D. Grbic is manager, Medical Education Research, Association of American Medical Colleges, Washington, DC.
B. Gunter is lead research and data analyst, Strategic Operations and Data Services, Association of American Medical Colleges, Washington, DC.
Acad Med. 2023 Nov 1;98(11):1294-1303. doi: 10.1097/ACM.0000000000005332. Epub 2023 Oct 20.
One-third of medical school applicants attend a community college (CC), and they represent a diverse group of applicants. However, they have a lower likelihood of being accepted to medical school. Using application-level data, this study examines how an applicant's CC attendance impacts the likelihood of application acceptance and how 3 medical school characteristics moderate this association.
Data examined were from 2,179,483 applications submitted to at least one of 146 U.S. Liaison Committee on Medical Education-accredited medical schools by 124,862 applicants between 2018 and 2020. The outcome was application acceptance. The main measures were applicants' CC attendance (no, lower [> 0%-19% of college course hours], or higher [≥ 20%]) and 3 medical school characteristics: geographic region, private versus public control, and admissions policy regarding CC coursework. Multilevel logistic regression models estimated the association between CC attendance and the likelihood of application acceptance and how this association was moderated by school characteristics.
Among applicants, 23.8% (29,704/124,862) had lower CC attendance and 10.3% (12,819/124,862) had higher CC attendance. Regression results showed that, relative to no CC attendance, applications with lower (adjusted odds ratio [AOR] = .96; 95% confidence internal [CI], .94-.97) and higher (AOR = .78; 95% CI, .76-.81) CC attendance had significantly decreased odds of acceptance when the 3 school characteristics were included. Each of the 3 medical school characteristics significantly moderated the association between an applicant's CC attendance and the likelihood of application acceptance.
The negative association between CC attendance and medical school application acceptance varies by medical school characteristics. Professional development for admissions officers focused on understanding the CC pathway and potential biases related to CC attendance would likely be beneficial in terms of trying to attract and select a diverse cohort of medical students in a holistic and equitable manner.
三分之一的医学院申请者上过社区大学（CC），他们代表了一群多样化的申请者。然而，他们被医学院录取的可能性较低。本研究使用申请层面的数据，考察了申请人在 CC 的就读经历如何影响其申请被接受的可能性，以及 3 所医学院的特征如何调节这种关联。
本研究的数据来自于 2018 年至 2020 年期间，124862 名申请者向 146 所美国医学教育联络委员会认证的医学院中的至少一所提交的 2179483 份申请。结果为申请的接受情况。主要测量指标为申请人的 CC 就读经历（无、低[>0%-19%的大学课程学时]或高[≥20%]）以及 3 所医学院的特征：地理位置、私立与公立控制以及对 CC 课程的招生政策。多水平逻辑回归模型估计了 CC 就读经历与申请被接受的可能性之间的关联，以及这种关联如何受到学校特征的调节。
在申请者中，23.8%（29704/124862）有较低的 CC 就读经历，10.3%（12819/124862）有较高的 CC 就读经历。回归结果显示，与无 CC 就读经历相比，当纳入 3 所医学院的特征时，较低 CC 就读经历（调整后的优势比[OR]为 0.96；95%置信区间[CI]为 0.94-0.97）和较高 CC 就读经历（调整后的 OR 为 0.78；95%CI 为 0.76-0.81）的申请被接受的可能性显著降低。3 所医学院的特征中的每一个都显著调节了申请人的 CC 就读经历与申请被接受的可能性之间的关联。
CC 就读经历与医学院申请接受率之间的负相关关系因医学院的特征而异。为招生官员提供有关 CC 途径和与 CC 就读经历相关的潜在偏见的专业发展，可能有助于以整体和公平的方式吸引和选拔多元化的医学生群体。
