Queen’s University to announce lottery for medical student selection

[indefatigable]

From

https://www.theglobeandmail.com/canada/article-queens-university-medical-school-lottery/

(also https://healthsci.queensu.ca/stories/news-announcements/new-admissions-process-improves-equitable-access-queens-md-program)

A wacky social experiment or an improvement on current system?

 Besides formalizing the idea of luck, ultimately it seems as if the final selection criteria are more or less the same (except for the low income pool) although the candidates that are being considered are based on the lottery (if meeting GPA/MCAT/Casper cutoffs ).  Not sure how it compares to the McMaster lottery year .. 

FYI - It appears to the lottery will narrow the field from around 3 000 (making cut-offs) to 650-750 - i.e. roughly 1/4 will make it to MMI.

https://www.cbc.ca/listen/live-radio/1-92-all-in-a-day

Queen’s University plans to introduce a lottery to its medical student selection process in the hope it will make admissions more open to candidates from diverse and low-income backgrounds.

The university in Kingston said the lottery component, set to be announced Tuesday, is unique among Canadian medical schools and will be in place starting this fall.

The lottery will occur early in the application process, not for the final selection. To reach the lottery stage, students must first exceed threshold cutoffs for grade point average, scores on the Medical College Admissions Test and the Casper test of ethical judgment.

A random lottery selection will winnow the pool of qualified applicants that exceed the cutoff scores to approximately 600 to 750 students. They will proceed to a series of online mini-interviews known as the MMI. From there, the top candidates are invited to an in-person panel interview, typically granted to about 300 to 400 students a year.

Queen’s School of Medicine admits only about 115 candidates every year from roughly 5,000 applications, so the process is highly competitive. Health sciences dean Jane Philpott said the admissions process has historically put up barriers to students who, for various reasons including socio-economic disadvantage, haven’t been able to develop a portfolio of accomplishments that gets them to the interview stage.

“This actually levels the playing field,” Dr. Philpott said of the lottery. “You still have to be exceedingly intelligent and be able to do well at school. But amongst those who can meet that bar, you have an equal chance of being offered an interview.”

Peggy DeJong, Queen’s assistant dean responsible for admissions to the MD program, said the school is trying to make data-driven and equitable decisions.

Under the new system, roughly 8 per cent of spaces at the MMI stage will be reserved for students of lower socio-economic status, although the number could fluctuate from year to year. Students who qualify would be entered into the first lottery to reach the MMI stage. If they aren’t successful, they would be entered into a second, smaller lottery with students who fit certain socio-economic background criteria.

The criteria were devised independently for a fee-waiver program used in the Ontario medical school admission system. They include student income, parental income, spousal income if applicable, student debt and a personal statement.

A 2020 study of Canadian medical student demographics, conducted through an online survey, found they had parents with significantly higher levels of education and who were more likely to be professionals or high-level managers compared with the Canadian population. They were more than twice as likely as the general population to have a family income greater than $100,000 a year.

Dr. DeJong said she was impressed by a lottery model that was used in medical school selection in the Netherlands. In that case, however, the lottery was used for final admission decisions, whereas in this case it’s only to get to an interview stage.

McMaster University used a lottery system in part of its med school admission process during the pandemic in 2020.

“We did not want to move to a lottery to admission, because I think that would be quite distressing and it would really reduce autonomy over the process to get into medical school,” Dr. DeJong said.

“We do know that when we look at the diversity of our class and looking at the data points, we’re often losing people in the admissions pathway and screening people at that initial step between application and file review.”qq

[dragoncat]

this sounds strange and cringe tbh. 

speaking as a person of color who grew up in a rural town and is an immigrant in Canada, i don't see how this lowers barriers to those less advantaged at all. the advantages lie in being able to pay for fancy prep courses for the MCAT and Casper, in being able to do interview coaching, in knowing others in medicine who lead you while those who don't know anyone in the field are asked to navigate a maze with a blindfold on. this lottery doesn't tackle any of those barriers in my opinion. it seems like a way for them to pat themselves on the back for "driving change" while they simultaneously ensure things stay exactly as inaccessible as they are. what a joke. 

U of Alberta's MD AIDE program is something that tackles such issues I think. it provides free MCAT prep and interview prep to students from disadvantaged backgrounds and has a pretty good success rate. UofT had something similar as well although I don't know the name of that initiative. 

[anonymouspls]

11 minutes ago, dragoncat said:

this sounds strange and cringe tbh. 

speaking as a person of color who grew up in a rural town and is an immigrant in Canada, i don't see how this lowers barriers to those less advantaged at all. the advantages lie in being able to pay for fancy prep courses for the MCAT and Casper, in being able to do interview coaching, in knowing others in medicine who lead you while those who don't know anyone in the field are asked to navigate a maze with a blindfold on. this lottery doesn't tackle any of those barriers in my opinion. it seems like a way for them to pat themselves on the back for "driving change" while they simultaneously ensure things stay exactly as inaccessible as they are. what a joke. 

U of Alberta's MD AIDE program is something that tackles such issues I think. it provides free MCAT prep and interview prep to students from disadvantaged backgrounds and has a pretty good success rate. UofT had something similar as well although I don't know the name of that initiative. 

Completely disagree. If you're talking about priviledge, competing on academic grounds is much easier for those from lower socioeconomic classes than competing on extracurriculars where you will be hopelessly outmatched as a low SES applicant. Many schools such as the ACCESS pathway at Western have simply provided a pathway for extremely privileged well connected ethnic students from rich families an easy way to get into medicine. I saw this in action at my own medical school and medicine class. I would advocate for a system that takes into account SES and completely disregards ethnic background, speaking as a racial minority myself.

[shikimate]

Just out of curiosity, does anyone know how they define low SES? 

[hero147]

I feel like lotteries are so ripe for abuse. It's not like anybody audits these lotteries do they? 

[indefatigable]

1 hour ago, shikimate said:

Just out of curiosity, does anyone know how they define low SES? 

It looks like they use the "Medical School Application Fee Waiver Program".  It's based on three components:

• applicant's pre-tax income (also +/- parents & partner income)
• annual deficit (i.e. how much going into debt each year - highest level is 18K+)
• personal statement

It's explained in detail on page 4-5 of the following link

https://www.afmc.ca/wp-content/uploads/2023/05/2023_Application_Fee_Waiver_Program_Guide.pdf

[1D7]

I understand what they're trying to do, but I don't think a lottery system is the right way to go about it.

They could have easily decreased weighting of ECs and created a separate stream (or percentile boost) based on income. IMO anything that decrease agency (or the illusion of agency) are negative changes.

[shikimate]

I love how the bureaucracy is always obsessed with "income".

WB has more asset than his all of us combined yet his income is less than his secretary.

if anything he can make himself have "negative" annual income on paper.

 

[innocentius]

About time! Med school admissions are a crapshoot anyways.. It makes more sense to do it this way. The rest should follow. You do not need 4.0 GPA, ++researché ECs (which  are mostly utter bollocks and resume padding), and have eradicated poverty to succeed in med school.

[innocentius]

.

[SnowmanTheSWOMEN]

A good work ethic, data gathering and critical reasoning skills, and the ability to craft a compelling narrative that conveys your awareness of the world (through personal statements, ABS) are collectively good indicators of success as a physician. A lottery does nothing to measure these parameters, minus the interview. The "barriers" that are at least relevant are largely socioeconomic, which as the above poster mentioned could be tackled through different means without undermining the entire admissions process. 

Even with the "low SES argument", you can only stretch it so far. I grew up in a low-income household as a POC where English was a second-language and I worked odd jobs to provide for my education and younger sibling. I still found time to succeed academically and non-academically and was accepted to multiple Ontario and American medical schools during the shitshow of the COVID-19 pandemic. I do agree that if my family had money, I would have had a much easier time during the application cycle, but I would have foregone the character development had I not grown up "disadvantaged". Getting into medical school is not easy, but it certainly should not be random. 


 

[anonymouspls]

1 hour ago, SnowmanTheSWOMEN said:

A good work ethic, data gathering and critical reasoning skills, and the ability to craft a compelling narrative that conveys your awareness of the world (through personal statements, ABS) are collectively good indicators of success as a physician. A lottery does nothing to measure these parameters, minus the interview. The "barriers" that are at least relevant are largely socioeconomic, which as the above poster mentioned could be tackled through different means without undermining the entire admissions process. 

Even with the "low SES argument", you can only stretch it so far. I grew up in a low-income household as a POC where English was a second-language and I worked odd jobs to provide for my education and younger sibling. I still found time to succeed academically and non-academically and was accepted to >1 Ontario medical schools during the shitshow of the COVID-19 pandemic. I do agree that if my family had money, I would have had a much easier time during the application cycle, but I would have foregone the character development had I not grown up "disadvantaged". Getting into medical school is not easy, but it certainly should not be random. 


 

You are assuming that you and I got into medicine because we’re more qualified than the people that didnt. I have been involved in the selection process both as a resident and as a medical student. Please understand the reality that the process has been random this entire time, atleast now it will also be fair at Queens. There are simply significantly more qualified applicants than there are spots.

[SnowmanTheSWOMEN]

1 hour ago, anonymouspls said:

You are assuming that you and I got into medicine because we’re more qualified than the people that didnt. I have been involved in the selection process both as a resident and as a medical student. Please understand the reality that the process has been random this entire time, atleast now it will also be fair at Queens. There are simply significantly more qualified applicants than there are spots.

I have been involved in the selection process as a medical student as well, although not yet as an incoming resident. When we try to differentiate among the top applicants, I agree that we are splitting hairs and it is largely random due to the hyper-competitive nature. But this logic does not apply across the entire cohort of applicants. It'd be a stretch to say that those near the bottom of the pile are as qualified as those receiving the highest file review score. These metrics exist for a reason and have been validated and put into practice by basically every single prestigious medical school in the US and Canada for a reason. Meritocracy, coupled with measures to increase equity in the process to eliminate systemic barriers, should be used to select future physicians. A lottery is not one of them. The majority of residents and attendings that I talked to have agreed that a lottery is... insane. What's next - should the CaRMS and NRMP match list be based on a lottery as well?

You and I were once accepted because we were both qualified and lucky. Many people do not get in even though they are qualified due to a stroke of bad luck, but far more are rejected simply because they are not yet qualified. 

I know we do not exactly know how the post-interview rankings would be conducted by Queen's (being the blackbox that they always were - so much for "transparency"), but it's not really fair to say that a person who worked their butt off to attain the highest academic standing and diverse life achievements would be treated the same as someone that threw in a half-assed application that barely made cut-offs because "why not". 

We can agree to disagree, but our opinions don't matter anyway. The higher-ups in suits will continue to implement tacky methods to gain favour, and we will continue to play the game.