Here Come ‘Holistic’ Admissions to Med School

Inside Higher Ed reports this morning on the  Success for ‘Holistic’ Med School Admissions at Boston University:

Boston University has demonstrated the success of “holistic” admissions for medical school, according an analysis published in  The New England Journal of Medicine.  Under such admissions, grades and test scores aren’t accorded the same dominant role they have traditionally played in admissions decisions, and factors such as empathy, strength of character and cultural sensitivity receive more attention. At BU’s medical school, such a policy was adopted in 2009. As officials had hoped, the new approach led to more diversity in the class — with the percentage of underrepresented minority students increasing from 11 to 20 percent.

I hope The New England Journal of Medicine will publish additional studies investigating and explaining the remarkable discovery B.U. seems to have stumbled upon. If we assume — as I’m sure B.U. would insist — that its new holistic admissions criteria are racially neutral both in intent and as applied, then it has discovered that at least among its medical school applicants “factors such as empathy, strength of character and cultural sensitivity” are disproportionately possessed by “diversity”-providing racial and ethnic minorities. This association of “underrepresentation” with moral superiority demands further study.

Another possible explanation for B.U.’s dramatic discovery — although one that also calls out for scholarly investigation — is that those admirable “holistic” qualities are for some reason sadly and disproportionately lacking in those applicants with high grades and test scores, so that decreasing the number of academic high achievers increases the number of those with high “holistic” scores.

Potentially complicating this alternate explanation is that B.U. also found that after the adoption of the new “holistic” policy in 2009 both the college grade point average and the MCAT scores of its students increased. Since presumably those traditional measures did not improve because they were de-emphasized, I suspect they increased because the GPAs and MCAT scores of applicants increased across the board over those years. If so, then then those traditional scores did not increase as much as they would have if they had been accorded their traditional weight.

Most of the concern with “diversity” in the medical profession seems to come from medical schools, the producers of health care. But what about the consumers, those on whom the practice of medicine is practiced? Are there any surveys, for example, for example, that investigate how patients rank such “holistic” qualities as llempathy and cultural sensitivity compared to more traditional measures of accomplishment and skill (at least as measured by grades and test scores) in their physicians? Do medical schools care?

A prevalent and persuasive argument against preferential admissions — whether the preference is based on race (overtly or “holistically”) or on other issues such as legacy status — is the stigma that attaches to the preferred as well as those who “look like” them. In the case of race that stigma often survives long after graduation, leading some patients to avoid doctors whom they suspect were held to lower standards.

That avoidance suggests an irony: supporters of racial preference justify their support by pointing to the persistence of bias and discrimination, but lower standards for the preferred perpetuates that very bias.

John S. Rosenberg

John Rosenberg blogs at Discriminations.

One thought on “Here Come ‘Holistic’ Admissions to Med School”

  1. This research reminds me of the research the University of Michigan conjured up to defend the goodness of its diversity policy: whatever looks good on campus, attribute it to “holistic” admissions.

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