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


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Note that many students do complete an undergraduate degree in Quebec before applying to or being accepted to medicine, and while tuition is lower than other provinces, many individuals still need to work to pay for their education. While the French medical schools don't require a CV, that only leaves anglophones with McGill, which does look at your extracurriculars. Of course many students apply out of province as well, but again extracurriculars play a strong role.

While many people do have an undergraduate degree, my point stands since half the class doesn't, which considerably changes the demographics of the class. Moreover, people with an undergraduate degree have access to pretty generous scolarships and interest free loans (about 8 000-10 000$ un scolarships and 3 000$ in loan) from the government. I honestly don't know somebody who works during the school year because they feel that they have to do it, those who do (and they are few) do it because they love their job. 

 

Indeed, Mcgill requires a CV, but I was talking of the french schools because that's what I know. I have no idea how well off Mcgill's students are. 

 

Sorry if I made it seem like Québec is some kind of heaven for students and that money makes no difference. It obviously does, but not as much as in the rest of Canada I believe.

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If you had seen enough of the issues that low SES people deal with, I'm guessing you wouldn't disagree.    Wealthy people are, despite maybe a higher VR or CARS score, or maybe a 0.1 higher GPA, ver

Man, I hate to revive an old forum post from 2016, but I just started medical school at McMaster this year, and I've definitely noticed this. I've noticed it so much that it really, really bugged me,

We're taught that patients will assume all doctors will have a baseline competence in their medical knowledge but are more concerned about having a physician who has more of the softer skills in medic

 Like was already said Medway12 was just saying the admissions committees do not look at your income, so no they don't directly select for people of higher incomes. I am not really sure what you mean by getting their kids jobs they are not qualified for in sciences and healthcare as that is likely not legal. They could perhaps know someone to give a really good reference on an application or something, but I really doubt your run of the mill average higher socioeconomic family has those kind of connections.

 

 

Maybe it's just my school, but they do. Most kids seem to have parents in the same field as well. University professors, doctors, etc. They quite literally often either create a job for them, or hire them for a publically advertised job. Particularly in science/research....countless people at my school have done a couple weeks work and have had their mom/dad-who is the PI-put them first or second author on their publications.

 

The other day, I heard a girl complaining that her father, an exec at the NCR, was making her apply for a summer job in his department. Not that he wasn't planning to hire her-he was-but she was mad that she had to write a cover letter like 'normal people'. 

 

People do crazy things, especially when the stakes are high. I've seen you on the MUN/Dal threads though, and being from the East too, I find this kind of thing happens far, far less often there vs here in ON

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I didn't read the whole thread, but statistically, med students are disproportionately more often from families where parents make over 100k combined.

I went to a public elementary school in a poor neighbourhood, then attended a private HS, where many kids had rich parents. I then went to UdeM, a very public university, where many students manage their own living expenses, and afterwards got into med school, where it felt like private high school all over again.

 

Think about it this way: let's use an example where 2 candidates are equally bright and talented

Candate A: private elementary school, private HS, tutors, doesn't have to work (and if they want a job, can get it anytime because their parents have friends who can hire them as a medical secretary rather than doing some less fancy jobs such as pizza delivery guy, or Subway sandwich artist), money to attend university full time, time and money to play piano etc... volunteer/voluntourism/travel during summer.... facebook profile pic with a 3rd world black kid -  "research" during summer - can withdraw from a course if performance wasn't good in the midterm - lives in a nice and safe neighbourhood - can go buy a 10-15$ meal during study sessions 

vs

Candidate B: poor parents, living with single mom since childhood, local public elementary school/HS where most students don't go to university afterwards, have to work 15-25 hrs/week at McDonald (had to apply to 20-50 different places to get that job, been working since the age of 16) to support themselves, no time/money for sports - cannot really afford to withdraw from a class if they perform poorly - lives in a poor neighbourhood where it's dirty - can't afford a 10-15$ meal during evening study sessions after class

          and I can go on and on and on....

 

Whelp, sounds like Candidate A is more likely to get into med school! I don't even think I'm exaggerating anything. In fact, ask yourself: how many of your classmates are actually from poor families? <5% perhaps?

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Maybe it's just my school, but they do. Most kids seem to have parents in the same field as well. University professors, doctors, etc. They quite literally often either create a job for them, or hire them for a publically advertised job. Particularly in science/research....countless people at my school have done a couple weeks work and have had their mom/dad-who is the PI-put them first or second author on their publications.

 

I don't mind to quibble, but that would be in general difficult to do in general science/research.  Probably much harder than in a company especially private family company.  Unless the prof is particularly (exceptionally) powerful, their access to discretionary funds would be fairly limited.  Usually most funded student positions would require department and/or faculty approval which would need to justify the choice.  But a PI, with no teaching obligations and only research may have access to more funds.  

 

Although a prof is an impressive sounding title, the starting salary maybe about R3 to R5 (same salary starting as a nurse).  Usually nurse isn't synonymous with wealth - but profs may have access to subsidized housing in more expensive areas (and more job security).  

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Candidate B: poor parents, living with single mom since childhood, local public elementary school/HS where most students don't go to university afterwards, have to work 15-25 hrs/week at McDonald (had to apply to 20-50 different places to get that job, been working since the age of 16) to support themselves, no time/money for sports - cannot really afford to withdraw from a class if they perform poorly - lives in a poor neighbourhood where it's dirty - can't afford a 10-15$ meal during evening study sessions after class

and I can go on and on and on....

 

I knew a number of candidate B people growing up. The only one who had to support themselves had been separated from their parents partly because of poor performance in athletics (and was from a "good" family). The ones that went to university looked at it as a means to a degree and job - looking for high GPA was not typically a priority. The only good news is that in Canada, there is relatively high social mobility - much higher than the US (imagine being stuck in a ghetto). And even if most of the people in Candidate B's shoes didn't end up as physicians, at least they moved into decent careers than their parents had.

 

http://www.conferenceboard.ca/hcp/details/society/intergenerational-income-mobility.aspx

 

I have to agree with earlier comments and I would say Quebec (outside McGill) doesn't seem to have the same feel as other med schools, in terms of high wealth disparities.

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The median income among Canadian medical school matriculants is much much higher than the median income for all Canadians. It's a real problem not just an anecdotal one... the physician workforce should reflect the population they serve as far as life experiences go, we're missing the mark pretty hard right now.

 

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.

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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.

The mistake you're making here is forgetting that there are probably at least 5 times as many qualified applicants as spots. The "cut-offs" for med school are based on the number of applicants, not suitability to be a physician.

 

Therefore, if there are more qualified applicants than spots, you can theoretically pick people to match a population without decreasing quality in any real way.

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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.

There are far more qualified people than seats. Let's not pretend that those of us who were admitted are somehow special. There are plenty that dont get in who could easily replace the others. Just so happens those with more privileged lives, on average have better odds being at the top of the cutoff. Supply and demand, doesn't mean those who didn't make.the cut are somehow less suited for Medicine etc

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The mistake you're making here is forgetting that there are probably at least 5 times as many qualified applicants as spots. The "cut-offs" for med school are based on the number of applicants, not suitability to be a physician.

 

Therefore, if there are more qualified applicants than spots, you can theoretically pick people to match a population without decreasing quality in any real way.

This, though maybe 5 times is a stretch. At least 2x-3x for sure!

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The mistake you're making here is forgetting that there are probably at least 5 times as many qualified applicants as spots. The "cut-offs" for med school are based on the number of applicants, not suitability to be a physician.

 

Therefore, if there are more qualified applicants than spots, you can theoretically pick people to match a population without decreasing quality in any real way.

 

While technically true, that doesn't necessarily mean it should be done. There's certainly arguments that can be made for both sides

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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.

 

Given the contemporary paradigm shifts, your idea isn't going to sell well, the culture of medicine is working towards valuing patient preference and experience, which is intimately tied with the therapeutic alliance and building a rapport (increases compliance, motivates patients etc.). Besides, the marginal benefit of a candidate slightly more "qualified" (by what metric? a voluntourism stint in Africa?) is absolutely minimal at best. I'd argue that, on average, the patient benefit provided by the first choice medical school applicant vs. the last one to get in off the wait list is absolutely negligible. Meritocracy provides very little added benefit in such an oversaturated and competitive market for medical students, schools DO have the luxury of choice without costs to quality.

 

We should have a mandate in place to have a physician workforce that reflects the values, experiences, and cultures of the patients we treat. Because trust me, the people I grew up around don't care about the mark their physician got in histology lab, they care about whether they understand that when they leave the office they can't pay for the prescription or that they have to go home and live in conditions that make it impossible for them to be proactive about their health. And I can guarantee you that if you measured the benefit of shared/similar experiences on patient satisfaction, you'd see it. There's a lot of work going into patient preference and selection effects, it's sometimes just as important as the treatment effect.

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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.

If you had seen enough of the issues that low SES people deal with, I'm guessing you wouldn't disagree. 

 

Wealthy people are, despite maybe a higher VR or CARS score, or maybe a 0.1 higher GPA, very often totally unaware of most of the issues facing low SES families. Not only are they often unaware, in my experience with these students, they often *deny* the existence of these issues-because it's so very far from their own lives they can't imagine it in  Canada today. 

 

For example, I  bet many of my peers would be shocked to know I skipped 3 weeks of a prescription medication in September when I submitted my OMSAS application. The 90$ that I still needed to pay wasn't there until my next paycheck. Maybe, if my doctor had asked about my situation, or I felt comfortable explaining I was short on cash, we could have found a cheaper alternative. 

 

And that's just one tiny, insignificant example. I am by far more privileged than many Canadians, so I know I am unaware of the issues facing many of them. That's why we **need** to ensure people from all walks of life enter medicine. SES diversity is no less important than any other kind of diversity.

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If you had seen enough of the issues that low SES people deal with, I'm guessing you wouldn't disagree. 

 

Wealthy people are, despite maybe a higher VR or CARS score, or maybe a 0.1 higher GPA, very often totally unaware of most of the issues facing low SES families. Not only are they often unaware, in my experience with these students, they often *deny* the existence of these issues-because it's so very far from their own lives they can't imagine it in  Canada today. 

 

For example, I  bet many of my peers would be shocked to know I skipped 3 weeks of a prescription medication in September when I submitted my OMSAS application. The 90$ that I still needed to pay wasn't there until my next paycheck. Maybe, if my doctor had asked about my situation, or I felt comfortable explaining I was short on cash, we could have found a cheaper alternative. 

 

And that's just one tiny, insignificant example. I am by far more privileged than many Canadians, so I know I am unaware of the issues facing many of them. That's why we **need** to ensure people from all walks of life enter medicine. SES diversity is no less important than any other kind of diversity.

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. 

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The mistake you're making here is forgetting that there are probably at least 5 times as many qualified applicants as spots. The "cut-offs" for med school are based on the number of applicants, not suitability to be a physician.

 

Therefore, if there are more qualified applicants than spots, you can theoretically pick people to match a population without decreasing quality in any real way.

No I didn't miss that. Yes there are many qualified applicants but I was talking about selecting the most qualified, whether it is an extra .01 GPA or 10 MCAT points. I think any actual merit should take priority over demographics. When med schools do end up choosing some of the qualified applicants from a larger pool of qualified candidates, they do exactly that - they choose the most qualified of that group.

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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. 

I can't say I agree with you at all there. By saying that lower SES people are less likely to do well in school, you are misinterpreting data. 

 

Personally, I'm kind of offended by the suggestion that we want the 'best doctors we can have' and that low SES people aren't it. No, we don't need to save seats based on SES, but perhaps just be more aware of the disadvantages when reviewing work vs volunteering on applications. 

 

A course on social determinants of health can't compensate for a lifetime. In my own experience, 90% of wealthy students manage to complete such courses and still remain in complete and total denial of their privlege. Shocking, but very true

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I can't say I agree with you at all there. By saying that lower SES people are less likely to do well in school, you are misinterpreting data. 

 

Personally, I'm kind of offended by the suggestion that we want the 'best doctors we can have' and that low SES people aren't it. No, we don't need to save seats based on SES, but perhaps just be more aware of the disadvantages when reviewing work vs volunteering on applications. 

 

A course on social determinants of health can't compensate for a lifetime. In my own experience, 90% of wealthy students manage to complete such courses and still remain in complete and total denial of their privlege. Shocking, but very true

See this (offend you) is what I did not want to do. There are clear correlations between SES and education level and performance. There is no reason you should be offended. The disparity in education and performance has nothing to do with the people themselves but the environments they are in. For example: someone with a low SES has the stresses of needing to juggle a job to pay for living expenses during undergrad while one with a high SES does not have this stress to worry about. I'm sure you can agree with me that the person with a higher SES is more likely to do well as they will have less on their plate with respect to stress and will have much more time to study and do well. 

 

In regards to admissions committees reviewing work and volunteering, I think that whether you work or volunteer really doesn't matter. I feel that they are looking more for how your experience has contributed to you as a person and whether you have been able to acquire the skills they are looking for through these experiences. Really when you think about it, who cares if you acquired communication skills via paid work or volunteer work. The important thing is that you acquired those communication skills. Everyone has a relatively equal opportunity to work and acquire those skills through experience one way or another so I don't see how this should really be affected by SES. if you're from a lower SES you may have to acquire those qualities through paid work whereas if you're from a higher SES you may acquire it through volunteer work, but in the end both the lower and higher SES students had the opportunity to acquire the skills required for medicine. And if you disagree with me on this then you are just saying that the lower SES students don't have the qualities required for medicine because how could they get them without the opportunities. Therefore, should they be doctors? The point is that the problem needs to be addressed at a different level. If we are to get more doctors which match the demographic more closely, then I say the solution is to decrease the gap between SES's to begin with - not an easy problem to solve. In the end, the easiest solution to this problem is communism - something that's not exactly favoured by the masses in North America. 

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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. 

 

Your meritocracy argument doesn't float. Again, the difference between the first person to get into a medical school and the first person not to is negligible. It's not unlikely that those students from lower SES backgrounds (who are competitive applicants in their own rights), if given the same opportunities as those from higher SES households, would have outperformed their wealthier counterparts (on paper anyway, which is a ridiculous metric to judge future physician quality). I'm a fan of meritocracy, sure, but taking a wealthy applicant with a 3.98 GPA and a 34 MCAT who had access to prep courses and didn't have to work 20 hrs/week during school over a poorer applicant with a 3.91 and a 32 MCAT on the premise of one will likely be a higher quality physician than the other is a joke, plain and simple. You can't measure or predict the success of a physician with such marginal differences, especially when adjusting for disparity in opportunity for dedicated study and volunteering time, would likely be negligible anyway. Schools have the ability to build classes that reflect the Canadian population without changing their median/mean/mode accepted GPA or MCAT.

 

The premise that a 0.07 difference in GPA or 2 points on the MCAT produces a physician that generates more QALYs over their career (which I'm using as a metric for "quality" because people keep using that word without defining what it means) than a physician who has the life experiences and values that mirror the majority of Canadians is funny to me.

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Given the contemporary paradigm shifts, your idea isn't going to sell well, the culture of medicine is working towards valuing patient preference and experience, which is intimately tied with the therapeutic alliance and building a rapport (increases compliance, motivates patients etc.). Besides, the marginal benefit of a candidate slightly more "qualified" (by what metric? a voluntourism stint in Africa?) is absolutely minimal at best. I'd argue that, on average, the patient benefit provided by the first choice medical school applicant vs. the last one to get in off the wait list is absolutely negligible. Meritocracy provides very little added benefit in such an oversaturated and competitive market for medical students, schools DO have the luxury of choice without costs to quality.

 

We should have a mandate in place to have a physician workforce that reflects the values, experiences, and cultures of the patients we treat. Because trust me, the people I grew up around don't care about the mark their physician got in histology lab, they care about whether they understand that when they leave the office they can't pay for the prescription or that they have to go home and live in conditions that make it impossible for them to be proactive about their health. And I can guarantee you that if you measured the benefit of shared/similar experiences on patient satisfaction, you'd see it. There's a lot of work going into patient preference and selection effects, it's sometimes just as important as the treatment effect.

 

I completely get what you're saying but I wasn't suggesting that one method is better than the other for the patient. I am simply saying that prioritizing merit over the socioeconomic background actually makes it a more fair process. Nobody should be given an edge because of their socioeconomic background, whether they are rich or poor. This isn't the same as affirmative action (for Aboriginals) or regional bias (like SWOMEN), both of which are different stories and serve a strong purpose. My argument is purely in terms of one's socioeconomic status, everything else aside. Overall, I do think this is a grey area and in terms of benefits, a more relatable/reflective physician with slightly lower merit at the time of admission may be an overall net benefit to his or her society. But that was not my argument in the first place.

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I can't say I agree with you at all there. By saying that lower SES people are less likely to do well in school, you are misinterpreting data. 

 

Personally, I'm kind of offended by the suggestion that we want the 'best doctors we can have' and that low SES people aren't it. No, we don't need to save seats based on SES, but perhaps just be more aware of the disadvantages when reviewing work vs volunteering on applications. 

 

A course on social determinants of health can't compensate for a lifetime. In my own experience, 90% of wealthy students manage to complete such courses and still remain in complete and total denial of their privlege. Shocking, but very true

 

I agree with you, and I've spoken with a dean about this, they know the system is broken. They're working on it, but it's behind closed doors and who knows what'll happen. And beyond that, it's a difficult change to make, the selection process needs to fair and objective, but the road for applicants to even set foot in the selection process isn't.

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Your meritocracy argument doesn't float. Again, the difference between the first person to get into a medical school and the first person not to is negligible. It's not unlikely that those students from lower SES backgrounds (who are competitive applicants in their own rights), if given the same opportunities as those from higher SES households, would have outperformed their wealthier counterparts (on paper anyway, which is a ridiculous metric to judge future physician quality). I'm a fan of meritocracy, sure, but taking a wealthy applicant with a 3.98 GPA and a 34 MCAT who had access to prep courses and didn't have to work 20 hrs/week during school over a poorer applicant with a 3.91 and a 32 MCAT on the premise of one will likely be a higher quality physician than the other is a joke, plain and simple. You can't measure or predict the success of a physician with such marginal differences, especially when adjusting for disparity in opportunity for dedicated study and volunteering time, would likely be negligible anyway. Schools have the ability to build classes that reflect the Canadian population without changing their median/mean/mode accepted GPA or MCAT.

 

I laugh at the premise that a 0.07 difference in GPA or 2 points on the MCAT produces a physician that generates more QALYs over their career (which I'm using as a metric for "quality" because people keep using that word without defining what it means) than a physician who has the life experiences and values that mirror the majority of Canadians.

I agree with you that such a small difference is negligible and it truly is to the medical schools. This is why they interview people and someone with a 3.91 may get in and the person with the 3.99 may not. The adcomms have clearly realized that the difference between these two individuals is negligible. If they didn't realize this then the adcomms would simply rank everybody according to MCAT and GPA and then admit the highest (this clearly does not occur). I think the issue here is that people often forget that the true issue at hand here is that limited spots. There are definitely many qualified applicants that get rejected each year and the best the adcomms can do is accept the ones they feel are the best. in doing this they evaluate more than just grades and MCAT. They evaluate the person through interviews and ABS reviews.  

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I agree with you that such a small difference is negligible and it truly is to the medical schools. This is why they interview people and someone with a 3.91 may get in and the person with the 3.99 may not. The adcomms have clearly realized that the difference between these two individuals is negligible. If they didn't realize this then the adcomms would simply rank everybody according to MCAT and GPA and then admit the highest (this clearly does not occur). I think the issue here is that people often forget that the true issue at hand here is that limited spots. There are definitely many qualified applicants that get rejected each year and the best the adcomms can do is accept the ones they feel are the best. in doing this they evaluate more than just grades and MCAT. They evaluate the person through interviews and ABS reviews.  

 

Yeah, it's a sticky process. Removing essay components has made everything more objective, but deprives applicants of that personal appeal that really is the driver of delivering medical care. In the US they offer a chance to claim disadvantaged status based on a set of SES criteria and an essay, and schools make it a priority to ensure their class is diverse in that regard. In Canada, we ignore it completely, just a list of things we've done, with no caveat about how hard it was to even get a chance to be in the arena. It's about moving away from the cold objectivity we've embraced in the last decade that ignores disparities in equity that are reflected in achievement on paper but not in potential, but maintaining it to ensure we do train physicians that will be good at what they do.

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Yeah, it's a sticky process. Removing essay components has made everything more objective, but deprives applicants of that personal appeal that really is the driver of delivering medical care. In the US they offer a chance to claim disadvantaged status based on a set of SES criteria and an essay, and schools make it a priority to ensure their class is diverse in that regard. In Canada, we ignore it completely, just a list of things we've done, with no caveat about how hard it was to even get a chance to be in the arena. It's about moving away from the cold objectivity we've embraced in the last decade that ignores disparities in equity that are reflected in achievement on paper but not in potential, but maintaining it to ensure we do train physicians that will be good at what they do.

The sad part about the essays is that there are times when applicants are dishonest and have other people write them for them. Additionally, I think a contributing factor is the limited resources that medical schools have. It would be nice if the schools could do a holistic review of every applicant but that's just not possible and so they strive to strike some sort of a balance. I think that applicants really need to try and explain their life stories to adcomms during interviews. I know the opportunity does not always come up and for this reason I feel like interviewers should make it a standard to ask "tell me about yourself".

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Yes Canada is probably a little more objective than the US, however, I feel that subjectivity is a double-edged sword. Yes, you really get to know that applicant and all of that good stuff but on the other side there will be adcomms who have their own agenda. There will be times where their own agenda is probably not the best and where politics comes into play. These parts of the subjectivity I am personally not too fond of. 

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