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Abstracts Online Below, you will find a full abstract from the association's official journal, The Advisor. If you are a member of NAAHP, and an abstract piques your interest, please feel free to request a full copy of the article free of charge from the national office, c/o Jerolyn Attwood If you are not yet a member, please email Jerolyn Attwood to request the latest on NAAHP membership, services and publications, including a year's subscription to The Advisor. Back to Main Abstracts Online page
Toward Improving Communication Between Health
Professions Advisors Jerry W. Lester and Billy B. Rankin Summary In addition to using the traditional cognitive criteria (grades and MCAT scores) most medical school admissions committees try in various ways to assess other aspects of applicants such as interests, attitudes and personality. Considerable research into this "all else" or noncognitives realm has been done using the standardized instruments available. However, no clear cut noncognitive description of the "ideal" medical applicant has emerged. The vehicles most commonly used to gain insight into the noncognitive are the Health Professions Evaluation and the personal interview. If these are to be of maximum benefit, two objectives must be met: 1) evaluators must have some notion of what to look for and, 2) the evaluators must be able to communicate with one another, i.e., advisor to committee members and committee member interviewers to other committee members. The objectives of this study were to: 1. Identify the adjectives which advisors, admissions committees and enrolled medical students felt important in describing "ideal medical school applicants." 2. Develop operational definitions of these descriptive adjectives. 3. Determine if the noncognitive qualities sought in medical students can be identified and/or measured in other or more precise ways. 4. Share with advisors and medical school admissions committees, students and prospective applicants the results of the study. V3-4-1 Identifying Students Compatible with Medical School Goals Prior to Admissions Interviews Gerry R. Schermerhorn, M.A., Jerry A. Colliver, Ph.D. and Paul Kolm, Ph.D. Abstract — A screening procedure was added to the admissions process to determine whether applicant congruence with the purpose of a particular medical school could be assessed prior to interview. The supplementary application form sent to all academically qualified, in-state applicants included a description of the institutional purpose and asked the applicant to describe how he or she personally identified with this purpose. Responses to this item were evaluated by a subcommittee of the admissions committee to select for interview those applicants who provided the most convincing statement of identification with the School. With two years of data, the procedure was found to have interrater reliability and construct validity and was effective in reducing the number of admissions interviews by 45 percent. This reduction conserved time and resources for both the medical school and the applicants while yielding a more than sufficient pool of interviewed applicants for further consideration by the admissions committee. V5-1-1
Survey of Medical School Admissions Committees in the United States David M. Arnold, M.D., Rodney M. Coe, Ph.D., and Max Pepper, M.D., M.P.H. Abstract — This communication reports the results of questionnaires mailed to the admissions officers of the 123 medical institutions affiliated with the AAMC as listed in the Medical School Admission Requirements 1982-83 (AAMC). The questionnaire was designed to elicit information about medical school admissions committees structure and function. The questionnaire was completed and returned by representatives of 86 (70 percent) of the 123 institutions solicited. The structure of committees has changed since 1970, but the process and criteria for admission have changed little. V5-3-1
Profile of the 1981 and 1982 Medical School Applicants in Texas Part IV. Accepted and Non-accepted Applicants: Motivational Influences, Extracurricular Involvement, and Work Experience Jeanne M. Lagowski, Ray Whiteside, Harold D. Murray, Virgil L. Tweedie, and John C. Little Introduction This paper is the fourth in a series reporting results of a study of the 1981 and 1982 medical school applicants from a large and varied geographical area, i.e., Texas. Previous reports have appeared in the Advisor (Murray et al., 1983; Little et al., 1984; Whiteside et al., 1985). Part IV examines motivational influences, when career decisions were made, extracurricular involvement, and health-related work experience. This report, as well as the previous ones in the series, is based on a study conducted by the Texas Association of Advisors for the Health Professions (TAAHP) under the auspices of a grant from the Josiah Macy, Jr. Foundation. In sharp contrast to the voluminous literature on the correlation between cognitive or intellective factors, i.e., MCAT scores and grade point averages (GPAs), and medical school acceptance, there is a paucity of published quantitative data on the influences of the non-cognitive or non-intellective factors considered in this paper. On the other hand, these factors have been the subject of widespread discussion and debate between and among advisors and medical schools. At least one medical school has reported on the role of non-intellective factors in their selection process (Jenkins and Eiland, 1982). In view of the GPEP Report (Physicians for the Twenty-First Century, 1984) and its caution concerning the possible overemphasis of MCAT scores in particular, our study — because of its quantitative approach — is both timely and important. This report addresses the following questions: 1) When considered one at a time, which self-reported motivational influences, which extracurricular activities, which health-related work experiences, and what attitudes toward pre-medical advising distinguish accepted from non-accepted applicants to medical school? 2) Which subset, consisting of a few variables, is most highly correlated with acceptance to medical school? These two questions are discussed and answered in the Results and Discussion section of this paper. 3) Could information of this type be used by advisors in counseling their advisees? The Summary considers this last question. V6-1-1
The Effect of Medical School Admissions on Undergraduate Pre-Medical Education: A Case for Change Keith W. Young Introduction Recent reports indicate a resurgence in concern over the education of physicians in the United States. This article will examine one aspect of that education — the medical school admissions process. In particular, it will focus on three aspects of the process: 1) current medical school selection factors; 2) the effect of the current process on undergraduate pre-medical students; and 3) potential structural remedies for some of the resulting problems. This paper is designed to elucidate the admissions process for both pre-medical students; and 3) potential structural remedies for some of the resulting problems. This paper id designed to elucidate the admissions process for both pre-medical students and their faculty advisors. However, the topic is also relevant to all consumers utilizing the health care system. As Eckhert and Cronin, 1984, indicate, "Today’s decisions by medical school admissions committees will profoundly affect individual applicants, medical institutions, the health care system, and society well into the 21st century." Current research in the field of medical education is utilized to substantiate claims regarding the effect of status quo admissions procedures on pre-medical students. V6-2-2
The Legal Aspects of Medical School Admissions and Dismissals Cynthia H. Grieger, J.D., Natalie K. Shemonsky, M.D., J.D., and Robert E. Driscoll, III, LL.B. Abstract — Implementation of the recommendations made in 1982 by the Council on Medical Education of the American Medical Association which emphasize the importance of evaluating noncognitive abilities in both admission to and dismissal from medical school will become a source of litigation unless adequate guarantees of due process are afforded the medical school applicant and student. In this article, the authors review the law as it applies to medical school admissions and dismissals and offer recommendations intended to reduce the potential liability of medical schools using noncognitive evaluations. V6-2-3
Regression Analysis of Factors Related to Acceptance to Medical School Jocelyn C. Clark, M. Elaine Costello, and Claude H. Yoder Abstract — Regression analyses were performed using the grade point averages and standardized test scores of 189 Franklin & Marshall College students who applied to medical school during the years 1981-1985. The results suggest that an ability to solve problems and to deal with concepts in the physical sciences are important determinants in obtaining interviews. V8-1-1
NAAHP’S Resolutions — A Bold or Foolish Attempt to Elicit Change?? Harry L. Fierstine, Ph.D. Introduction At the Board of Directors’ meeting in St. Louis, MO, June, 1986, the Northeast representatives presented for action two resolutions conceived by Daniel Marien, pre-health advisor from Queen’s college. One resolution was concerned with the need for non-competitive medical school applicants to complete secondary applications, and the other was concerned with the timely rejection of medical school applicants. The resolutions were discussed, modified, and then unanimously passed. It was my duty to follow through on the Board’s action. A transmittal letter, along with the resolutions, was forwarded to the deans of all allopathic medical school and to the national and regional chairs of the Group on Student Affairs (GSA). In addition, the resolutions were published in The Advisor. Medical school responses ranged from agreement to indignation and raised the concern as to whether NAAHP should be an advocate for the pre-health professions student or take sides on any health education issue. The following fulfills an obligation to share the results of our action with the membership. V8-1-4
Changes in the Qualifications of Medical School Applicants, 1981 to 1985 Cynthia G. Tudor, Ph.D. and Robert L. Beran, Ph.D. Abstract The decline in the number of medical school applicants has prompted concerns among medical educators regarding the effects of this decrease on the qualifications of the applicant pool. Changes in the qualifications of medical school applicants were analyzed in terms of age, sex, and ethnicity or racial group using two measures of quality: Medical College Admission Test (MCAT) scores and grade-point averages. The distributions of these measures for 1981 and 1985 applicants were compared. The results showed that there were significant but modest gains over the years in the percentage of men and women applicants who scored from 10 to 15 on the MCAT biology, chemistry, physics, and science problems subtests. There were also significant percentage gains of applicants in all age categories, except applicants over age 32, and for all ethnic or racial groups except blacks. The authors conclude that a variety of sociodemographic, educational, and selection factors may account for these changes. V9-1-1
Competency Requirements: A New Approach to Medical School Admissions Fredric D. Burg, M.D., Susan R. Croll, George E. Ruff, M.D., and Edward J. Stemmler, M.D. The faculty of the University of Pennsylvania School of Medicine, Philadelphia, have substituted definitions of knowledge and skills for course requirements as requirements for admission. The school expects that this action will allow students more flexibility in the development of their undergraduate academic programs, while guiding them specifically to the necessary preparation in the sciences. It is further hoped that this action will encourage the faculties of undergraduate schools to examine the way in which they prepare students for careers in medicine. This article describes the approach used for bringing about this change in policy and presents the new admissions requirements. V9-1-2
The Accreditation of Programs Leading to the M.D. Degree Harry S. Jonas, M.D. and Barbara M. Barzansky, Ph.D. The accrediting process for medical school programs assures the public, the medical profession, and the student that the education at an institution meets national standards. Currently, the Liaison Committee on Medical Education (LCME) is recognized as the accrediting agency for medical school programs by the licensure boards of the 50 states and U.S. territories, the Canadian provinces, the Council on Postsecondary Accreditation and the U.S. Department of Education. Sponsorship and financing of the LCME is jointly shared between the Council on Medical Education of the American Medical Association (CME/AMA) and the Association of American Medical Colleges (AAMC) (1,2). The LCME has 15 voting members. Each sponsoring association appoints six members who serve six year terms. These include medical school faculty and administrators, teaching hospital executives, and practicing physicians. There is also a Canadian member appointed by the Committee on Accreditation of Canadian Medical Schools and two public members, elected by the LCME. In addition there is a federal liaison designated by the Secretary of the Department of Health and Human Services, and two medical student participants without vote (1,2). V9-2-2
A Statistical Analysis of Admission Criteria for Target M.D., An Accelerated Premedical Program Connie J. Horstman Abstract — A study designed to evaluate the ten-year-old Target MD Program, an accelerated premedical program sponsored jointly by the University of Wisconsin-Milwaukee and The Medical College of Wisconsin, focused initially on three questions: are the admission criteria valid, can other predictors of success in the program be identified, and is there any academic rationalization for continuing to distinguish between regular and alternate students in the program? The study used simple correlations to examine the relationship between 52 variables relating to participants and their success in the program as well as their status as regular or alternate students. The results support the validity of the admission criteria, suggest three additional criteria, and support the elimination of any distinction between regular and alternate students. V9-3-1
Unchanging Dilemmas in American Medical Education Deborah Borek, M.D. Abstract — The Author reviews "the leitmotiv of unresolved dilemmas" in American medical education: the problems of determining the premedical and medical school curricula and of selecting medical students. She offers suggestions for each area, but cautions that there are no simple answers. Acad. Med. 64(1989):240-244. V9-4-2
Profile of the 1981 and 1982 Medical School Applicants in Texas Part V. A 1988 Retrospective Ray Whiteside, Harold D. Murray, Jeanne M. Lagowski, Virgil L. Tweedie, and John C. Little Introduction The 1981 and 1982 medical school matriculants have now graduated and entered a residency program, or they did not finish. Previous papers in this series reported on a multifaceted study of 1981 and 1982 medical school applicants from Texas undergraduate institutions. Accepted and non-accepted applicants were compared on the basis of: cognitive and demographic variables (1); selected personality traits (2); self-perceptions of selected skills and abilities (3); and motivational influences, work experiences, and extracurricular activities (4). The study was conducted by the Texas Association of Advisors for the Health Professions and funded by the Josiah Macy, Jr. Foundation. In the early 1980's, and still today, there is both a statewide and a nationwide concern regarding the paucity of primary care physicians. Accordingly, one goal of this study was to identify predictive indicators that relate to a student’s decision to enter primary care. The retrospective analysis reported here focuses on the identification of differences among study-group cohorts who entered different types of residencies and those who either withdrew or delayed their graduation from medical school. These latter groups, i.e., those who withdrew or delayed graduation, were also compared with the cohort of the original study group that was not admitted to medical school. V10-1-1
The M.D./J.D. Dual Degree Program at Southern Illinois University Theodore R. Leblang and W. Eugene Basanta Introduction During the past two decades, there has been increasing focus on medical legal education in medical schools and law schools throughout the country. As a result, integration of legal medicine course work into the elective curricula of law schools is now fairly widespread. Similarly, a growing number of medical schools have begun to include learning experiences in legal medicine as part of their undergraduate academic programs. V10-1-3
Understanding and Predicting the Yield in Medical School Admissions Theodore M. Bross, Ed.D. Abstract — Graduate and professional schools in general, and medical schools in particular, have traditionally not paid a great deal of attention to applicant "yield" — the proportion of accepted applicants who eventually confirm their intention to matriculate. This study examined data for all students who were accepted for the years 1985-1987 at an urban, private medical school in the Northeast. The author attempted both to estimate the probability of an accepted applicant’s matriculating at the institution and to demonstrate the relative effects of selected variables on the applicant’s final decision. Through the use of the maximum-likelihood estimation technique, the resulting model indicated that probability ranges for matriculation may be derived using data available from computerized student records. The model was able accurately to classify more than 70% of the students into either the "matriculant" or the "non-matriculant" category. Acad.Med. 64(1989):458-462. V10-2-1
Qualitative Variables in Medical School Admission William C. McGaghie, Ph.D. Abstract — Personal qualities, character traits, life experience, and adaptive capacities are all associated with effective professional life and work. Despite widespread acknowledgment that qualitative factors are crucial for success as a medical student and physician, the variables are rarely measured or considered when medical schools reach decisions about student admission. This essay examines the qualitative variables that medical school admission committees might consider when filling their classes, and it offers recommendations about using qualitative data for admission decisions. It concludes with an agenda for research on medical school admission. Acad.Med. 65(1990):145-149 V10-4-1
Moral Dilemmas in Medical School Admission Donnie J. Self, Ph.D. Abstract — The wide range of complex moral and ethical issues of medical school admission committees are seldom publicly acknowledged, reflected upon, analyzed, or discussed although they are faced regularly. Three cases are presented that illustrate some of the common and unusual moral dilemmas in the admission process. These issues and several practical strategies for ethical decision making are discussed, along with their limitations and weaknesses. These practical strategies are applied to the three cases to see what solutions might be offered. Acad.Med. 65(1990):179-183. V10-4-2
The Declining Medical School Applicant Pool: Enhancing the Undergraduate School-Medical School Partnership William A. Thomason, Ph.D., Quentin W. Smith, M.S., Leslie M. Miller, Ph.D., Zenaido Camacho, Ph.D Abstract — Over the past decade medical schools across the nation have witnessed a disturbing trend toward fewer qualified applicants applying for admission. In April of 1989, an invitational premedical advisors conference was held at Baylor College of Medicine for the purpose of exploring issues that influence applicants who consider careers in medicine. The conferencing effort identified a number of areas in which medical school can begin to ct in partnership with undergraduate institutions toward the goals of eliminating barriers to the pursuit of careers in medicine and enhancing the attractiveness of medicine as a career option for qualified young people. V11-1-1
Perspectives on Medical School Admission William C. McGaghie, Ph.D. Abstract — This article is the author’s formulation of important issues concerning medical school admission: that (1) in recent years, almost all applicants who have been admitted to medical school have obtained the M.D. degree and been licensed to practice; (2) given this high success rate, an accepted applicant’s economic security is virtually guaranteed; (3) the admission decision contributes directly to the formation of a highly paid, high-status professional elite; (4) the link between students’ academic aptitude for medical education and their achievement in medical school is weak; (5) schools pay lip-service to the importance of students’ character, motivation, and other personal qualities but continue to select students with high grades in science courses and high MCAT scores; (6) admission officers and committees often confuse selecting students with predicting their achievement in medical school; (7) two core values in American culture (self-reliance and competition) encourage the use of norm-referenced measurement in all phases of education; and (8) there are alternatives to the traditional approach to defining eligibility for professional education. Acad. Med. 65(1990):136-139. V11-1-2
Financing Medical Education Robert G. Petersdorf, M.D. Abstract — The cost of a medical education may dissuade qualified young people from entering the medical profession or may so load them with debt that they cannot pursue relatively low-paid careers in primary care or clinical investigation. Three aspects of this problem are examined: (1) the cost of medical school, (2) the magnitude of student indebtedness, and (3) the effects of this indebtedness on career choices. High tuition and fees require many students to assume sizable educational debts, some of which are so large that the trainees will be unable to repay them unless they enter highly remunerative specialties. Also, high levels of indebtedness may increase default levels once graduates feel the full impact of scheduled repayments. Several steps would help to alleviate this problem, but are unlikely to solve it. First, medical schools should lower tuition or at least declare a moratorium on increases. Second, limits should be imposed on the amount of total education debt a student is allowed to assume. Third, hospitals with extensive residency programs should assume some responsibility for helping trainees manage their finances. Fourth, the government should institute a loan forgiveness program that addresses the need for physician-investigators, primary care physicians, those willing to practice in underserved areas, and those from underrepresented minorities. And fifth, all institutions involved in medical training and its finance should work together to advise students on managing their debts. V11-4-1
Current Practices in Admission Interviews at U.S. Medical Schools Eugene K. Johnson, Ph.D., and Janine C. Edwards, Ph.D. Abstract — Although the interview is widely used in the selection of applicants for admission to U.S. medical schools, little is known about current interview practices. The authors formulated a 46-item questionnaire concerning the interview process for medical school applicants, then in 1989 sent it to admission officials at all the 127 LCME-accredited schools in the United States. The questionnaire concerned the interview’s status as a predictor; interviewers and interview structure; interviewer training; and the utility of interview data. Seventy-two percent of those sent the questionnaire completed and returned it. The responding admission officials indicated that the interview had two major purposes at their schools: as a means of assessing candidates’ noncognitive skills and as a public relations tool. Most schools’ interview processes were loosely to moderately structured, and interviewers received minimal training. It is concluded that the interview’s role is primarily subjective and that it has a definite but imprecise influence on admission decisions. V12-1-1
Descriptive Analysis of Medical School Application Forms Richard I. Emmett, M.P.A. Abstract — A detailed analysis was conducted of the application forms for the 1992-93 and 1993-94 entering classes at all 126 U.S. medical schools, with the expectation that knowledge of the types of information that admission committees and their institutions solicit through these materials would help to eliminate the little-understood nature of the medical school admission process. Although application forms are only one component of the admission process, these documents are key sources of information about the character and/or mission of individual medical schools as well as about prospective students. The analyses began with a detailed inventory of the information requested by the American Medical College Application Service (AMCAS) form. Then each medical school was grouped by the type of application form(s) it used, and an analysis was conducted of the application forms of schools that used their own primary (i.e., non-AMCAS) forms or combinations of the AMCAS form and their own supplemental forms. Finally, some of the additional types of biographical and behavioral information that schools sought through their own forms were examined and clustered. The analyses provided a detailed picture of the various application forms that medical schools use in their application processes and the ways in which those forms are used, either singularly or together, to obtain information from applicants. Another major finding concerned variations among schools in the use of questions requiring in-depth responses. The schools eliciting more extensive responses seemed to be attempting to gauge prospective students’ possession of or potential to develop a set of qualitative characteristics that are deemed desirable in today’s physician. The specific qualitative characteristics that such questions attempted to assess appeared to correlate strongly with each school’s particular character and/or mission. This study raises more questions than it has answered and highlights the need for further analyses of both the application form and the overall admission process, and their relationships to the content and outcomes of undergraduate medical education. V14-2-1
The Advisor's Relationship with the College Administration John F. Klein, Ph.D. Introduction — The work of pre-health professions advisors can easily be seen as a round of activities that delivers a set of services to undergraduate students with specific career goals. While the preparation of advisors differs and the institutional settings in which they are located vary, one factor remains constant: an accountability to the administration of the organizations in which they are located. This formal accountability to an administrative structure officially links the position of the advisor to the organization and results in a variety of additional formal and informal linkages to other areas of the organization. The purpose of this article is to examine different organizational factors that impinge upon the work of advisors as a result of their complex organizational linkages throughout the line of administration. V15-1-1
The Longer Road to Medical School Graduation Donald G. Kassebaum, M.D., Philip L. Szenas, M.A. The authors followed the academic progress and graduation rates of students matriculating in U.S. medical schools each year between 1976 and 1988. The four-year graduation rates of medical students in MD programs declined from 91.4% for students who matriculated in 1976 to 81.2% for 1988 matriculants. During the same period, the percentage graduating in five years increased from 5.5% to 10.6%, while those still enrolled or on leaves of absence after five years rose from 1.9% to 4.1%. The lengthening of undergraduate medical education is associated with students’ spending extra time on special studies or research, but to a greater extent graduation has been delayed for mediation of academic difficulty or slowing of the pace of education to overcome handicaps in academic preparation and learning skills. Underrepresented minority students, particularly black Americans, have lower four-year graduation rates than majority students, and the rate has fallen steadily across successive classes matriculating between 1976 and 1988. The longer periods of undergraduate medical education since 1984, however, have been accompanied by a reversal of the growing attrition rate for black-American students, probably the result of more appropriate pacing of education over the first year or two and the wider availability of student academic support. The longer road to graduation also accumulates greater educational costs, contributing to the escalation in student indebtedness that has been out of proportion to increases in tuition and fees. While a consistent influence of the longer period of undergraduate education on specialty choice was not defined, members of the 1988 matriculating class who graduated after five years were more inclined toward the generalist and medical specialties and less interested in the surgical and support specialties than were their four-year compatriots. Acad. Med. 69(1994):855-860. V15-2-1
Critical Features of the Letter of Recommendation John F. Klein, Ph.D. Introduction — Letters of recommendation for pre-health professions students, especially medical school applicants, seem to be the "agony or the ecstasy" for both pre-health professions advisors and for admission committee members. There can be a sense of intellectual rapture on the part of an advisor who has constructed a letter for an applicant that clearly captures just "who the applicant is" and goes far beyond the statistical data. For admission committee members, there can be a sense of euphoria in having a "gestalt" or an insightful preview of an impending interview. The other side of the coin, of course, are letters that say little about the "persona" of an applicant, possess broad generalities that lack any concrete evidence or focus on factual information that is found elsewhere in the application materials. This can be agony for admission committee people who spend time reading such letters and feel "cheated" for having gained very little understanding about candidates. By the same token, advisors may often spend considerable time and experience distress crafting a letter that flounders in capturing the essential qualities of a candidate. How might these peaks of joy be gained and valleys of despair be avoided for both advisors and admission committee members? V15-3-2
Traditional Predictors of Academic Performance in a Medical School’s Independent Study Program C. Benjamin Meleca, Ph.D., M.S. Purpose. To provide predictive information as an initial screening device for admission decisions, generalizable to the population of students opting for the Independent Study Program (ISP) at The Ohio State University College of Medicine. Method. A stepwise multiple-regression technique was used to generate predictor-criterion relationships. A priority code was developed as an applicant screening device. The code is a numeric value based on a combination of applicant gradepoint average (GPA) and Medical College Admission Test (MCAT) scores that provides a prediction of first-year performance in medical school. The study sample consisted of the 596 first-year students in the ISP track from 1980 through 1989. The measure of their academic performances was the average score on three National Board of Medical Examiners (NBME) subject ("shelf") examinations in the basic sciences (anatomy, physiology, and biochemistry). Results. The largest multiple correlations were found between averaged scores on the NBME subject examinations and undergraduate GPAs (R= 34.20; F = 16.79; p = .0001) and scores on the MCAT Biology Knowledge (R = 13.24; F = 47.64; p = .0001), MCAT Chemistry Knowledge (R = 7.86; F = 17.39; p = .0001), and MCAT Skills Analysis: Quantitative (R = 1.39; F = 3.93; p = .0479). Conclusion. The predictive value of traditional predictors of preclinical academic performance was established for the nontraditional program at The Ohio State University College of Medicine. Admission officers at other schools may find the priority code helpful as a sorting tool. It may further serve as an "early warning" system for students with marginal academic preparation. Acad. Med. 70(1995):59-63 V15-4-1
Primary Care and Non-Primary Care Physicians: A Longitudinal Study of Their Similarities, Differences, and Correlates Before, During, and after Medical School Mohammadreza Hojat, Ph..,. Joseph S. Gonnella, M.D., James B. Erdmann, Ph.D., J. Jon Veloski, M.S., and Gang Xu, Ph.D. Purpose. To investigate similarities and differences between physicians in primary care and non-primary care specialties on performance measures prior to, during, and after medical school, and on demographic characteristics, professional plans and preferences in medical school, professional activities, career satisfaction, perceived problems and research activities, and to predict primary — non-primary care career choices from information obtained in medical school. A questionnaire was mailed to 1,076 physicians who graduated from Jefferson Medical College between 1982 and 1986. Of those who responded (62%), 232 were primary care and 406 were non-primary care physicians (29 physicians in mixed specialties were excluded). Data from the questionnaire concerning professional activities, satisfaction, problems, and research productivities were merged with the college’s longitudinal study database. Results. Comparisons of primary care-non-primary care physicians indicated no significant difference between them on performance measures before, during, and after medical school, with the exception that non-primary care physicians had higher scores on quantitative tests before medical school, and primary care physicians scored higher on a licensing examination of general clinical skills and patient management taken during residency training. Also, compared with non-primary care physicians, those in primary care were less likely to be employed full-time, were less likely to locate in metropolitan areas, had a lower rate of academic appointment, and had a higher rate of board certification. Other results showed differences between the groups in terms of age at entrance to medical school, proportion of women, estimates during medical school of anticipated income, career plans during medical school, satisfaction with career and income, and research and scientific activities. V15-4-2
Relationship Between Quantity of Undergraduate Science Preparation and Preclinical Performance in Medical School Michael L. Hall, Ph.D., and Michael T. Stocks, M.S. Purpose. The primary purpose of this study was to determine whether a relationship existed between the quantities of undergraduate science education completed by medical students and their subsequent preclinical performances in medical school. The secondary purpose of the study was to determine the nature of any relationship present and to reverify standard predictors of preclinical performance in medical school. Method. This study was undertaken at Albany Medical College in conjunction with Sage Graduate School, Albany, New York. The analysis encompassed 120 systematically and 80 randomly selected medical student academic records (200 total cases) from the entering classes of 1977 through 1992. Twelve distinct variables were collected. Data transformations were completed as required, and the data subsequently standardized. Standard descriptive statistics, correlation between variables, t-tests between systematically and randomly selected groups, and factor analysis were performed on the data collected. Results. It was determined that there was no significant relationship between total hours of undergraduate science completed and average preclinical performance in medical school. In addition, correlation between subdivisions of total house of undergraduate science (total hours of chemistry, total hours of biology, total hours of math, and total hours of physics) and subdivisions of average preclinical performance (year-one preclinical performance and year-two preclinical performance) also proved to be nonsignificant. However, significant relationships between average preclinical performance and its subdivisions and other standard predictors of preclinical performance (Medical College Admission Test score and science grade-point average) were found to be in line with values in recent literature. In addition, significant relationships were found with the national Board of Medical Examiners Part I examination. Factor analysis of all variables yielded three underlying factors: medical school preclinical performance factor, undergraduate performance factor, and quantity of non-life-sciences factor. Conclusion. Quantity of science-based undergraduate premedical education, either in its entirety or in subdivisions, did not materially affect the performances of the selected medical school students in their preclinical years of medical school. (Acad. Med. 70(1995):230-235.) V15-4-4
Age and Gender Differences in Student’s Preadmission Qualifications and Medical School Performances Mary Ramsbotton-Lucier, M.D., M.P.H., Mitzi M.S. Johnson, Ph.D., and Carol L. Elam, Ed.D. Purpose. To investigate the age- and gender- related differences in matriculants’ preadmission performances and in their subsequent medical school performances. Method. A longitudinal database was used to provide information on the 557 students in six entering classes (1984-1989) at the University of Kentucky College of Medicine. The preadmission variables were undergraduate science and cumulative grade-point averages (GPAs), Medical College Admission Test (MCAT) scores, and interview ratings. The medical school variables were GPAs for the four years of school and scores on the National Board of Medical Examiners Part I and Part II examinations. Age- and gender-related differences were analyzed by analyses of variance. To examine age differences, the students were grouped by age at matriculation: less than 23 years old, between 23 and 27, and 28 and older. Results. The younger matriculants had significantly higher undergraduate GPAs than did their older peers; however, their performances on the MCAT were nearly identical. The men had higher MCAT scores than the women in all age groups, but the older women had higher undergraduate GPAs than the older men. The younger students tended to have slightly higher medical school GPAs than the older students. No age differences were found for the NBME I and II, and no gender difference was found for the NBME II; however, a modest gender difference was found for the NBME I, with the men performing better than the women. Conclusion. Dramatic age and gender differences were evident in the preadmission performances, while the differences in the medical school performances were much smaller. Acad. Med. 70(1995):236-239 V16-1-1
Relationship of Medical Students’ Admission Interview Scores to Their Dean’s Letter Rating Frances R. Hall, Ed.M., Martha Regan-Smith, M.D., Ed.D., and Terrence Tivnan, Ed.D. Abstract — The authors examined the relationship between the admission interview scores for 62 students in the 1986 entering class at Dartmouth Medical School and the students’ dean’s letter ratings given four years later; they found the relationship to be significant (V = .372, p = .014) and the interview scores to be better independent predictors of the ratings than were total Medical College Admission Test scores or science grade-point averages. Among the 17 students receiving "strong" admission interview scores, 53% received dean’s letter ratings in the top one-third and 47% received ratings in the lower two-thirds; all 11 students who received "weak" interview scores received ratings in the lower two-thirds. The authors suggest (1) that admission interview scores help schools to identify more clearly those applicants most likely to become strong, competitive performers in residency and (2) that the significant relationship between interview scores and dean’s letter ratings indicates a need to discover what qualities the interview actually measures and to consider the methods by which interviewers are trained, rather than to forsake the interview. Acad. Med. 67(1992):842-845 V16-1-2
The Effect of a Medical School’s Admission and Curriculum Policies on Increasing the Number of Physicians in Primary Care Specialities Janice Barnhart, M.D., Paul Shekelle, M.D., Ph.D., and Charles Lewis, M.D., Sc.D. Purpose. The Charles R. Drew University of Medicine and Science, which is affiliated with the University of California, Los Angeles, UCLA School of Medicine, has a mission to increase the number of physicians pursuing careers in primary care and/or providing care to the underserved. The authors sought to determine whether Drew’s initial classes are pursuing career paths consistent with the institution’s mission. Method. In June 1992 the alumni from the Drew and UCLA classes of 1985 through 1987 were mailed questionnaires to ascertain their specialty choices and practice settings. Responses were analyzed using bivariate analyses and multiple logistic regression. Results. The response rates were 89% (402 of 454) for the UCLA graduates and 76% (44 of 58) for the Drew graduates. Bivariate analyses shoed that Hispanics, women, older individuals, and Drew graduates were more likely to choose primary care specialities (p=<.001 for each variable). Multiple logistic regression also showed that these variables predicted primary care career choice: for being a Hispanic, odds ration (OR) = 3.2, 95% CI (1.66, 6.35); for being a woman, OR = 3.2, 95% CI (1.28, 2.97); for being older, OR = .92, 95% CI (.86, .99); and for being a Drew graduate, OR = 2.4, 95% CI (1.09, 5.27). Older graduates practiced in underserved areas more than did younger ones (26% vs 13%, p = .03). Conclusion. To some degree, Drew has fulfilled its mission of graduating physicians who are primary care specialists and/or practice in underserved areas; however, the results raise questions regarding possible early influences on career choice. Acad. Med. 1996; 71:293-295. V16-3-1
Prediction of Students’ USMLE Step 2 Performances Based on Premedical Credentials Related to Verbal Skills Karl S. Roth, M.D., William T. Riley, Ph.D., Richard B. Brandt, Ph.D., and Hugo R. Seibel, Ph.D. Purpose. To examine the relationship between the objective premedical credentials and performances on Step 2 of the United States Medical Licensing Examination (USMLE) of 480 students in three classes at the Virginia Commonwealth University Medical College of Virginia School of Medicine. The purpose of the study was to seek those selection criteria that might best predict performance on an examination designed to assess problem-solving skills, the essence of clinical medicine. Method. Premedical data from two classes (1993, 1994) were analyzed, and a regression equation was used to calculate theoretical USMLE Step 2 scores for the students in the class of 1995, who had not yet taken this examination. The premedical variables were scores on the verbal and math sections of the Scholastic Aptitude Test (SAT), scores on the six sections of the pre-1991 Medical College Admission Test (MCAT), grade-point average (GAP) in science courses required of premedical students, and undergraduate major. Once the class of 1995 had taken the USMLE Step 2, the equation was cross validated, and the theoretical and actual scores of the class of 1995 were correlated. Results. The correlation between theoretical and actual scores was r = .443. In the analysis for the classes of 1993 and 1994, the single variables most highly predictive of USMLE Step 2 performance were scores on the verbal section of the SAT (r = .317) and the Skills Analysis: Reading section of the MCAT (r = .331). However, the MCAT scores were excluded from the final regression analysis because the pre-1991 MCAT cannot be useful in predicting the performances of present medical school applicants. The resulting regression equation (using the SAT verbal section and premedical GPA) was able to account for 21.2% of the variance for the class of 1995. Conclusion. The use of the verbal section of the SAT as a predictive factor is unique. It is significant that this variable was strongly related to premedical GPA, suggesting that high verbal aptitude serves one well, even when coping with complex scientific concepts. Acad. Med. 1996;71:176-180. V16-3-2
Risky Practices and Unrealistic Expectations: Improving the Financial Advising of Premedical Students Daniel A. Burr, Ph.D., and John F. Klein, Ph.D. Abstract — The educational debt of medical school graduates has been growing rapidly at a time when consumer credit is readily available to students and managed care is making significant changes in physician reimbursement. This combination of circumstances has given financial planning an increasingly important role in the lives of medical students. The more we understand about the financial practices and attitudes of our students before they come to medical school, the better we can target our financial advisement programs to address their needs during and after their enrollment. Previous studies have analyzed factors influencing medial student borrowing, the relationship between medical student debt and career choice, and how medical student attitudes toward educational debt and future income affect career choice. There have been studies, based on focus group interviews, of the financial attitudes, practices, and knowledge of students in general, but no study has attempted to analyze these elements for the medical student subset, which tends to be heavily indebted. The purpose of our study is to assess the financial practices, expectations, and knowledge of medical school applicants and to analyze them based on the demographic characteristics of sex and ethnicity differences. V20-2-2
A Primer on Federal Financial Aid for Dental Students Anne Wells, Ed.D. Introduction — In the eighteen years that I have been involved in dental education, I have seen student borrowing become a way of life. The average debt of a dental school graduate has increased from around $20,000 in 1982 to nearly $100,000 in 1999. Dental educators recognize that increasing student loan debt has the potential to impact dental education in many ways. Potential dental students must consider whether the cost of dental education is worth the financial investment and the acquisition of substantial debt. Dental school graduates must make practice decisions reflective of their potential ability to repay student loans. Dental educators are becoming increasingly concerned about the availability of dental health care to disadvantaged populations, and ethicists are considering how debt could compromise practice decisions of heavily indebted practitioners. Higher education has entered the era of "pay as you go" consumerism. Meanwhile, the cost of dental education, and all higher education, continues to climb. Although the economy is strong and the dental applicant pool is relatively plentiful, are we setting ourselves up for a time when we cost ourselves out of business? Will only the wealthy be able to afford a dental education? Will dental health care become less widely available to disadvantaged populations? A booming student loan industry has emerged as the outgrowth of federal legislation authorizing student financial aid. Student loans have become big business for many banks and lenders. Companies that employ thousands have been established to service student loans. University financial aid offices have grown and expanded their scope as they try to keep up with the explosion of federal regulations and the call for institutional accountability. There is no specific career path to become a financial aid administrator. In fact, many of us fell into this business quite by accident. Further, the responsibilities of financial aid officers has grown from facilitating the process of applying for and receiving financial aid to that of financial planner and debt management specialist. As someone with one foot in the financial aid office and the other foot in the dental school admissions office, I offer this perspective. Journal of Dent Ed, 62 (5) V20-2-2
Michael Kuchera, D.O. Introduction — Over one hundred years after its introduction
as a distinctively American approach to health care, osteopathic medicine is now
the fastest growing segment of the U.S. healthcare field. Organized around a
distinctive philosophy, it is a complete system of health care delivery and
disease prevention. V21-1-1 Back to Main Abstracts Online page
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