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On Admitting Nice, Ethically-Minded People to Med School

This week the Times ran a leading story on a new med school admission process, with mul­tiple, mini-​​interviews, like speed dating. The idea is to assess appli­cants’ social, com­mu­ni­cation and ethical thinking (?) skills:

…It is called the mul­tiple mini interview, or M.M.I., and its use is spreading. At least eight medical schools in the United States — including those at Stanford, the Uni­versity of Cal­i­fornia, Los Angeles, and the Uni­versity of Cincinnati — and 13 in Canada are using it.

At Vir­ginia Tech Car­ilion, 26 can­di­dates showed up on a Sat­urday in March and stood with their backs to the doors of 26 small rooms. When a bell sounded, the appli­cants spun around and read a sheet of paper taped to the door that described an ethical conundrum. Two minutes later, the bell sounded again and the appli­cants charged into the small rooms and found an inter­viewer waiting. A chorus of cheerful greetings rang out, and the doors shut. The can­di­dates had eight minutes to discuss that room’s sit­u­ation. Then they moved to the next room, the next sur­prise conundrum…

This sounds great, at first glance. We all want friendly doctors who get along. It might even be fun, kind of like a game. (Sorry for the cyn­icism, injected in here, but it’s needed.) I’d even bet that the inter­viewers and suc­cessful inter­viewees would emerge feeling good about the process and themselves.

But don’t you think most premed stu­dents, who get through college, and numerous letters of rec­om­men­dation, take the MCATS and achieve scores high enough to get an interview, are smart enough to get through this social test without failing? It’s what these young men and women are thinking, inter­nally, that matters. According to the same article, the country’s 134 medical schools have long relied almost entirely on grades and the MCAT to sort through over 42,000 appli­cants for nearly 19,000 slots.

My math: that means nearly 19 out of 42 (almost half!) of med school appli­cants get in, here in the U.S.

If we want future doctors who are smart enough to guide patients through tough, data-​​loaded, evidence-​​based and ethically-​​complex deci­sions, we should make the aca­demic require­ments for entry more rig­orous, espe­cially in the areas of science, math and ana­lytical thinking.

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3 comments to On Admitting Nice, Ethically-​​Minded People to Med School

  • This is cause for concern. What’s next? Med stu­dents who can give a great Twitter diag­nosis with 140 char­acters or less? I’d rather have a doctor who can cor­relate book smarts with the par­tic­ulars of my case.

  • So true on the “out-​​smarting” of the social test. I’m not sure what the answer is — I see the same issues in vet­erinary med­icine too. Many of these kids are just too young to be entering vet school — emo­tionally young, not nec­es­sarily chrono­log­i­cally. How we screen it is another matter. Having been involved in admis­sions com­mittees for vet school entry, I’ve seen so many kids enter vet school who I per­sonally “declined” on the basis of the interview process alone — some­where along the line, the gained enough points else­where in the process to get in. On a similar “social-​​ethical” note, I’ve been so fre­quently dis­ap­pointed by behaviors of these so-​​called pro­fes­sional stu­dents whilst in school — cheating in exams, whining about exam marks, wanting to be spoon-​​fed infor­mation (back in the day when I was a vet student, we had these things called “libraries” where I’d spend all my free, waking hours! OK, I’ll jump off my soapbox now, hehe! Your point really stirred up some­thing in me –it’s an issue that I too feel very strongly about. Very dif­ficult to resolve, but I like your thoughts in your closing para­graph very much.

  • Hi Dr. S and thanks for this intriguing example. Last year I was asked to serve as a per­sonal ref­erence for a won­derful young woman I know who was applying to med school. I was con­tacted by all four med schools she had applied to, and I was SO IMPRESSED by how thorough and com­pre­hensive the uni­versity staff ques­tions were.

    They already had her uni­versity tran­scripts. They already knew she was a brainiac. What they REALLY wanted to know from me, however, was heart­ening stuff.

    Was she a good lis­tener? Give examples. Was she kind-​​hearted? Examples please. Did she show up on time or keep others waiting? Was she empa­thetic? Sym­pa­thetic? Hard-​​working? A self-​​starter? What about her sense of humour?

    I can say that by the 4th interview, I felt utterly elated by knowing that our future doctors are being vetted through more than just aca­demic scores.

    Every patient I know has horror stories about doctors who may be smart, but are quite clearly socially retarded. In fact, I wrote about some of them in “Stupid Things That Doctors Say To Heart Patients” at http://​myheart​sisters​.org/​2​0​1​1​/​0​1​/​1​3​/​s​t​u​p​i​d​-​t​h​i​n​g​s​-​d​o​c​t​o​r​s​-​s​a​y​-​h​e​a​r​t​-​p​a​t​i​e​n​ts/

    Maybe these docs fea­tured should have done the speed-​​dating MMIs.…

    Regards,
    C.

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