Medical school enrollment is too high

[medhopefuls2016]

Dear All,

 

I know that this is a very controversial thread, but perhaps I am wondering whether decrease of medical school enrollment might be something that we should consider since the job market out there right now is not as good? Of course, this can start from increasing GPA/MCAT requirement, but perhaps people can have a much more holistic input?

[a1b1]

Finding the best is very subjective and not necessarily defined as someone who has the stats you mentioned. Suppose 2 people get into med school, person A (3.7 gpa and 30 MCAT), person B (3.9 gpa and 36 MCAT), person A may end up being a "better" physician than person B in the end, in which case raising the admission requirements to the point where person A can no longer get into med would of been a poor choice. There are many more factors to consider here than just grades.

[Leon]

... In doing so, we recruit only the best of the best instead of this socialistic model of admission where even the average (in my view) can get in. Concentration of resources for only the best of the best and career/job planning in matching with residency/infrastructure limitation from the get-go.

 

I disagree that the changes you propose allow recruiting the "best of the best." I believe there is a threshold beyond which GPA/MCAT do not necessarily correlate as strongly with intellectual ability and intelligence.

[thebouque]

There are not enough doctors in Canada. With your plan you're going to create a crisis and we'll have the sh1ttiest healthcare system in the world… and it already isn't great as it is

[medhopefuls2016]

THIS. When a diagnosis of cancer is being made, nobody gives a crap about your GPA, they just want to be comforted by a warm-hearted human. Will your 3.90 GPA help you feel human, or will it help you put your life in that patient's shoes? No.

 

Increasing admission standards and feeling humans are two different things. You can get the best of the best and select then for those that will practice good art of medicine.

[Rorzo]

A 36 is around 96th percentile. Manitoba invited 24 OOP people to interview last year, the lowest of whom had an 11.9 MCAT score on their scale. Add in the 3.9 GPA requirement, and you're essentially saying anyone with those stats gets entry - there simply aren't enough people to provide actual competition. The top 10 schools in the US have way more qualified applicants than any Canadian school could ever get.

 

This means that every person with a terrible interview who would, in our current system, be easily replaced by someone more fit for the spot (in the eyes of the admissions committee), now gets in. As previously mentioned, academic stats play a small role past a certain point, I'm fairly certain someone with a 90th percentile MCAT and a 3.7 is capable of understanding everything presented in medical school.

 

If there is truly a numbers problem necessitating that we cut admissions and take on the best of the best, then that's where ECs should come in, not when they should be removed from the equation. I think most people would consider starting a fundraiser, being a community leader, or authoring a paper to be more exceptional than another point on PS or 0.03 GPA.

[Leon]

I hate to say that we really have too many medical students around who do not really qualify to be here.

 

May I ask what drove you to say this? In a pass/fail system, how are you assessing that a portion of your class does not "deserve" to be in medicine?

[thebouque]

THIS. When a diagnosis of cancer is being made, nobody gives a crap about your GPA, they just want to be comforted by a warm-hearted human. Will your 3.90 GPA help you feel human, or will it help you put your life in that patient's shoes? No.

 

You mean when a diagnosis of cancer is being announced to the patient. Physicians who diagnose cancers and those who tell the dx to the patients are 2 different docs.

[mrewmrew]

I think Mac needs to change their admission standards. They need to stop accepting people with 3.5s and potentially no background in science AT ALL. Also they need to start to at least LOOK at the BS and PS scores on the mcat. Also, they need to standardize casper, especially since it's worth so much, by not having random third year med students nonchalantly mark 4000+ of them.

[thebouque]

 

Also, for your information, a cancer diagnosis may not mean much depends on what it is. Would you want a warm human being who can't perform a thryoidectomy if you are diagnosed with thyroid adenoma or would you prefer someone who is competent but has zero bedside manners, knowing that he will be able to effectively cure you?

 

Well I would be pissed if someone performed a total thyroidectomy on me because of an adenoma.

[Exocytosis]

I disagree that the changes you propose allow recruiting the "best of the best." I believe there is a threshold beyond which GPA/MCAT do not necessarily correlate as strongly with intellectual ability and intelligence.

 

And given the admission policies of many schools, it would seem they would agree.

 

That doesn't mean they're right, of course, but the reason these schools let in people with less than perfect stats isn't to be nice or fair, it's because they'd rather train a schmitty or a Real Beef than someone with perfect stats and not much else.

 

I'd also like to add that academic standards have only been increasing, and current crop of attendings (who got in under those standards) are doing fine. In fact it would be interesting to see how physician skill changed over time as the admission process became more and more competitive. (Although that may be balanced somewhat by grade inflation).

[simplyfood]

I vote for increasing MCAT requirement/average MCAT/GPA to be around 36 and 3.90 above and cut down admission by 50%.... In doing so, we recruit only the best of the best instead of this socialistic model of admission where even the average (in my view) can get in. Concentration of resources for only the best of the best and career/job planning in matching with residency/infrastructure limitation from the get-go.

 

The inherent problem with this argument is that you assume that higher GPA = extremely capable student and lower GPA = incapable student. IMO this is a pretty shortsighted view of people. Lots of people take different paths into medicine - your system would effectively rule out all non-traditional students (engineers, second career applicants etc) who don't have the numbers but have everything else. The ones who made it in with these stats are far from "average" and medicine would be a terribly boring and ineffective place without this type of diversity.

 

I also agree that past a certain point, higher GPA/MCAT produces diminishing returns. I don't think they are as correlated with eventual physician success as you imply, though perhaps someone has numbers to share here.

[ArchEnemy]

And given the admission policies of many schools, it would seem they would agree.

 

That doesn't mean they're right, of course, but the reason these schools let in people with less than perfect stats isn't to be nice or fair, it's because they'd rather train a schmitty or a Real Beef than someone with perfect stats and not much else.

 

I'd also like to add that academic standards have only been increasing, and current crop of attendings (who got in under those standards) are doing fine. In fact it would be interesting to see how physician skill changed over time as the admission process became more and more competitive. (Although that may be balanced somewhat by grade inflation).

 

Schmitty is probably one of the academically stronger students in my class right now.

[Exocytosis]

Schmitty is probably one of the academically stronger students in my class right now.

 

Oh I didn't mean to imply that he wouldn't be, just that he wouldn't meet the OP's definition of an excellent candidate.

[JohnDakota]

This proposed system would dramatically limit the diversity of successful applicants. I'm not just talking about cultural diversity. While I don't think any of us want scholastically incapable people becoming medical doctors, or even occupying a valuable spot in medical school, I think we all acknowledge the importance of training people from vastly different life experiences. This, inherently, allows the med-student population to fill the remarkably diverse positions in the public sphere that demand their skill sets.

 

I think if you would have sat back and thought about WHY medical schools use interviews as the last hurdle to get in to their programs (for the most part), you would have realized that GPA/MCAT are important, but there's so much more to being an MD then just grades. I can't pretend to know what being an MD involves, but I'm going to differ to those that are actively involved in selecting crops of med trainees year after year. Obviously personality/social interaction is very important.

 

Not everyone is academically perfect out of the gate in university. The experiences with failure that this brings to the non-traditional applicants force them to reflect on what caused them to fail and devise often unique strategies to overcome their limitations and achieve success. These experiences, and the skill sets they develop in people are invaluable later on in life and what I'm sure medical schools are after. Imagine the degree of persistence and determination required for someone >30 years old to decide they are going to study for 3+ months to take the MCAT, then dedicate 4 years of their life to medical school while figuring out how to support a family. It's just a fundamentally different person from a rockstar undergrad who slides in to med at 22-23 years old. Therefore their approach to medicine is going to be different, and the value of the medical establishment isn't in the intelligence of individual people. It's the cumulative/combined intelligence AND experience of the medical teams.

[myriad]

One of the major problems Canada is facing right now is that we don't have enough full-time attending/staff positions available for the medical students.

 

Can you give a source for this statement, please? Perhaps I've missed something, but every academic report I've seen has said that while we have too many physicians in certain specialties and locations, we still have a shortage overall. What you're proposing wouldn't help to alleviate the distribution problem and would actually exacerbate the numbers problem.

[rmorelan]

Can you give a source for this statement, please? Perhaps I've missed something, but every academic report I've seen has said that while we have too many physicians in certain specialties and locations, we still have a shortage overall. What you're proposing wouldn't help to alleviate the distribution problem and would actually exacerbate the numbers problem.

 

it is really hard to track all of this - as doctors are not employees of the government but rather business owners so it is harder to get exact answers. The most recent government report and analysis in Ontario indicates the overall the shortage is ended for most specialities, except family medicine - for that it will be 2017, which is still close enough anyone not yet in medical to school to come up against. The CMA is trying to track this a lot better and just release new information showing again the areas of surplus - which are expanding as we go along at our current enrollment numbers and residency structure.

 

You are right of course that the raw numbers don't exactly deal with the distribution problem - but the counter argument is pushing out more and more doctors is a less than ideal solution to that anyway. There is a huge capacity to absorb at of course reduced income doctors in major cities in the sorts of specialties there we would want to work in more remote areas.

[TheBoss]

The "soft" qualities, like compassion, are certainly important but people overestimate the ability of the admissions process to select for them.

[A-Stark]

As a second year medical student, I have always had a problem with the extremely high medical school admission rate and the socialistic model of admission here in Canada.

 

How is it "socialistic"?

 

When you have a bunch of medical school with mediocre intellectual level (average MCAT= only 33/34), perhaps we should increase the admissions standards.

 

I vote for increasing MCAT requirement/average MCAT/GPA to be around 36 and 3.90 above and cut down admission by 50%.... In doing so, we recruit only the best of the best instead of this socialistic model of admission where even the average (in my view) can get in. Concentration of resources for only the best of the best and career/job planning in matching with residency/infrastructure limitation from the get-go.

 

Well, I guess that's it for me then since I had neither a 36 on the MCAT nor a 3.90. I should tell my program director that I'm just not at the necessary "intellectual level" for medicine. Though I did pretty well on the LMCC part 1.

 

Anyway the only really gross deficiencies in knowledge and clinical ability I've seen have been among some Caribbean students, but even where they might not have been as strong in undergrad as the "average" Canadian med student, it's hard not to blame the shoddy quality of their schools for that.

[Renoir]

+1 to above.

 

I also notice a funny trend around PM101 sometimes to lean into this rhetoric of grades somehow being the primary indicator of intelligence, and that life sciences are somehow the only important parts of being a doc. Perhaps in some specialties.

 

I am very much looking forward to MCATs testing for more interdisciplinary knowledge like psych, soc, history, etc. Physicians by nature must be interdisciplinary, flexible, and able to integrate vast areas of knowledge.

 

There are too many "pre-meds" I've personally met that I am very concerned (read: scared poopless) will get in. No social life, no ability to communicate, no self-confidence, no direction in life, no maturity, no ethics, no life philosophy, no broad appreciation for other fields or peers that exist besides them, no leadership... But they have a 4.0 because they stay at home and study. Scary.

[PhoenixFlare500]

I hate to say that we really have too many medical students around who do not really qualify to be here.

I'm curious as to how you came to this conclusion. Have many people in your class been failing exams or do they give incorrect answers to questions when they may not have studied the material before?

 

When you have a bunch of medical school with mediocre intellectual level (average MCAT= only 33/34), perhaps we should increase the admissions standards.

The MCAT can only evaluate your knowledge in certain areas, and it will be affected by your study habits. There may be some correlation with intelligence (or just ability to memorize), but then again many students pay thousands of dollars to increase their MCAT scores and thus you could say to inflate their on-paper intelligence. Study habits and work ethic would also play an important role. GPA would correlate even less because of the difference in program or individual class/prof difficulty.

 

I vote for increasing MCAT requirement/average MCAT/GPA to be around 36 and 3.90 above and cut down admission by 50%.... In doing so, we recruit only the best of the best instead of this socialistic model of admission where even the average (in my view) can get in. Concentration of resources for only the best of the best and career/job planning in matching with residency/infrastructure limitation from the get-go.

Schools across Canada have been consistently trying to increase medical school admissions to get more doctors graduated, mostly into family medicine since that's the most widespread or publicized area of shortage. Since they were trying to make up for a deficit, I agree that admissions will have to be cut down eventually, although 50% seems a bit drastic and you might run into the original problem again.

 

And I agree with the above posts stating there is no reason to believe the most intelligent people in our population will make the best doctors, of any kind.

[simvastatin]

Not everyone who wants to be a doctor has lived an idealistically perfect pre-med life. Some have to work, some have issues in the family or some have debilitating conditions. What OP's model does is filter out those individuals from the admissions process for reasons that are beyond their control. They may have been intellectually at par with those who have 3.90s/36 stats, but their lives didn't allow that to translate on paper.

 

Also, while the average MCAT for registrants in Harvard is ~36, the average accepted GPA is 3.80. In your world the average Harvard med student is not competitive GPA-wise.

 

Source: http://hms.harvard.edu/departments/admissions/admissions-faqs

[Leon]

Not everyone who wants to be a doctor has lived an idealistically perfect pre-med life. Some have to work, some have issues in the family or some have debilitating conditions. What OP's model does is filter out those individuals from the admissions process for reasons that are beyond their control. They may have been intellectually at par with those who have 3.90s/36 stats, but their lives didn't allow that to translate on paper.

 

+1

 

This is extremely important and I'm very happy to see most medical schools acknowledge this (eg best/last 2 years policies, dropped lowest marks policies, differential weighing of higher years etc)

[futurefamilydoc]

What OP's model does is filter out those individuals from the admissions process for reasons that are beyond their control. They may have been intellectually at par with those who have 3.90s/36 stats, but their lives didn't allow that to translate on paper.

 

This. Especially for something like the MCAT, where prep courses and practice exams are quite expensive, people from privileged backgrounds have an advantage simply because they can afford (or their parents can) to spend an entire summer studying and doing a prep course, rather than having to study while working full-time like many other students. When you raise the academic requirements to such high levels you end up putting the applicants from lower economic backgrounds at a disadvantage compared to equally intelligent people from wealthier backgrounds.

[mrewmrew]

I vote for increasing MCAT requirement/average MCAT/GPA to be around 36 and 3.90 above

 

3.90 as an average is actually not too far from the actual stats these days. UofT's entrance avg was 3.92 this year, so I wouldn't be surprised if this became the norm across all Ontario schools if things keep getting more competitive in the next decade (which it probably will).

 

A 36 MCAT though is wayyyy too high imo to use as a cutoff haha, especially because it's only a point estimate of one's academic abilities. I don't think you can even fill one med school's class per year if a 36 mcat was used as a cutoff.