Department of Medical Education, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
Med Educ. 2015 Jan;49(1):84-92. doi: 10.1111/medu.12506.
This study aimed to evaluate a selection and programmatic intervention designated 'Conditional Admissions' (CA), which is intended to expand access to medical education for individuals from under-represented ethnic, racial and rural groups. Further aims were to establish principles of practice designed to increase access for under-represented groups based on an empirical comparison of programmatic changes made to CA in 2005, and to quantify the costs associated with its implementation.
Data for all students admitted between 1999 and 2009 (n = 3227) were compiled; these included demographic data, undergraduate college performance grades, medical school performance indicators, and information on honours, residency placement and md degree completion. To examine the outcomes of the CA intervention, students were divided into two cohorts of those admitted through the CA initiative during 1999-2004 and 2005-2009, respectively, and analysed for differences. Costs associated with CA were also calculated.
There were 274 students admitted through CA (8.5% of all admittances) during 1999-2009; of these, 81.4% were from under-represented ethnic or racial backgrounds and 18.6% were from rural backgrounds. These students had more hours of science coursework, lower science and cumulative grade point averages (GPAs), and lower mean Medical College Admission Test (MCAT) scores than non-CA students. However, first-time pass rates and mean scores on the US Medical Licensing Examination (USMLE) Step 1 and USMLE Step 2 Clinical Knowledge increased significantly in the CA cohort during 2005-2009. Additional costs incurred per student ranged between US$849 and US$3801.
Interventions such as CA can significantly increase diversity in the physician workforce. Interventions must be based on careful assessment of academic preparedness, as well as on non-academic factors that contribute to ability to successfully manage the rigors of medical education. Furthermore, the selection and subsequent professional development of students must nurture commitment to addressing the health care needs of diverse communities. Equity must be viewed as a means of increasing fairness for both prospective medical students and the residents of communities that may benefit from the eventual service.
本研究旨在评估一项名为“有条件录取”（CA）的选拔和项目干预措施，该措施旨在为来自代表性不足的族裔、种族和农村群体的个人扩大接受医学教育的机会。进一步的目的是根据对 2005 年 CA 进行的项目变更的实证比较，确定旨在增加代表性不足群体入学机会的实践原则，并量化与实施相关的成本。
编译了 1999 年至 2009 年期间所有被录取学生（n=3227）的数据；这些数据包括人口统计学数据、本科院校成绩、医学院表现指标以及荣誉、住院医师安置和医学博士学位完成情况的信息。为了检验 CA 干预措施的结果，将学生分为两个队列，分别为 1999-2004 年和 2005-2009 年通过 CA 倡议录取的学生，并对其进行分析。还计算了与 CA 相关的成本。
1999-2009 年期间，有 274 名学生通过 CA 录取（占总录取人数的 8.5%）；其中，81.4%来自代表性不足的族裔或种族背景，18.6%来自农村背景。与非 CA 学生相比，这些学生的科学课程学习时间更多，科学和累计绩点（GPA）更低，医学入学考试（MCAT）成绩也更低。然而，在 2005-2009 年期间，CA 队列的首次通过率和美国医师执照考试（USMLE）第 1 步和第 2 步临床知识部分的平均成绩显著提高。每名学生的额外成本在 849 美元至 3801 美元之间。
像 CA 这样的干预措施可以显著增加医生队伍的多样性。干预措施必须基于对学术准备情况的仔细评估，以及对有助于成功应对医学教育严格要求的非学术因素的评估。此外，学生的选拔和后续专业发展必须培养他们对解决不同社区卫生保健需求的承诺。公平必须被视为增加未来医学生和可能从最终服务中受益的社区居民公平性的一种手段。
