Department of Medical Education Tufts University School of Medicine, Boston, Massachusetts, USA.
Department of Surgery and Emergency Medicine, Albany Medical Center, Albany, New York, USA.
Med Educ Online. 2022 Dec;27(1):2010291. doi: 10.1080/10872981.2021.2010291.
Many U.S. medical schools conduct holistic review of applicants to enhance the socioeconomic and experiential diversity of the physician workforce. The authors examined the role of first-generation college-graduate status on U.S. medical school application, acceptance, and matriculation, hypothesizing that first-generation (vs. continuing-generation) college graduates would be less likely to apply and gain acceptance to medical school.Secondary analysis of de-identified data from a retrospective national-cohort study was conducted for individuals who completed the 2001-2006 Association of American Medical Colleges (AAMC) Pre-Medical College Admission Test Questionnaire (PMQ) and the Medical College Admissions Test (MCAT). AAMC provided medical school application, acceptance, and matriculation data through 06/09/2013. Multivariable logistic regression models identified demographic, academic, and experiential variables independently associated with each outcome and differences between first-generation and continuing-generation students. Of 262,813 PMQ respondents, 211,216 (80.4%) MCAT examinees had complete data for analysis and 24.8% self-identified as first-generation college graduates. Of these, 142,847 (67.6%) applied to U.S. MD-degree-granting medical schools, of whom 86,486 (60.5%) were accepted, including 14,708 (17.0%) first-generation graduates; 84,844 (98.1%) acceptees matriculated. Adjusting for all variables, first-generation (vs. continuing-generation) college graduates were less likely to apply (odds ratio [aOR] 0.84; 95% confidence interval [CI], 0.82-0.86) and be accepted (aOR 0.86; 95% CI, 0.83-0.88) to medical school; accepted first-generation college graduates were as likely as their continuing-generation peers to matriculate. Students with (vs. without) paid work experience outside hospitals/labs/clinics were less likely to apply, be accepted, and matriculate into medical school. Increased efforts to mitigate structural socioeconomic vulnerabilities that may prevent first-generation college students from applying to medical school are needed. Expanded use of holistic review admissions practices may help decision makers value the strengths first-generation college graduates and other underrepresented applicants bring to medical educationand the physician workforce.
许多美国医学院校对申请人进行整体评估，以提高医生队伍的社会经济和经验多样性。作者研究了第一代大学毕业生身份对美国医学院校申请、录取和入学的影响，假设第一代（而非连续代）大学毕业生申请和获得医学院录取的可能性较低。对回顾性全国队列研究的匿名数据进行二次分析，针对完成 2001-2006 年美国医学协会（AAMC）医学院预科入学考试问卷（PMQ）和医学院入学考试（MCAT）的个人进行分析。AAMC 通过 2013 年 6 月 9 日提供医学院申请、录取和入学数据。多变量逻辑回归模型确定了与每个结果相关的人口统计学、学术和经验变量，并确定了第一代和连续代学生之间的差异。在 262813 名 PMQ 受访者中，有 211216 名（80.4%）MCAT 考生有完整数据进行分析，其中 24.8%自认为是第一代大学毕业生。在这些人中，有 142847 人（67.6%）申请了美国 MD 学位授予医学院，其中 86486 人（60.5%）被录取，包括 14708 名（17.0%）第一代毕业生；84844 名（98.1%）被录取者入学。在调整所有变量后，第一代（而非连续代）大学毕业生申请医学院的可能性较低（优势比[aOR]0.84；95%置信区间[CI]，0.82-0.86），被录取的可能性也较低（aOR 0.86；95%CI，0.83-0.88）；被接受的第一代大学毕业生与他们的连续代同龄人一样有可能入学。有（而非没有）医院/实验室/诊所以外有偿工作经验的学生申请、被接受和入学的可能性较低。需要加大力度减轻可能阻止第一代大学生申请医学院的结构性社会经济脆弱性。扩大使用整体评估招生做法可能有助于决策者重视第一代大学毕业生和其他代表性不足的申请人为医学教育和医生队伍带来的优势。
