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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  • 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://myheartsisters.org/2011/01/13/stupid-things-doctors-say-heart-patients/

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


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