NORTH AMERICA

How to improve selection for professional schools
Every year, students around the world will spend countless hours and even significant amounts of money optimising their applications for professional schools. This is a stressful time for students as they face academic and career uncertainty.The stakes are even higher for institutions. Traditional screening tools are rife with implicit bias yet have been used for decades to select ‘top’ candidates. Furthermore, selecting ill-suited applicants has far-reaching consequences for the institution and the public at large. Headlines about professional misconduct by a lawyer or a malpractice lawsuit brought against a dentist are all too common.
Diversity thwarted
The need for reform in the admissions process has been acknowledged for a long time. In medical school selection, for example, during the 1960s the emphasis was on academic aptitude and achievement, while in the ’70s and ’80s attention shifted to personal qualities and selecting applicants more for medical practice than for medical school survival.
Even at that time concerted efforts were made to broaden the socio-economic diversity of entering classes. However, recent studies show that these efforts have not been as successful as hoped.
A recent study by our research team found that almost one third of those accepted come from households making more than US$120,000 per year, while only 9% of the general population in the United States makes over US$100,000 per year. A concerning finding was that 75% of future doctors were primarily motivated to apply to medical school by status, financial gain or familial tradition, which will only perpetuate the above trends.
The majority (54%) of respondents in the study identified as Caucasian, with 39% of those coming from families earning over US$120,000 per year, the highest proportion of all groups.
Importantly, none of the current admissions screening tools such as standardised testing, personal statements, situational judgment tests and interviews or mini-interviews were immune to the observed bias. In another independent study, we found almost identical trends in Canada.
The medical school community is aware of this persisting problem. In 2016 a Harvard report urging reforms in the admissions process garnered endorsement from more than 50 institutions. Even as far back as 2012, the Association of American Medical Colleges outlined an admissions initiative aimed at transitioning to ‘competency-based admissions’. This would mean focusing on specific interpersonal competencies.
In practice, however, very little progress has been made. Several Canadian schools have phased out autobiographical essays. Some medical schools no longer require the Medical College Admission Test or MCAT.
The Icahn School of Medicine at Mount Sinai in New York has had a Humanities and Medicine Early Acceptance Program, which allows approximately 35 undergraduate students who study the humanities, rather than the sciences, an opportunity to pursue medical studies.
Outdated practices
Despite these minor steps in the right direction, the majority of schools fall back to outdated admissions practices that are permeated with inherent bias and inevitably introduce barriers to underrepresented minorities and lower socio-economic status applicants.
To promote diversity while selecting the best applicants, diversity advocate and admissions researcher, Dr Behrouz Moemeni, has a radical proposal. He has identified several scientifically proven strategies that institutions should consider adopting to screen the entire pool of applicants.
Current selection practices filter most applicants before the interview stage, thus drastically reducing the talent pool. But technology can dramatically reduce the time and cost of interviewing an applicant and allows the quantification of key attributes:
- • Select applicants based on their motivation for the job. Motivation predicts future behaviour. The intrinsically motivated individual is moved to act by interest, curiosity or the sheer enjoyment of doing the activity itself, while extrinsic motivation refers to the desire to engage in an activity to achieve status and-or financial gain and to avoid social pressure or through fear of being judged. Studies continuously show that intrinsically motivated individuals have comparatively more interest, excitement and confidence, which results in enhanced performance, persistence, creativity, self-esteem and general well-being.
- • Assess coachability. The ability to accept and adapt to constructive criticism can be more valuable than capability for the job.
- • Pay attention to conscientiousness. Successful individuals share the five characteristics of conscientiousness: attention to detail, industriousness, organisation, diligence and prudence. Selecting conscientious applicants ensures your future professionals are organised, responsible and plan ahead.
- • Eliminate written applications, situational judgement tests and in-person interviews. Written applications can be deceiving and situational judgement tests and mini-interviews are vulnerable to gender and socio-economic bias.
- • Rule out ‘back-up’ candidates. Often applicants apply to programmes that are not their top choice to have a back-up plan. The costs included in replacing an applicant include: cost of screening and selecting a new person, lost productivity, lost engagement and an increase in errors.
- • Identify untruthful statements in applications. Estimates of individuals who exaggerate their applications range from 40-70%. People think it is more acceptable to lie to an employer than to a romantic partner and 95% of one sample were willing to lie to get a job.
- • Circumvent inherent bias. Bias can present at every step of the selection process whenever people are involved. A male name is significantly more likely to receive an interview or an offer than the identical application with a female name. An English-sounding name is more likely to receive an interview than an ethnic-sounding one. The overall effect is a narrowing of the talent pool. Masking gender and cultural identifiers and using strict assessment rubrics can help avoid bias pitfalls.
- • Impose time limits. Timing applicant responses can ensure genuine answers and gauge critical thinking.
- • Use multiple raters. Reduce interviewer bias by considering multiple interviewers. Interviewer reliability can be increased with a carefully structured and optimised scoring rubric.
- • Use a robust numeric scoring system. Numeric scales can also help eliminate bias by preventing resorting to intangible, ‘gut feeling’ ranking. High resolution ranking scales like Likert scales offer higher resolution.
- • Weigh references wisely. The identity and validity of the referee and reference is rarely confirmed and it is often difficult to do so. A more sophisticated admission process could involve asking for a chronological list of individuals who have acted as supervisors, bosses or colleagues and randomly sampling a number to contact.