has value as an evaluating tool, but I think that way because it is reproducible with some evidence for predictability on future performance, not because it's objective. 

 

3) To respond to uwopremed's point that on the 2015 set of AFMC data, women had an 8% better chance of admissions despite lower MCAT scores, I'd like to point out that the other considerations for medical school admissions are not reported, like GPA, ECs, interviews, etc. It's impossible to say men are better applicants when looking at only one criteria to the exclusion of others. Likewise, an 8% advantage is a far cry from uwopremed's original claim of schools having a final class that is 70-75% female with only 55% female applicants, which represents at whopping 90% to 145%(!!!) advantage. That's a dramatic, egregious deviation from the norm and even well beyond the outliers in Canada when it comes to gender preference (Calgary, at a 69% advantage for women). It's also a difference that's entire within year-to-year variations.

 

How do I know it's within the year-to-year variations? Because surprise, surprise, they just released the new year of data! And guess what, it's showing an 8% advantage for men. Now, a good portion of this swing is likely the inclusion of Western in the data (U of T is still not included), as Western had a 56% preference for men on the final numbers in the year just released. Contrary to uwopremed's assertions, Western had slightly more female applicants than male applicants.

 

I don't believe this year's data is any evidence of a bias towards men in the admissions process, despite an 8% advantage for them relative to women, just as I don't think the 8% advantage for women relative to men the prior year was any real evidence of a bias towards women in the admissions process. It's noise in the data and most consistent with rough, geographically-inconsistent parity between men and women when applying to medical school at this time. More data would be helpful to keep an eye on trends, as there did appear to be a wider preference for women a decade ago or so (as well as a much larger preference for men three decades ago and earlier). Still, my take-away from the data is that the primary reason there are more women in medicine than men is that they apply in greater numbers. Why they apply in greater numbers may be due to gender inequalities and is very much worth exploring, but claims of inequality in admissions across the entire country were, at a minimum, vastly overstated by uwopremed.

 

4) Lastly, uwopremed, when it comes to speaking out about controversial issues, saying things like "But when an interview process for medical schools, that are more tightly controlled by university academics (that lean left in general) show clear advantages to women - it can't be discussed?" is nothing short of disingenuous when you're currently have that discussion, freely and openly. Likewise, when offered to make this discussion more public - I can make specific recommendations where I can guarantee a voice on this matter at Western, and that includes non-print mediums - but then refusing (unless it's the time and medium of your exact choosing), then no one is censoring your voice other than you. The worst that can happen is people can disagree with you. If, as you confidently say, that your opinion is that of the majority, even that shouldn't be an issue, as more people would be on your side than not. But perhaps your view is not in the majority. You'll only know if you let your views into the public light, where they can be supported or scrutinized as appropriate. I strongly encourage you to do so.

[uwopremed]

Glad to see some greater variety of viewpoints being expressed. A few things to clarify, apologies for incoming wall of text

 

1) fastrunningfish made an excellent point about requiring more data before being able to make assured, sweeping conclusions. When their are holes in the data, conclusions are inherently based on assumptions and those assumptions may or may not be true. For example, when looking at MCAT scores, it's clear that among applicants to Canadian medical schools, men have higher MCAT scores than women. Does that mean men do better on the MCAT than women? Not necessarily. The populations being compared are not standardized nor are they necessarily comparable. If men with lower MCAT scores are choosing not to apply to medicine - say because they have better career options elsewhere, or because their GPA precludes them from having a meaningful chance without a high MCAT - that can skew the results. When interpreting data, it's vital that any caveats are kept in mind and that conclusions be made only with mindfulness to any assumptions that lead to that conclusion. To bring that back to the example of MCAT scores, when I see that data, I think the assumptions necessary to turn that data into being gender-neutral or showing that women do better on the MCAT are less likely than any assumptions that would leave men as having a higher overall performance. However, I maintain skepticism about the degree to what men are doing better than women on the MCAT, because any assumptions I would have to make that would lead to a definitive conclusion would be unsupported by the information available.

 

Men do score higher then women on the MCAT - whether applicant level or matriculant level.  That is a simple fact that the AFMC has on their website.   The delta between male and female scores is remarkably consistent year after year.  The strong emphasis on the MCAT in the USA (necessitated because of thousands of universities)  leads to a slight male advantage at the matriculant level.  I have not noticed any significant difference in the quality of Canadian medical students and non-affirmative action us medical students.  

 

Along those lines, I can't answer fastrunningfish's question about 3rd year/4th year status of applicants by year, but the AFMC data does indicate that male applicants tend to be a bit older than female applicants. That data's in keeping with fastrunningfish's theory, but the only way we could conclude that their idea is correct is with more specific data which I haven't been able to find.

 

However, when information is available, we should look at it. When uwopremed says that Canadian schools are 63% female, that's false. Flatly false. The percentage of women entering medical school in any one year has never been above 59.2%, while the percentage of women graduating has never been above 59.6%. Both those numbers have declined from their maximum values over the past several years.

 

The numbers I added up actually did not include Western (which often doesn't publicly release it's ratio, even if we all know it).  But a simple review of the CaRMS match results consistently show women at 55-60% consistently overall.  That means close to 25-50% more females than males graduating most years.  Western is one of the few schools that actually helps keep the ratio closer to the centre.  

 

2) The term objective is being thrown around in a way that overstates its meaning. The MCAT is objective, but so is GPA. Regardless of who submits their MCAT score or GPA, or who evaluates it, an applicant's MCAT and GPA are unchangeable. The difference between the MCAT and GPA comes in standardization. The MCAT is standardized, but GPA is not. Both the MCAT and GPA have subjective components within them (MCAT less so that most people's GPA), but the final number is an objective value. Likewise, standardization is frequently used with subjective criteria as well - interviews are typically standardized, but subjective.

 

Yet, the difference between objective and subjective, or standardized vs unstandardized, is really meaningless when it comes to admissions. What matters for admissions is reproducibility, lack of bias, and predictability of future performance. Both objective and subjective criteria, regardless of standardization, can be reproducible if give sufficient time and iterations. Likewise, both tend to be non-reproducible if done in small numbers. A single MCAT question is very unreliable, but the full test has good reproducibility. Likewise, a single interview with a single interviewer for 5 minutes will certainly have poor reproducibility, but several interviews with several people have higher reproducibility. That's the whole idea behind the MMI. Similarly, while Western uses a traditional interview format rather than the MMI, they also use 3 interviewers and do internal testing to ensure reproducibility.

 

Objective vs subjective doesn't speak to bias either. As uwopremed pointed out, objective criteria can be biased, just as subjective criteria can.

 

For predictability of future performance, the best data is for the MCAT and GPA, but there are some big caveats. The MCAT, for example, correlates best with USMLE Step 1 performance - particularly the Bio section - but doesn't do as great a job at predicting, say, GPA in medical school, where undregrad GPA does better. In short, like predicts like. Of course, we don't care particularly how well students do on standardized tests or GPA in medical school as much as we care about their clinical performance, and on that front, MCAT and undergrad GPA both have less evidence behind them last I checked. It'd be great to see more data on that (if anyone knows of studies I might have missed, please share or PM!)

 

In any case, when we say the MCAT is an objective measure, it's a meaningless statement. I like the MCAT, it's what got me into medical school and I think it has value as an evaluating tool, but I think that way because it is reproducible with some evidence for predictability on future performance, not because it's objective. 

 

The MCAT is what I would say is Objective and FAIR.  And by FAIR, I mean, it's the exact same test for everyone with a syllabus that is public and a scoring scale that is fair simply because of numbers used.  (and before someones yells out - 'well rich kids can better prepare for the MCAT' - i mean it's fair in simply being the same obstacle course for everyone- sadly society isn't fair in regards to opportunity for all, and never will be completely fair)  Definitely not true for GPA - totally dependent on the scale of the undergraduate school, courses taken, and field of study.  Clinical performance will always be difficult to evaluate.  Patients probably rate doctors that give them great prescriptions the best.  A well spoken and well published surgeon might be though of as great, but in the OR actually not be that good.  There is also the politically loaded idea of researching long term outcomes of women vs men in medicine.  I presume that the MCAT helped you get in because you took a tough undergrad and your marks were not as competitive at schools like Toronto or Ottawa.  That's the fairness of the MCAT I like.  You can't 'scam' the MCAT.  The USMLE's also are designed to standardize the evaluation of students from different medical schools - which in the USA actually vary in quality much more than Canada.

 

3) To respond to uwopremed's point that on the 2015 set of AFMC data, women had an 8% better chance of admissions despite lower MCAT scores, I'd like to point out that the other considerations for medical school admissions are not reported, like GPA, ECs, interviews, etc. It's impossible to say men are better applicants when looking at only one criteria to the exclusion of others. Likewise, an 8% advantage is a far cry from uwopremed's original claim of schools having a final class that is 70-75% female with only 55% female applicants, which represents at whopping 90% to 145%(!!!) advantage. That's a dramatic, egregious deviation from the norm and even well beyond the outliers in Canada when it comes to gender preference (Calgary, at a 69% advantage for women). It's also a difference that's entire within year-to-year variations.

 

How do I know it's within the year-to-year variations? Because surprise, surprise, they just released the new year of data! And guess what, it's showing an 8% advantage for men. Now, a good portion of this swing is likely the inclusion of Western in the data (U of T is still not included), as Western had a 56% preference for men on the final numbers in the year just released. Contrary to uwopremed's assertions, Western had slightly more female applicants than male applicants.

 

I should have been more specific.  The MCAT means there are more realistic male applicants then women for admission, and the school interviews many more men than women.  By a lot.  The discrimination against women is in the MCAT,  not the rest of the interview process.  I would like the see the new data.  But the 8% advantage for women that existed earlier was way worse even 10 years ago.  I know MAC and UBC have been trying to get rid of the pro-female bias - perhaps they have gone too far if what you say is true.  In which case, I am also concerned about a potential pro-male bias.

 

I don't believe this year's data is any evidence of a bias towards men in the admissions process, despite an 8% advantage for them relative to women, just as I don't think the 8% advantage for women relative to men the prior year was any real evidence of a bias towards women in the admissions process. It's noise in the data and most consistent with rough, geographically-inconsistent parity between men and women when applying to medical school at this time. More data would be helpful to keep an eye on trends, as there did appear to be a wider preference for women a decade ago or so (as well as a much larger preference for men three decades ago and earlier). Still, my take-away from the data is that the primary reason there are more women in medicine than men is that they apply in greater numbers. Why they apply in greater numbers may be due to gender inequalities and is very much worth exploring, but claims of inequality in admissions across the entire country were, at a minimum, vastly overstated by uwopremed.

 

When you are talking thousands of applicants, 8% is hardly noise by any statistical measure.  Schools are always tweaking their processes.  I do think CASPER at Ottawa has taken away some of the pro-female bias there.  So I will concede...things may be improving.  And 8% bias in favour of men is also concerning.  Please link the data if possible.

 

4) Lastly, uwopremed, when it comes to speaking out about controversial issues, saying things like "But when an interview process for medical schools, that are more tightly controlled by university academics (that lean left in general) show clear advantages to women - it can't be discussed?" is nothing short of disingenuous when you're currently have that discussion, freely and openly. Likewise, when offered to make this discussion more public - I can make specific recommendations where I can guarantee a voice on this matter at Western, and that includes non-print mediums - but then refusing (unless it's the time and medium of your exact choosing), then no one is censoring your voice other than you. The worst that can happen is people can disagree with you. If, as you confidently say, that your opinion is that of the majority, even that shouldn't be an issue, as more people would be on your side than not. But perhaps your view is not in the majority. You'll only know if you let your views into the public light, where they can be supported or scrutinized as appropriate. I strongly encourage you to do so.

 

Having an open discussion on this board is safer than public.  I don't know how privy you are to the undergrad committee discussions - but recently one of our faculty suggested that some of the women only awards may not be as relevant in a system where females are 55-60% of medical students in Canada.  One of the more leftist staff copied everyone about how evil that suggestion was, and about the innate biases women experience everywhere.  And the thing is several people agreed with the first person before that email.  And that email shut up conversation pretty fast.  As for me, I am more bold in expressing my opinions at the medical school level.  My opinion is not oppressed - it's just not considered the 'right' opinion I suppose.  And hope to advocate for those causes once I have my CaRMS position settled in a couple of years.

[ralk]

Replying in the quote makes it very hard to respond point-by-point 

 

1) You missed my point on the MCAT entirely. Yes, both the AFMC and AAMC data point to male applicants doing better on the MCAT, I am not disputing that fact at all. However, that's not the same thing as "men do better on the MCAT". The pool of applicants is not the same as the pool of people writing the MCAT, or those who would be interested in medicine, or men and women in general. Matriculants are another group of people as well. It may be true that men do better on the MCAT even if we were comparing representative groups of men and women. I suspect that it is true. However, it's not guaranteed to be true and it's certainly not guaranteed that a comparison of representative groups of men and women writing the MCAT would have the same degree of separation as they do in the AFMC and AAMC stats. The data says that male applicants and matriculants do better on the MCAT than female applicants and matriculants, nothing more.

 

As for the stats on female percentages in Canadian medical schools, there's no need to fumble around with CaRMS data, which are for residency applications and have nothing to do with medical school admissions. The CMA puts out the appropriate stats directly. The number you quoted about medical schools in Canada being 63% female is unambiguously wrong. I also have no idea where you get "50% more females than males graduating most years", which is also directly at odds with the CMA data and thus also unambiguously wrong. You're entitled to your own opinion, but not your own facts.

 

2) Again, I like the MCAT, but let's use specific language to describe it. It is standardized. That's not the same as being fair and the MCAT isn't completely fair. There are ways to game it to an extent and certainly some groups - poorer individuals, as you mention - can be disadvantaged by it, but I agree, I consider it a more fair assessment than many alternatives. It has its limitations, however. Realistically, we're not going to have every school with Western-level MCAT cutoffs, it's just not feasible. And so, other factors have to play a role and really should play a role, because the MCAT, for all its advantages, has a limited scope with which to evaluate students and only captures a portion of what's important to being a physician.

 

3) I'm glad you're concerned that the pendulum may have swung too far. That shows a willingness to see the other side of this whole gender-in-admissions issue, arguably for the first time in this thread. However, I'm worried you're still not thinking through what the data actually says. Ottawa wasn't using the CASPer yet in the year the data applies to yet, which was your entry year. Ottawa's gender-specific probabilities of admission changed without any substantial change in their admissions criteria! You're so focused on thinking about admissions through a lens of gender and intentional decision-making in admissions based on gender that you're not even considering non-gender based explanations, like something as benign as a small degree of randomness in the numbers.

 

4) If it helps, I do have an idea or two of how to keep public discussions to students only. In any case, my point is that self-censuring is not the same as being censured by others. In the situation you described, the claim of bias didn't shut people up, they shut themselves up. The original speaker could have used support, but was left in the wind, simply because someone disagreed with them.

[Edict]

Wow guys, so much discussion. The way I see it, things are great as they are. Ontario has a school for every kind of application strength which you rarely see anywhere else. We have it good already. 

 

Also, in regards to gender gaps, I believe the ratio is relatively balanced. McMaster used to skew female but is in the recent few classes closer to 55% female whereas I've at least heard of a skew towards males at Western and Ottawa. Queens and Toronto I think are relatively balanced. Overall, nothing to be terribly concerned about. 

[indefatigable]

The AAMC website has average MCAT scores over the years by race and gender for each component. Please look at the writing sample data prior to 2008 or so, and compare it to 2013 or so (when they got rid of it). The average difference between men/women disappeared when computers came into the mix - and handwriting could no longer be evaluated. To be fair = men might also have worse penmanship to begin with - but still not enough of a reason to punish their scores.

 

Irrespective, pursue the site and look at all the data. It's all there.

 

ADD: I reviewed the site - and now for the writing sample they only keep matriculant data, not applicant data. Probably removing WS stuff as it was removed from the MCAT anyways. https://www.aamc.org/download/321470/data/factstablea7.pdf and similar pages do show interesting gender data. Though they really only apply to the USA - a much more conservative and, dare I say, even misogynistic society. I don't want to emulate them either.

 

Here is average matriculant data by gender for each section of he MCAT: https://www.aamc.org/download/321506/data/factstablea22.pdf

 

Of Note - men have slightly higher Science GPAs, women have slightly higher non-Science GPAs, and the aggregate slightly favours women.

The AFMC has detailed MCAT statistics for Canadian students applying to and accepted to medical school broken done by sex up until 2010. The writing sample scores for men and women are pretty similar - handwriting doesn't look like it was a factor. Verbal reasoning is also similar. A superficial glance suggests that male applicants had a higher proportion of "high scores" (12+) especially in the physical science section and to some extent biological sciences section of the old MCAT. There could be various reasons for the score differences in the physical sciences including gender imbalance in higher scoring majors - GPA breakdowns are not given however.

 

https://www.afmc.ca/publications/canadian-medical-education-statistics-cmes/archives

[sometimesmad111]

Done

[Bambi]

I applied to a male dominated surgical specialty where females are exceedingly few. At CaRMS, on a panel of 6, only one interviewer was female. All successfuil candidates for the residency positions were female. As I understand it, they selected those they considered would make the best fit. For sure, a decade earlier, I would not have had a hope in hell. This field continues to remain male dominated and likely, won't change. However, there is no longer discrimination and they simply pick the best candidates in their judgment.  

[JohnLe]

From women I know, they say that males have a higher chance of getting accepted because there are more female applicants while medical schools try to achieve a 1:1 ratio between males and females. 

[DocDocWhosThere]

From women I know, they say that males have a higher chance of getting accepted because there are more female applicants while medical schools try to achieve a 1:1 ratio between males and females. 

 

Tell them to look at the stats, they're wrong.