An Interesting Read (1984 CMAJ article about medical admissions)

[neutral]

What do you guys think?

 

http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1483247&blobtype=pdf

 

Anyone have the full version?

[edge_w]

"McGill university... willing to accept high numbers of out of province students"

 

My my how things have changed...

[kaymcee]

Well, over my lunch hour, I decided to get this journal article. I had the intentions of scanning it and using OCR to put into a text file, but in my haste I logged out of the computer before I saved the files... and they're gone. So, I'll type up some of the article (my apologies for type-os and missing words):

 

...ing good with folks isn't enough”, points out Dr. Laurence Wilson of Queen's. “You have to be an intelligent achiever to survive the course.”

 

Other qualities count in varying degrees and different schools. On one of the spectrum is Toronto, which attaches great weight to science backgrounds and MCAT scores, and interviews its successful candidates only after they have been selected by computer. On the other end of the spectrum is McMaster, which accepts average school marks, and arts as well as science qualifications, and interviews four applicants for every available place in search for the right “personal qualities”.

 

The other 14 schools are strung along the spectrum, and rely on different techniques to select their rookies. At Dalhousie, for example, all applicants from the Maritimes are interviewed by third-year students. Faculty can overrule student assessments, but of the 12 candidates accepted against student advice in the last 9 years, nine subsequently had difficulties in medical schools, reports Dr. Reid.

 

No school has found a magic formula for identifying human attitudes, ability in interpersonal relationships, motivation and other characteristics we want in our doctors. Interviews are recognized as very subjective procedures. “It’s a daunting problem none of us are happy with”, comments Dr. Wilson. “How do you measure empathy?”

 

Admissions committees are wrestling with three other challenges:

 

• Should a science background be a prerequisite of admission? Several US educators have recently argued that premedical science is mainly useful as a language necessary for clinical medicine and this language can be acquired at medical school. The McMaster experience has suggested that medical school students without previous training in biology, general and organic chemistry, and physics, are indistinguishable from those with science training by the time they graduate.
   
  
• Should medical schools look for students who intend to enter fields that are currently shorthanded? Saskatchewan is already considering supernumerary position for native Indian candidates as part of an attempt to improve native people’s health care in the province. The government of Quebec is known to be looking at ways to steer physicians into its under-serviced northern areas. There will be an increasing need for geriatricians as the Canadian population ages; should schools allocate places to students professing and interest in the field?
   
  
• Are medical schools vulnerable to litigation on the grounds of discrimination if they positively discriminate in favour of particular groups, e.g. native people, or if they do not publish and adhere to their admission criteria? Some observers suggest that the geographical criteria many schools already enforce conflict with the new Canadian Charter of Rights, which guarantees equal opportunity for all Canadians.
  

 

If anyone wants the whole thing, I'll go back and do the scanning.

[Kuantum]

MEDICAL EDUCATION IN CANADA

Physicians who graduated from Canada's 16 medical schools have always been

well-qualified; our system of medical education is acknowledged to be one of the

finest in the world, and its graduates are welcomed anywhere. But during the last

two decades the style and content of medical education here have changed

dramatically. The process of change will inevitably continue, as educators strive to

produce the finest possible doctors to serve a society that is increasingly

cost-conscious and a client population eager to act as partners in their own health

care. In this special report, CMAJ contributing editor Charlotte Gray looks at the

broad range of issues confronting medical educators today.

Who stands the best chance of getting into a Canadian medical school?

Statistically, the perfect candidate for a Canadian

medical school is a 20-year-old woman from

Manitoba or Quebec who backs up applications to

three or four medical schools (including the one

closest to her home) with glowing academic references.

She should sail in.

The odds lengthen for a male resident of Alberta,

British Columbia or Ontario, aged 24 to 29, who has

set his heart on one school and applies to no other.

He stands a lower than average chance of success.

And anybody who is not a Canadian resident, is

over 30, or is applying for the fourth or fifth time

should just forget it. The chances are not just slim,

they're emaciated.

Of course, any of these applicants might make a

superb physician, given the opportunity. But the

number of well-qualified applicants to Canadian

medical schools far exceeds the slots available. So the

selection system is closer to a lottery than to a

systematic winnowing of the wheat from the chaff.

Our young Manitoban can thank her lucky stars as

much as her Medical College Admissions Test

(MCAT) scores.

Competition to enter a Canadian medical school is

keen: four students apply for each place. All 16

schools are looking for candidates who combine

academic strength with personal qualities that might

make them good physicians. The particular mix

varies from school to school. "Medicine is concerned

with human problems", declares Dalhousie loftily in

its admissions requirements, before mentioning "intellectual

maturity" and "proficiency in communication"

as two qualities that will win points. Saskatchewan

wants students of "good moral character".

University of British Columbia aspirants are scrutinized

for a dazzling list of attributes, including

"motivation, maturity, integrity, emotional stability,

realistic self-appraisal, social concern and responsibility,

reliability, creativity, and scientific and intellectual

curiousity".

It's hard to escape the impression that selection

committees must be composed of psychiatrists and

police officers, trained to detect such traits, and that

every successful candidate is well on the way to

sainthood. The reality of course, is a little more

prosaic. Especially since, as Association of Canadian

Medical Colleges statistics show, different groups of

students from different parts of the country do not

have similar opportunities to study medicine.

* In the last 5 years women have fared slightly

better in the admissions competition, when the proportions

of male and female applicants who are

successful are compared. However, more men than

women apply for medical school.

* Age does wither hopes. In 1981 close to onethird

of those aged 20 and younger were successful,

compared to one quarter of those 21 to 23, one sixth

of those aged 24 to 29 and less than 1 in 10 of those

aged 30 and over.

* Canadian citizens have the best chance of

gaining admission to medical school here. In 1981,

27.4% of applicants who were Canadian citizens were

admitted, compared to 20.6% for landed immigrants,

8.1% of those on student visas and 3.3% for foreign

applicants.

* Those who apply to three or four schools stand

the best chance of success. The following chart,

 

* French-speaking students do well in the medical

school application stakes. In 1983-84, about 28% of

first-year students had French as their other

tongue. According to the 1981 census, francophones

make up 25.7% of the total population of Canada.

* It is far tougher for natives of Alberta, British

Columbia and Ontario to get into medical school

than for applicants in other provinces. Residents of

Manitoba and Quebec have a greater than average

chance of studying medicine.

These geographic inequities are dictated by the

influence that place of residence has on admissions

decisions. Only the University of Calgary, McGill

University, Queen's University and Memorial University

are happy to accept a considerable number of

out-of-province students. The other schools rely

mainly on students from within their provincial

borders (or, in the case of Dalhousie, Maritime

region borders) to fill their slots. The University of

Saskatchewan and the University of Manitoba operate

almost exclusively as provincial institutions.

This means that applicants living in provinces

where there is a large number of places available

relative to the size of the provincial population do

well, whereas those from regions where the population

is large and the medical school small have a

harder time.

British Columbia applicants may feel particularly

aggrieved: the average MCAT score of their rejectees

in 1981 was greater than the average MCAT score

not only of all the young Canadians who wrote

application forms that year, but also of successful

applicants from Newfoundland, Prince Edward Island

and New Brunswick.

These inequities have prompted some medical

educators to suggest that it is time for medical

schools to reconsider geographically-based admissions

criteria, so that all applicants have an equal chance

no matter where they live.

In the meantime, rejectees can get some consolation

from the fact that dogged determination pays

off. Repeat applicants are taken seriously. About

42% of applicants resident in Canada will eventually

be offered admission to a medical school.

How do you measure

empathy?

hen it comes to designing selection criteria,

WT the problem is that there is no satisfactory

way to predict who will become a good physician.

Two recent developments have further complicated

the issue. The first is the huge increase in the number

of students applying for medical schools throughout

North America; excellent applicants far outnumber

places available. The second is the degree of specialization

within the profession. Medicine is no longer a

job. It is a thousand jobs, including those of medical

administrators, medical writers, medical computer

experts as well as surgeons, geriatricians and family

physicians. Can one selection system identify the

different personalities and abilities that these slots

will require?

One of the most passionate critics of selection

criteria that attach a great deal of weight to academic

performance is Dr. Augustin Roy, president and

secretary general of the Professional Corporation of

Physicians of Quebec. He argues that the three

French language schools in Quebec rely far too

heavily on grade point averages. "I know students

with high marks who have no common touch and are

afraid to see patients. They're just book addicts. The

system attracts and encourages compulsive learners."

Such recruits to the profession, argue the system's

critics, have uptight Type-A personalities, and risk

failing to meet their own high standards. The high

incidence of drug and alcohol addiction (estimated to

be 10% to 20% of doctors) is often ascribed to the

number of such compulsive over-achievers within the

profession. The system is also too narrow, charge its

critics. There is a disturbing sameness about the

bright, highly-motivated achievers it selects on the

basis of test results.

Most deans dismiss these criticisms tersely. "High

achievers are usually all-round achievers", points out

Dr. Arnold Naimark, former dean of Manitoba's

medical school and now president of the University of

Manitoba. "They're leaders in student bodies, athletics,

music. . . It is not true that the present systems

recruit inappropriate students with the wrong motivation

and skills." Adds Dr. Byron Reid, assistant dean

of admissions at Dalhousie, "When I had my coronary

bypass operation I was very thankful that my

surgeon was a Type A and didn't fall asleep on the

job."

Marks - as measured by grade point averages or

MCAT scores - still count a lot. Good grades may

not predict who will make good physicians, but at

least they predict who will perform well in medical

school - an intensive educational experience during

which the student must acquire large amounts of

information and develop problem-solving skills. "Be-

140 CAN MED ASSOC J, VOL. 131, JULY 15, 1984

[AMmd]

can you summarize that in 100 words please

[Kuantum]

I tried...this is the best I could do.

[vip_138]

i don't think this accurately described age correlations. It seemed to suggest that older aged people are discriminated against by medschools. Couldn't this just be due them being less desirable candidates (not based on age). Maybe they had to pad their gpa a little, rewrite the mcats a few times, maybe take more advanced studies for more consideration. There's a reason why they didn't get accepted after 2/3 years.

 

i would be interested in hearing statistics for 2/3 year entrance vs. >4 year entrance for medschool performance

[TimmyMax]

Hey,

 

I would be interested in hearing statistics for 2/3 year entrance vs. >4 year entrance for medschool performance.

I don't think that you'll find much of a difference (in Canada anyway) because medical school performances are generally pretty closely guarded and a lot of schools are on the Pass/Fail system, which can skew the numbers significantly- ie: why would I bother working hard to get a 90s grade when I can be slacker/do better things than study, get 63 and have the same letter grade as those poor saps who busted their arses to get higher in the end?

In the end, pretty much everyone matches somewhere and it's hard to tell who got their first choice and who didn't because the questionnaire (which CaRMS uses to generate such statistics) is self-reported after the match results, which would also skew the results. The people who end up not matching are usually few and consist of either those who voluntarily withdraw from the match, those don't get what they want in the first round and would rather try again next year than match to something else or are pathologic personality types who shouldn't have gained admission to medical school in the first place.

So yeah, I don't think that you'll be able to find said statistics and even if you did, would they really be all that acccurate?

[karkis]

As a 32 year old male from BC who speaks mostly english and has applied 4 times now, i rilly dont like that article.

Thanks for sharing tho.