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The influence of income on medical school admissions in Canada: a retrospective cohort study.

ABSTRACT: BACKGROUND:The socioeconomic status of applicants to Canadian medical schools has been understudied in the past two decades. Institutional efforts have been made to address the lack of socioeconomic diversity across Canada during this time. We investigated the income characteristics of medical school applicants, as well as the relationship between applicant income and offer of admission, to characterize the current state of socioeconomic diversity in medical admissions. METHODS:We conducted a retrospective cohort study on 26,120 applicants at one Ontario medical school from 2013 to 2018. Characteristics of applicants who were offered admission were compared to the general population and applicants not offered admission. Regression analyses were used to investigate the association between median total neighborhood income and successful admission. RESULTS:The median total neighborhood income for medical school applicants was $98,816, which was approximately $28,480 higher than the Canadian general population. Those not admitted to the medical school had a median total neighborhood income of $98,304 compared to $105,984 for those offered admission (p?75th percentile income group had 54% increased odds of being offered admission when compared to applicants in the <25th percentile in our unadjusted model. Income was not significant in our adjusted models but showed that the income medians drastically shifted between pre-interview and post-interview periods, from $98,816 to $104,960 (p?

SUBMITTER: Pitre T

PROVIDER: S-EPMC7329437 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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The influence of income on medical school admissions in Canada: a retrospective cohort study.

Pitre Tyler T Thomas Alexander A Evans Kyle K Jones Aaron A Mountjoy Margo M Costa Andrew P AP

BMC medical education 20200701 1

<h4>Background</h4>The socioeconomic status of applicants to Canadian medical schools has been understudied in the past two decades. Institutional efforts have been made to address the lack of socioeconomic diversity across Canada during this time. We investigated the income characteristics of medical school applicants, as well as the relationship between applicant income and offer of admission, to characterize the current state of socioeconomic diversity in medical admissions.<h4>Methods</h4>We ...[more]

PMID: 32611410

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Project description:ImportanceMedical schools promote admission pathways as well as diversity and inclusivity to prospective students who are underrepresented in medicine (UIM) primarily via their websites. Research from organizational structures supports the use of instrumental values (which focus on behavior and core beliefs), rather than terminal values (which focus on the end goal), to promote diversity.ObjectiveTo characterize the use of instrumental and terminal values to promote institutional diversity and inclusivity on Canadian medical school websites.Design, setting, and participantsThis qualitative study analyzed the contents and themes of Canadian medical school websites based on a theoretical value framework and an organizational diversity management framework. A literature review was conducted to explore the use of instrumental and terminal values in promoting diversity and inclusivity, and a codebook was created that outlined the characteristics of these values. The content of all application pathway websites for UIM applicants to all Canadian medical schools was coded between July and August 2022.Main outcomes and measuresUse of terminal vs instrumental values across the UIM-targeted admission websites of medical schools.ResultsTwenty-two websites for 17 Canadian medical schools were included. Content on most of these websites promoted diversity in response to government policies or public accountability and often supported a dominant culture while treating diversity as an exception. The use of terminal rather than instrumental values was also more prominent on websites that targeted Indigenous prospective students compared with Black prospective students and applicants with lower socioeconomic status (11 [50%] websites vs 5 [23%] and 4 [18%] websites). Instrumental values, although seldom used, promoted diversity as a means to improve health care and training for all students in a program.Conclusions and relevanceResults of this qualitative study suggested that medical schools in Canada promoted diversity and inclusivity to prospective students primarily as an end goal rather than as a core value. Medical schools should highlight the benefits of diverse lived experiences and reinforce their commitment to diversity and inclusion by aligning their website content with their ongoing work in this area.

Project description:BackgroundAlthough used widely, there is limited evidence of the BioMedical Admissions Test's (BMAT) predictive validity and incremental validity over prior educational attainment (PEA). We investigated BMAT's predictive and incremental validity for performance in two undergraduate medical schools, Imperial College School of Medicine (ICSM), UK, and Lee Kong Chian School of Medicine (LKCMedicine), Singapore. Our secondary goal was to compare the evidence collected with published evidence relating to comparable tools.MethodsThis was a retrospective cohort study of four ICSM (1188 students, entering 2010-2013) and three LKCMedicine cohorts (222 students, 2013-2015). We investigated associations between BMAT Section 1 ('Thinking Skills'), Section 2 ('Scientific Knowledge and Applications') and Section 3a ('Writing Task') scores, with written and clinical assessment performance across all programme years. Incremental validity was investigated over PEA (A-levels) in a subset of ICSM students.ResultsWhen BMAT sections were investigated independently, Section 2 scores predicted performance on all written assessments in both institutions with mainly small effect sizes (standardised coefficient ranges: ICSM: 0.08-0.19; LKCMedicine: 0.22-0.36). Section 1 scores predicted Years 5 and 6 written assessment performance at ICSM (0.09-0.14) but nothing at LKCMedicine. Section 3a scores only predicted Year 5 clinical assessment performance at ICSM with a coefficient <0.1. There were no positive associations with standardised coefficients >0.1 between BMAT performance and clinical assessment performance. Multivariable regressions confirmed that Section 2 scores were the most predictive. We found no clear evidence of incremental validity for any BMAT section scores over A-level grades.DiscussionSchools who wish to assess scientific knowledge independently of A-levels may find BMAT Section 2 useful. Comparison with previous studies indicates that, overall, BMAT seems less useful than comparable tools. Larger scale studies are needed. Broader questions regarding why institutions adopt certain admissions tests, including those with little evidence, need consideration.

Project description:ObjectivesTo better characterise the Awarding Gap (AG) between black, Asian and other minority ethnic (BAME) and white students in UK undergraduate medical education by examining how it affects eight minority ethnicity subgroups (Bangladeshi, black, Chinese, Indian, Pakistani, mixed, other Asian background and other ethnic background) and whether the AG varies by medical school attended.DesignRetrospective cohort study.SettingData extracted from the UK Medical Education Database on students enrolled at 33 UK medical schools in the academic years starting 2012, 2013 and 2014.Participants16 020 'Home' tuition fee status students who sat the University Clinical Aptitude Test on entry to university and obtained a UK Foundation Programme (UKFP) application score on exit.Primary outcome measureUKFP Z-scores on exit from medical school.ResultsThere were significant differences in UKFP Z-scores between ethnicity subgroups. After white students, mixed ethnicity students performed best (coefficient -0.15 standard deviations [SD]) compared with white students, (95% confidence interval [CI] -0.23 to -0.08, p<0.001) and Pakistani students scored lowest (coefficient -0.53 SD, 95% CI -0.60 to -0.46, p<0.001). In pairwise comparisons of scores between all nine individual ethnicity subgroups, 15/36 were statistically significant. The AG varied considerably across medical schools. The largest gap showed the coefficient for BAME was -0.83 SD compared with white students (95% CI -1.18 to -0.49, p<0.001), while the smallest demonstrated no statistically significant difference in performance between BAME and white students (+0.05 SD, 95% CI -0.32 to 0.42, p=0.792).ConclusionsBAME students are significantly disadvantaged by the current UK medical education system. There are clear differences in medical school outcomes between students from different ethnicity subgroups, and the size of the AG also varies by medical school attended. Urgent and effective action must be taken to address the AG and achieve an equal learning environment for our future doctors.

Project description:ObjectiveTo determine whether the quality of press releases issued by medical journals can influence the quality of associated newspaper stories.DesignRetrospective cohort study of medical journal press releases and associated news stories.SettingWe reviewed consecutive issues (going backwards from January 2009) of five major medical journals (Annals of Internal Medicine, BMJ, Journal of the National Cancer Institute, JAMA, and New England Journal of Medicine) to identify the first 100 original research articles with quantifiable outcomes and that had generated any newspaper coverage (unique stories ≥100 words long). We identified 759 associated newspaper stories using Lexis Nexis and Factiva searches, and 68 journal press releases using Eurekalert and journal website searches. Two independent research assistants assessed the quality of journal articles, press releases, and a stratified random sample of associated newspaper stories (n=343) by using a structured coding scheme for the presence of specific quality measures: basic study facts, quantification of the main result, harms, and limitations.Main outcomeProportion of newspaper stories with specific quality measures (adjusted for whether the quality measure was present in the journal article's abstract or editor note).ResultsWe recorded a median of three newspaper stories per journal article (range 1-72). Of 343 stories analysed, 71% reported on articles for which medical journals had issued press releases. 9% of stories quantified the main result with absolute risks when this information was not in the press release, 53% did so when it was in the press release (relative risk 6.0, 95% confidence interval 2.3 to 15.4), and 20% when no press release was issued (2.2, 0.83 to 6.1). 133 (39%) stories reported on research describing beneficial interventions. 24% mentioned harms (or specifically declared no harms) when harms were not mentioned in the press release, 68% when mentioned in the press release (2.8, 1.1 to 7.4), and 36% when no press release was issued (1.5, 0.49 to 4.4). 256 (75%) stories reported on research with important limitations. 16% reported any limitations when limitations were not mentioned in the press release, 48% when mentioned in the press release (3.0, 1.5 to 6.2), and 21% if no press release was issued (1.3, 0.50 to 3.6).ConclusionHigh quality press releases issued by medical journals seem to make the quality of associated newspaper stories better, whereas low quality press releases might make them worse.

Dataset Information

The influence of income on medical school admissions in Canada: a retrospective cohort study.

Publications

The influence of income on medical school admissions in Canada: a retrospective cohort study.

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