Ever Feel Like Med School Is A Big Rich Kids Club?

[daftjustice]

I wonder if the GPA should be used as a threshold thing, much like how some schools use the MCAT.

 

Not as a high cutoff - but rather as a minimum that you need to meet.

[NLengr]

That's how it's done for some schools. The issue is there are so many applicants with a high GPA that even if you set a minimum score, it still ends up being quite high.

[daftjustice]

That's how it's done for some schools. The issue is there are so many applicants with a high GPA that even if you set a minimum score, it still ends up being quite high.

At some schools the old MCAT cutoff was 9/9/9 (27), which is kinda low.

 

I would suggest meet a minimum GPA (3.4-5), and minimum MCAT and then turn to other things in the application.

[NLengr]

One problem would be that would leave them with a ton of applications to wade through just to get down to interviews.

 

What other things would you suggest increasing the focus on? I'm not sure that anything else (volunteering, past career, hobbies, SES, research) would be any better correlated with performance as a clinician.

 

The other thing to remember is that it's not like med schools are selecting a bunch of high GPA/MCAT anti-social nerds with no empathy or ethical traits at the expense of everything else they might value. They can easily get people with 3.8+ GPAs, 30+ MCATS (or whatever the scale is now) who have volunteered hundreds-thousands of hours, worked in alternative professions, published research and/or participated in elite level sports.

[_ _]

I wonder if the GPA should be used as a threshold thing, much like how some schools use the MCAT.

 

Not as a high cutoff - but rather as a minimum that you need to meet.

That's exactly what Queen's does, and everyone now just complains that  their too 'random'

[Bede]

I have to disagree. We need the best/most qualified people taking care of the sick rather than people who reflect the population. If the most qualified people tend to come from strong socioeconomic/wealthy backgrounds then so be it - regardless of whether or not that is fair to the rest of us. It would be better if physicians did reflect their patient population but this should never take priority over actual merit.

I can't believe I'm arguing for affirmative action, but there is little evidence that the "best/most qualified people" make the best physicians. 

[1D7]

I can't believe I'm arguing for affirmative action, but there is little evidence that the "best/most qualified people" make the best physicians. 

Just to be overly pedantic, by definition the best/most qualified individuals [to become physicians] would become the best physicians lol. However, I do somewhat agree with what you mean. Medical schools don't look for the best/most qualified individuals to become physicians (as defined by the best patient population outcomes), they look for individuals who have been good, relatively well-rounded students (and are thus likely to be good, relatively well-rounded students in the future). There is the assumption that such students make good doctors, which to be fair, is an intuitive assumption that's probably supported by some data.

 

This is the argument that I believe is being made by most posters in this thread: individuals from low SES perform better than individuals from high SES when treating low SES patients in a low SES environment. An intuitive understanding of what life is like in a low SES area probably does outweigh 0.1 GPA and 1 point on the MCAT when it comes to actual competency in a low SES area.

 

Personally though, I don't think Canada's socioeconomic disparity is bad enough that children of physicians have become out of touch with the reality of the lower class nor do I believe affirmative action will provide significant enough improvements to patient outcomes to justify selective admission of low SES applicants. Moreover, affirmative action is a policy used to address historical social injustices rather than economic disparities (hence why rich black Americans in America still benefit from affirmative action).

[ralk]

That's exactly what Queen's does, and everyone now just complains that  their too 'random'

 

It's also not clear whether Queen's admissions process helps with socioeconomic disparities. My sense is that they're better for non-trad applicants, but non-trads are often from higher SES backgrounds too. 

 

I'm a huge fan of Queen's process in general, I consider it to be by far the best approach in Ontario and I think it provides a lot of benefits for the school/region/profession, but I'm not sure it's all that effective from an SES perspective. The problem is that lower thresholds mean not just that more low SES applicants get a shot, but more high SES applicants as well. Depending on GPA/MCAT curves look at different SES levels, lower thresholds could theoretically worsen the ratio of high SES to low SES individuals who are given consideration. Plus, if non-GPA/MCAT factors also carry a bias towards higher SES students - and there's reason to believe they do - even if the ratio of high SES to low SES applicants stays the same or even gets better once moving to more subjective measures, it might not do much good as there are now simply more high SES students in the pool to crowd out lower SES applicants.

 

I still like Queen's approach for a lot of other reasons, and I think it has some validity in addressing SES disparities in medical school admissions if combined with other interventions, but I'm skeptical that approach of using GPA/MCAT as a threshold only, while keeping those thresholds low, will do much for lower SES applicants on its own.

 

(As an aside, their direct-from-high school entry program probably doesn't help on the SES disparity front, as I hear that cohort is generally quite socioeconomically advantaged. It's not a surprising result, given that it's basically selecting the 10 most qualified high school students in the country, most of whom would probably get into medical school at some point anyway, but I'd argue it's shifting the distribution in the wrong direction overall.)

[LeBronto2019]

Really enjoyed reading this discussion and especially happy with sunnyy et al.'s advocacy for one end of the SES spectrum. 

 

Personally, I come from a lower middle class family. Parents did IT and nursing (only 0.5 FTE) and we have had to support 3 households on that income. I've always felt ashamed of my family growing up and never invited my friends over because we have nothing to do here. It wasn't until undergrad when I realized that coming from this background helps me appreciate and understand people from different walks of life. I never truly lived in poverty but I've seen what financial barriers can do to families and their limitations on opportunities in such a competitive world. 

 

Fortunately, UofA is looking to a different approach for admissions to allow students come in from lower SES backgrounds. Merit is one thing on paper, but the lived experiences would make someone a much better doctor than GPA or MCAT or X hours of ECs ever would. The argument has been whether representation from these communities would increase likelihood of them going back to those areas to practice and serve that population. It's the same arguments used against Aboriginal, rural, and other minorities in the admissions process. I don't know if that is what necessarily happens but I think that a better approach would be to select students who have had experiences working with these lower SES communities, whether they come from them or not. Yes, when working in the inner city as a doctor, an applicant who had lived through foster homes or had friends/family involved in substance use may have better relations with their patients than others. But if you'd worked in a social service agency even as a higher SES person, you'd still have a good understanding of what they go through. So I don't think they should completely focus on merit or on reflecting that population, but a balance of that and also focusing more on who has actually spent time with these communities and has some sensitivity with their needs would be best. 

[InstantRamen]

I'd also like to mention, everyone has their own battles, regardless of socioeconomic status. Perhaps someone has money, but it doesn't make them immune to personal issues that may affect their grades, MCAT, etc.

 

Nevertheless, really interesting discussion .

[RichardDegrasseSagan]

All these points are valid, however, it is clear that those from lower SES are less likely to do as well, with respect to education, as those from higher SES (due to upbringing and environmental nourishment). Don't we want the most competent doctors that we can have? There are already very limited seats. Do you think it would be right to make a quota to have the majority of the seats saved for those from lower SES? One cannot really control the family they are born into and the SES they are raised in. Would it be fair to deny someone the opportunity because we need to fill a specific quota or match a specific demographic even though they are more likely to be successful? If we do this we need to sacrifice physician quality as well as meritocracy. I think a solution to this should be to introduce prerequisite courses which teach about the social determinants of health and perhaps the issues and problems that those of lower SES families face. In fact, the new MCAT has included some of this in the psych/soc section. By doing this we don't necessarily have to sacrifice physician quality to attain that truly empathetic doctor. With all of that said, I want to clarify that when I say that we would be sacrificing physician quality by introducing more low SES individuals into the field, I am not saying that lower SES individuals cannot make great physicians. I am simply following the trends associated with SES and education. Those in higher SES tend to do better not because they are better, but simply because they have better/more opportunity. 

 

This is a tiny bit silly.

 

1. You automatically assume that higher SES applicants are more intelligent simply because their profiles are more robust than other applicants. Folks on here have already pointed out the fact that these applicants have to deal with a variety of issues that hinder the development of their CV (working, lack of educational resources, lack of social resources/opportunities etc.). I remember from my own first year how many of the kids who could afford it shelled out $120 per term test for that TLS tutoring seminar, which essentially guaranteed them an 80+. Also, how about that volunteer tourism that became so popular a few years ago? 
2. Doctors are not some elite intellectual group that need to push the boundaries of the human mind. You can afford to invite students from marginally weaker educational background (because teach you everything you need to know about being a doctor in medical school; hence humanities students being accepted) if these students are able to bring in diversity and relate to patient populations that other applicants may not be able to relate to. Also, you are able to achieve societal changes by having someone from that background in a position of power, where they're able to give back to their own communities.

[oshaku]

I'd also like to mention, everyone has their own battles, regardless of socioeconomic status. Perhaps someone has money, but it doesn't make them immune to personal issues that may affect their grades, MCAT, etc.

 

Nevertheless, really interesting discussion .

 

I think the discussion isn't saying that higher SES people have a perfect life and no stressors ever, but that there that people of lower SES have more battles compared to people of higher SES. I think it's especially pertinent to talk about the effect of differences in SES, as opposed to commonalities regardless of SES, on admission to medical school since medicine is a major vehicle of social mobility.

[Neurophilic]

 

 

 

 

You automatically assume that higher SES applicants are more intelligent simply because their profiles are more robust than other applicants. 

 

This is completely untrue. Nowhere have I stated that higher SES individuals are more intelligent. I am simply following trends and multiple studies have shown that education level is correlated with SES (i.e. higher SES individuals tend to have higher educations). Secondly, I never stated that their intelligence has anything to do with their profiles being more robust than other applicants.

 

Doctors are not some elite intellectual group that need to push the boundaries of the human mind.

 

Whoa! Where did this conclusion come from? Extreme much? Nowhere did I indicate this notion. 

 

You can afford to have someone come from a marginally weaker educational background if they're able to bring in diversity and relate to patient populations that other applicants may not be able to relate to.

 

I never denied this but considering the very limited spots we have, are we best utilizing our available resources? In other words, will these people with "weaker educational backgrounds", as stated by you, make the best doctors, or rather would they make doctors just as competent as those with "strong education backgrounds"? 

[InstantRamen]

I think the discussion isn't saying that higher SES people have a perfect life and no stressors ever, but that there that people of lower SES have more battles compared to people of higher SES. I think it's especially pertinent to talk about the effect of differences in SES, as opposed to commonalities regardless of SES, on admission to medical school since medicine is a major vehicle of social mobility.

 

I'm only mentioning it because people seem to be bringing up anecdotes with classmates having privilege and going to developing countries or ones that pout at the fact they can't use their privilege. IMHO, maybe they are privileged in some senses, but maybe they're actually disadvantaged in another sense.

 

You're totally right. Financial security is most definitely a very large factor! I hope we can come up with some kind of solution soon to ensure this population is being represented! I'm optimistic!

 

I am not a medical student, so maybe I'm not very informed on the issue.

[Neurophilic]

I'd also like to mention, everyone has their own battles, regardless of socioeconomic status. Perhaps someone has money, but it doesn't make them immune to personal issues that may affect their grades, MCAT, etc.

 

Nevertheless, really interesting discussion .

This is true but SES goes so much deeper than this. It reaches far back into your life and is not simply about having money. It's about environmental nourishment as a child all the way up to an adult. Having that nourishment or lack thereof is what creates the current inequities we see in healthcare, education, etc. The general trend is that people of lower SES are less likely to have this nourishment (i.e. resources) and therefore fair worse on specific indicators (i.e education, health, etc.). Notice my careful wording. "Tend to" or "less likely" mean correlation, not causation. I do not claim there are causative relationships, there are only correlations.  

[InstantRamen]

This is true but SES goes so much deeper than this. It reaches far back into your life and is not simply about having money. It's about environmental nourishment as a child all the way up to an adult. Having that nourishment or lack thereof is what creates the current inequities we see in healthcare, education, etc. The general trend is that people of lower SES are less likely to have this nourishment (i.e. resources) and therefore fair worse on specific indicators (i.e education, health, etc.)

 

Don't worry. We know. It's MMI prep 101. Lol.

[Neurophilic]

Don't worry. We know. It's MMI prep 101. Lol.

Some don't lol 

[RichardDegrasseSagan]

You automatically assume that higher SES applicants are more intelligent simply because their profiles are more robust than other applicants.

 

This is completely untrue. Nowhere have I stated that higher SES individuals are more intelligent. I am simply following trends and multiple studies have shown that education level is correlated with SES (i.e. higher SES individuals tend to have higher educations). Secondly, I never stated that their intelligence has anything to do with their profiles being more robust than other applicants.

 

Doctors are not some elite intellectual group that need to push the boundaries of the human mind.

 

Whoa! Where did this conclusion come from? Extreme much? Nowhere did I indicate this notion.

 

You can afford to have someone come from a marginally weaker educational background if they're able to bring in diversity and relate to patient populations that other applicants may not be able to relate to.

 

I never denied this but considering the very limited spots we have, are we best utilizing our available resources? In other words, will these people with "weaker educational backgrounds", as stated by you, make the best doctors, or rather would they make doctors just as competent as those with "strong education backgrounds"?

 

If it's not a discrepancy in intelligence, then why do you think they'll do worse as physicians? Everything a doctor needs to know about healthcare is taught in medical school and after.

 

And you do allude the idea that only the best of the best, as defined by the status quo, should be taken due to the high levels of competition.

[Neurophilic]

 

This is a tiny bit silly.

 

1. You automatically assume that higher SES applicants are more intelligent simply because their profiles are more robust than other applicants. Folks on here have already pointed out the fact that these applicants have to deal with a variety of issues that hinder the development of their CV (working, lack of educational resources, lack of social resources/opportunities etc.). I remember from my own first year how many of the kids who could afford it shelled out $120 per term test for that TLS tutoring seminar, which essentially guaranteed them an 80+. Also, how about that volunteer tourism that became so popular a few years ago?
2. Doctors are not some elite intellectual group that need to push the boundaries of the human mind. You can afford to invite students from marginally weaker educational background (because teach you everything you need to know about being a doctor in medical school; hence humanities students being accepted) if these students are able to bring in diversity and relate to patient populations that other applicants may not be able to relate to. Also, you are able to achieve societal changes by having someone from that background in a position of power, where they're able to give back to their own communities.

 

I love how you edited your post after seeing my response. I just hope you realize that you just implied that Humanities students are from weaker educational backgrounds. I don't really understand how you can claim that one discipline is a weaker education than another, but okay. Also you're missing the point of what lower SES does to you. It's not simply about having less education. It's about being less able to attain the same level of education due to lack of resources. If you put two identical individuals somewhere and give one of them more resources, the one with more resources is more likely to thrive and succeed relative to the other. This will apply in medical school as well and likely also be correlated with physician competency.     

[Neurophilic]

If it's not a discrepancy in intelligence, then why do you think they'll do worse as physicians? Everything a doctor needs to know about healthcare is taught in medical school and after.

I'll frame it differently. Everything required to complete highschool is taught in highschool. So why is it that people of higher SES are more likely to have the full highschool education? 

[RichardDegrasseSagan]

I love how you edited your post after seeing my response. I just hope you realize that you just implied that Humanities students are from weaker educational backgrounds. I don't really understand how you can claim that one discipline is a weaker education than another, but okay. Also you're missing the point of what lower SES does to you. It's not simply about having less education. It's about being less able to attain the same level of education due to lack of resources. If you put two identical individuals somewhere and give one of them more resources, the one with more resources is more likely to thrive and succeed relative to the other. This will apply in medical school as well and likely also be correlated with physician competency.

 

I edited my post about an hour ago. You were probably typing your response for that hour...

[Neurophilic]

I edited my post about an hour ago. You were probably typing your response for that hour.

A simple glance at the time stamps would indicate otherwise...

[RichardDegrasseSagan]

I'll frame it differently. Everything required to complete highschool is taught in highschool. So why is it that people of higher SES are more likely to have the full highschool education?

 

This doesn't make any sense? Because high-schools are supremely variable in their quality of education (in Canada), whereas all the medical schools are held to a high standard.

[LeBronto2019]

I'll frame it differently. Everything required to complete highschool is taught in highschool. So why is it that people of higher SES are more likely to have the full highschool education? 

 

Because high school isn't just about what is being taught...? How about the students who can afford to have their evenings free to play sports or join clubs or hang out with friends instead of having to be home or work a job most evenings to support their families? Or even about that same amount of time that they are limited to study for these classes and either fail courses or barely pass? High school to undergrad is one issue, but having these strains on their education and experiences from undergrad in hopes of getting into med makes it much harder than someone with a higher SES. I'm not saying higher SES = more free time but usually, other commitments like work are more of a choice than someone whose family is having trouble making ends meet. 

[Neurophilic]

This doesn't make any sense? Because high-schools are supremely variable in their quality of education (in Canada), whereas all the medical schools are held to a high standard.

It has nothing to do with highschool variability. Take individuals who went to the exact same highschool and do a study on them and you'll find that those from higher SES are more likely to have the complete highschool education compared to those of lower SES (just to remind you ... CORRELATIONS).