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Nontraditional Students, Minorities and Women

Evaluation of a Pre-entrance Enrichment Program for Minority Students 
Admitted to Medical School

Augustine Ugbolue, Ph.D., Patricia N. Whitley, M.D., and Phyllis J. Stevens

Abstract — The authors report on an enrichment program for minority students and its effect on those students’ performance in the first year of medical school. The six-week pre-entrance enrichment program (PEP) offers a curriculum of basic science courses, study skills training, and a seminar on special topics, typically on sociomedical issues. From 1973 through 1984, 115 students who had been admitted to Boston University School of Medicine participated in the PEP prior to matriculation. The PEP participants had lower scores on the Medical College Admission Test than minority nonparticipants admitted to the medical school. Analysis of the first-year performance of PEP participants, however, indicated that the participants had significantly higher proportions of pass and honors grades than minority nonparticipants in two courses and slightly higher (though not significant) proportions of pass and honors grades in six other courses of the nine courses in the first-year curriculum. In a related study, preliminary analysis showed that participation in the PEP was one of the consistent predictors of overall academic performance during the first year. Questionnaires completed by participants before and after the program and their responses to a survey at the end of their first year of medical school indicated the participants felt they had gained benefits from the program that enhanced their academic adjustment.

V7-1-1

Lois E. Kiss

First, I want to describe the dimensions of the problem we are facing in medical schools in approaching equity in the number of women and minority physicians we are training. Second, I will inform you about the steps being taken by the medical schools to address problems of equity, and finally I will give you some advice on how to best serve your advisees who are women and minorities.

V8-3-3

Academic Predictors of Minority Students’ Acceptance into Medical School

Carmen Montecinos and John Pohlmann, Ph.D.

In recent years the number of minority students admitted to medical schools has leveled off (1,2). This trend has led medical school admissions committees to reevaluate the role of traditional predictors of success in medical school for minority applicants. A matter of concern for minority applicants and their undergraduate advisers is the importance admissions committees attach to the various kinds of information supplied by the applicant. A statistical analysis of the discriminating power of these selection variables would be valuable not only for minority students applying for admission to medical school but also for minority students planning their undergraduate programs.

Accordingly, the authors’ purpose in the study reported here was to examine the predictive validity of the most common selection variables used by medical school admissions committees in a sample of minority applicants. The prediction criterion was the decision of the admissions committee, and the predictor variables were undergraduate grade point averages (GPAs) and scores on Medical College Admission Test (MCAT) subtests.

Previous studies that have statistically examined the medical school admissions process (3) have found that undergraduate GPA is the strongest predictor of the admissions decision. Scores on standardized tests, such as the MCAT, were found to be statistically significant predictors but not as discriminating as GPA. When undergraduate GPA is divided into science and non-science components, the science GPA is the better determinant of the admissions decision. When such analyses are performed on minority applicant samples (3), however, GPA and MCAT measures are more equivalent in their capacity to discriminate between admitted and rejected candidates than is true for all applicants.

V9-2-1

Paul Henry and Harold R. Bardo

Abstract — Premedical advisors, recommendation committees, and medical school admissions committees are continually faced with the problem of how to evaluate students on the basis of noncognitive characteristics, particularly minority students. The relationship of the eight noncognitive variables (proposed by Sedlacek and his associates) to academic success, as measured by the science grade point average (GPA) and the accumulative grade point average of sixty nontraditional premedical students, was examined in this study. The Noncognitive Questionnaire (NCQ) is administered, as part of a test battery, to applicants to the Medical Education Preparatory Program (MEDPREP) at Southern Illinois University-Carbondale and is used to assist in making MEDPREP admissions decisions. Results of the NCQ for entrants into the program were examined in relation to their science and cumulative GPAs at four criterion points: preadmissions and after their second, third and fourth semesters of enrollment respectively. Multiple regression analysis yielded validity evidence for the NCQ in predicting science and cumulative GPAs for the nontraditional premedical students in this sample. Implications for admissions as well as programmatic intervention are discussed.

V9-4-1

The Limitations of Traditional Variables in Predicting the Progress of Nontraditional Students

Evelyn W. Jackson, Ph.D. and Shirley McGlinn, M.S.

Abstract -- The purposes of this study were: 1) to apply a model that discriminated among nontraditional medical students who graduated on schedule, graduated off schedule, and did not graduate to another group of nontraditional students to predict their progress in medical school, and 2) to determine if any of the traditional application credentials predicted whether students graduated on schedule, graduated off schedule, or did not graduate. The nontraditional students in this study, former participants in the Medical/Dental Education Preparatory Program (MEDPREP), matriculated into 21 medical schools. Preadmissions credentials used as predictor variables were total undergraduate GPA, the six MCAT subtest scores and the MEDPREP Student Progress Committee recommendation. The dependent variables were the three graduation categories: on schedule, off schedule, and not graduate.

A discriminant model was developed using the preadmissions variables for 61 students who enrolled in medical school from 1978 through 1983 (Group I). When the model was applied to classify 47 students who entered medical school from 1984 through 1987 (Group II) and the 3 graduation categories, sixty-three percent of those currently on schedule were classified as being off schedule or out of school. When the preadmissions data for students in Group I were entered into a stepwise discrimination model, the MCAT Reading score was the only significant predictor of whether these students graduated on schedule, off schedule, or did not graduate. The reading score accounted for 26 percent of the variance in graduation.

The findings that 74 percent of the variance in graduation categories was not accounted for by the traditional preadmissions data for students in Group I and that more than 60 percent of the students in Group II are doing better than predicted by the discriminant model emphasizes the limitations of using traditional admissions variables in predicting progress of nontraditional students. Other variables that contribute to the prediction of progress of nontraditional students should continue to be investigated and used by admissions committees in making decisions about students.

V10-3-1

The Relationship of Minority Students’ MCAT Scores and Grade Point Averages to Their Acceptance into Medical School

Kathleen B. Lynch, Ph.D., and Moses K. Woode, Ph.D.

Abstract — The authors identified relationships between quantitative academic variables — specifically, grade-point averages (GPAs) and Medical College Admission Test (MCAT) scores — and the admission decision of 58 students from minority groups underrepresented in medicine. These students had participated in a summer enrichment program at the University of Virginia School of Medicine and has applied to medical school. A total of 49 of the students were offered admission, and ultimately enrolled in 17 different medical schools. Results of a stepwise multiple regression analysis indicated that scores on the Skills Analysis: Quantitative Subtest of the MCAT explained the greatest percentage of the variance related to medical school admission (26%); scores on the Skills Analysis: Reading Subtest contributed an additional 7% to the explained variance, and scores on the Physics Knowledge Subtest, another 5%. The overall GPAs did not contribute significantly to the explanation of the variance in admission decisions. These results differ from published findings based on data from minorities’ admissions to individual institutions. Caution must therefore b exercised when using GPAs and MCATs as medical school admission predictors for students from minority groups.

V11-3-2

Minorities and Women in Medicine: Issues and Challenges for the Nation and for Health Professions Advisors

Levi C. Adams, M.S.

Introduction and Background

It is impressive that well over 95 percent of the students who enter U.S. Medical school obtain their degrees. A sense of what is possible is gained when it is noted that the underrepresented minority enrollment in U.S. medical schools first year class increased from 292 (3.0%) in 1968-69 to 1,744 (10.3%) in 1990-91. The numbers of minority graduates increased from 264 (2.8%) in 1971-72 to 1,268 (8.2%) in 1989-90. Similarly promising is the enrollment of women in the first year of medical school. This has increased from 876 (9.0%) in 1968-69 to 6,153 (38.5%) in 1990-91. The number of women graduates has increased from 861 (9.0%) in 1971-72 to 5,231 (34.0%) in 1989-90. Health professions advisors have played an important role in influencing this success. So, it is appropriate to acknowledge, with gratitude, all that the advisors have done to help the nation to produce dentists, optometrists, pharmacists, physicians, podiatrists, veterinarians and others who serve the health needs of our nation.

It is reasonable to assume that some advisors took risks (or at least what were thought at the time to be risks) to make these accomplishments possible. The question of "risk-taking" is important in the context of today’s discussion because it recognizes that there may not be the question of whether the student being recommended is capable, but rather that the perception of colleagues and some other students will be that the student is not deserving. A decision to stick by the guns, to eschew conformance, and to invite criticism is risk-taking. Risk-taking is important because it pertains to the potential for reward. These rewards have to do with the needs of the nation and the potential contribution that minority and women health professionals can make to addressing these needs.

Despite success in getting students admitted who complete medical school at a remarkably high rate, America’s health status overall is only slightly better than it was twenty-five years ago. And, alarmingly, the disparity between the health status of minorities and that of the non-minority population keeps widening as time goes by. This growing gap, which sometimes reflects itself in statistics similar to those of developing nations, has far-reaching implications for America: educationally, economically and politically. None of us, health professions advisors included, can afford to bask in the glow of past accomplishments, because failure to rise to the challenges of a changing national demography is likely to leave us outside the mainstream of a new world order.

Following are some of the challenges which face health professions schools and health professions advisors as America seeks to enhance the effective participation of minorities and women in the health professions.

V12-1-3

The Honors Premedical Academy: Increasing Access to Medical Careers

Zenaido Camacho, Ph.D., William A. Thomson, Ph.D., Ronald L. Sass, Ph.D., Linda P. Driskill, Ph.D. and James P. Denk, M.A.

To increase the representation of minority citizens in medicine, The Robert Wood Johnson foundation in 1988 awarded Baylor College of Medicine and Rice University a grant to enhance opportunities for high-ability minority college students to access medical school. The resulting Honors Premedical Academy provides information, enrichment and academic instruction to selected applicants during a six-week summer program. Through the first two program years, 1989 and 1990, 236 students representing 23 states participated in the Academy. Most of these reported that the experience was rewarding and beneficial to their pursuit of medical education.

V12-1-4

Correlation Between Scores on the Medical College Admissions Test and the Developing Cognitive Abilities Test for Minority and Disadvantaged Premedical Students

Paul Henry and Harold R. Bardo

Abstract — The relationship of students' performance on the Developing Cognitive Abilities Test (DCAT) , a test of scholastic aptitude, and their subsequent performance on the Medical College Admission Test (MCAT) were examined for 89 nontraditional premedical students who participated in a medical educational preparatory program.  A stepwise multiple regression analysis produced moderate, though significant, multiple correlations among subscores on the two tests.  All of the subscores on the DCAT made a significant contribution to the regression equation in the prediction of scores on MCAT subtests.  Implications for the value of the DCAT as an admissions tool, as well as providing possible intervention, are discussed.  

V16-3-1

Fussell’s Folly: Academic Standards and the Case of Mary Putnam Jacobi

Carol B. Gartner, Ph.D.

Abstract — In 1864, Dean Edwin Fussell of the Female Medical College of Pennsylvania tried to prevent Mary Putnam (later the eminent physician Mary Putnam Jacobi) from graduating. He claimed she had not fulfilled the requirements, and that granting her degree would give critics ammunition for their charges that a medical school for women debased the standards of the profession. In his writings and speeches both before and after this incident, Fussell made clear his belief that women in medicine should be held to higher and stricter standards than those applied to men in order to win acceptance. Fussell’s case against Putnam, documented in the Minute Books of the Faculty and Board of Corporators of the college, was resolved, but this conflict raises larger issues. According to evidence in these records and the words of Fussell and those who knew him, Fussell emerges as a weak individual in a position of power in a weak institution who understood only quantitative measures of competence. This leads to the proposition that weak leaders in weak institutions today may continue to impose disparate standards on women and thereby adversely affect their careers.  Acad. Med. 1996;71:470-477

V17-1-2

Identifying Qualified Underrepresented-Minority Students who Otherwise Appear to be at Academic Risk

Lon J. Van Winkle, Ph.D., and Peter A. Perhac, Ed.D.

Purpose. To determine whether an academically intense program simulating six weeks of medical school could identify underrepresented-minority students at apparent academic risk who might actually have the time-management and other skills needed to succeed in medical school.

Method. In the summer of 1995, 16 premedical students from minorities underrepresented in medicine participated in a six-course, six-week program at the Chicago College of Osteopathic Medicine. Academic credentials prior to participation in the program and performances in the program were compared for students subsequently offered or denied admission to the Chicago College of Osteopathic Medicine. Statistical methods included use of Student’s t-test and Pearson correlation coefficients.

Result. Of the 16 participants, eight passed at least five courses and were accepted for early admission to the medical school; seven failed two or more courses and were denied admission; and one did not complete the program. The accepted and denied groups could be distinguished statistically by their overall performances in the program and their performances in four of the six courses, but not by their performances prior to the program: the accepted students had a mean grade-point average of 2.68, SEM, 0.07, versus 2.66, SEM, 0.07, for the denied students, and a mean total Medical College Admission Test score of 16.2, SEM, 0.5, versus 17.0, SEM, 0.7.

Conclusion. Programs such as the one at the Chicago College of Osteopathic Medicine might be relatively inexpensive ways for medical schools and underrepresented-minority students at apparent academic risk to learn whether the students are, nevertheless, prepared to succeed academically in medical school.

Acad. Med. 1996;71:508-510

V17-1-3

Effect of an Intensive Educational Program for Minority College Students and Recent Graduates on the Probability of Acceptance to Medical School

Joel C. Cantor, Sc.D., Louis Bergeisen, M.A., and Laurence C. Baker, Ph.D.

Context: Increasing the number of minority physicians is a long-standing goal of professional associations and government.

Objective: To determine the effectiveness of an intensive summer educational program for minority college students and recent graduates on the probability of acceptance to medical school.

Design: Nonconcurrent prospective cohort study based on data from medical school applications, MCATs, and the Association of American Medical Colleges Student and Applicant Information Management System.

Setting:  Eight U.S. medical schools or consortia of medical schools.

Participants:  Underrepresented minority (black, Mexican American, mainland Puerto Rican, and American Indian) applicants to U.S. allopathic medical schools in 1997 (N=3830), 1996 (N=4654), and 1992 (N=3447).

Intervention:  The Minority Medical Education Program (MMEP), a six-week, residential summer educational program focused on training in the sciences and improvement of writing, verbal reasoning, studying, test taking, and presentation skills.

Main Outcome Measure: Probability of acceptance to at least 1 medical school.

Results: In the 1997 medical school application cohort, 223 (49.3%) of 452 MMEP participants were accepted compared with 1406 (41.6%) of 3378 minority nonparticipants (P=.02). Positive and significant program effects were also found in the 1996 (P=.01) and 1992 (P=.005) cohorts and in multivariate analysis after adjusting for nonprogrammatic factors likely to influence acceptance (P<.001). Program effects were also observed in students who participated later and among those with relatively high as well as low grades and test scores.

Conclusions: The MMEP enhanced the probability of medical school acceptance among its participants. Intensive summer education is a strategy that may help improve diversity in the physician workforce. JAMA. 1998;280:772-776.

V20-2-1

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