Holistic Review, An Exciting Trend in Medical School Admissions

Over the past few months I've come to realize that there are quite a number of schools that employ holistic review as a part of their admissions process. While this is a huge step in the right direction (in my opinion!) the problem is that it's difficult to find a lot of information on exactly which schools participate. To remedy this, I did some research on my own and came up with a pretty impressive list.

First though, a bit about what holistic review is. This NEJM article which I posted previously states that the process "emphasizes attributes, including learning ability, that are associated with excellence in physicians. Applicants are evaluated according to criteria that are institution-specific, mission-driven, broad-based, and applied consistently across the entire applicant pool at a given school." That's kind of a mouthful!

Basically, holistic review considers the achievements of each applicant in context of their life experiences. It's a way of looking at an applicant as an individual and giving equal consideration to the many qualities that may contribute to their success in the medical field rather than just their MCAT scores and GPA. In particular, "adversities overcome, challenges faced, advantages and opportunities encountered, and the applicant's demonstrated resilience in the face of difficult circumstances" are all considered impactful and are assessed in this comprehensive approach.

I think the fact that this trend is gaining momentum is fantastic for several reasons. One is that we belong to an incredibly diverse society. America is a "melting pot," to borrow from popular vernacular, and our society consists of people from countless walks of life. Our physician population needs to reflect this diversity in order to deliver a higher standard of patient care. I feel particularly strongly about this as the daughter of an immigrant parent from Portugal who has only ever met one Portuguese, female doctor in her entire life.

Secondly, holistic review allows for greater consideration of nontraditional applicants. A student involved with exciting and challenging work or research but with minimal clinical experience may have cultivated vital qualities that will make them an amazing doctor. When you take the time to evaluate this student on the basis of all his experiences, you may see something in him that you might not see in a student who has a lot of volunteer experience but has never had to handle the responsibilities of being in the workforce.

Finally, there seems to be a dearth of physicians nowadays practicing medicine who are not very good doctors. I mean that in the sense that they can't connect, they aren't warm or caring, and they're ultimately unable to deliver proper care to their patients. I can think of over a dozen times I've talked with family members or friends who had a horrible experience at a hospital or with their primary care physician because their doctor simply didn't listen, didn't want to help or was just plain rude. I think that when looking for someone who will make a good future doctor, attributes like their ability to interact with their peers, cultivation of leadership skills, and demonstrated care for others are just as important as a good academic record.

Boston University, mentioned in the NEJM article as a pioneer school to transition from a more traditional admissions model to a holistic approach, is just one of the many schools I found that either explicitly state or otherwise imply that they are utilizing holistic review. In 2010 the AAMC launched a project on "Integrating Holistic Review Practices into Medical School Admission Processes." I came across this report that they published as a result and was impressed by the amount of information and the schools that participated. I won't go into the details because I think it's an important read but I will say that it's refreshing to see the amount of work that's being put into changing the way medical school admissions work (for the better!).

To make my list, I included all of the schools that were a part of the AAMC advisory committee and working group as well as all the schools that I've come across on my own that mention they employ holistic review. While it is by no means complete (I didn't look at every single school in the US), it is fairly large and I hope will be helpful. If you know of any others, please feel free to comment and I will add them! I update this list every application cycle so feedback is greatly appreciated.

Non-official list of medical schools using holistic review (31 total):

AAMC Advisory Committee on Holistic Review (12 schools)

1. University of Washington School of Medicine

2. Rush University Medical Center 

3. Pennsylvania State University College of Medicine

4. University of Arizona College of Medicine

5. University of Miami

6. Duke University School of Medicine

7. Oregon Health & Science University

8. George Washington University School 

of Medicine & Health Sciences

9. Johns Hopkins University

10. Boston University School of Medicine (three cheers for my alma mater!) 

11. Medical College of Georgia

12. University of Colorado at Denver and 

Health Sciences Center

AAMC Medical School Admissions Workshop Working Group (9 schools not on above list)

1. University of Texas Medical School

2. Tulane University School of Medicine

3. Creighton University School of 

Medicine

4. Mayo Medical School

5. Weill Medical College of Cornell University

6. Wayne State University School of Medicine

7. Geisel School of Medicine at Dartmouth 

8. University of Wisconsin Medical School

9. University of Iowa Carver College of Medicine

Additional Schools (10 schools)

1. New York Medical College

2. Oakland University William Beaumont School of Medicine

3. UC Davis School of Medicine

4. Drexel University College of Medicine

5. Florida Atlantic University Charles E. Schmidt College of Medicine
6. Rosalind Franklin University of Medicine & Science
7. Stony Brook University Medical School
8. University of Vermont College of Medicine
9. East Tennessee State University Quillen College of Medicine
10. Temple University

Ascovime USA - Part Deux

Hey everyone, I know this is sort of a repeat post but Mike (who is in charge of all the Ascovime USA efforts and who I've been working with to get the word out about the organization) wrote up a lovely piece about his volunteer experience in Africa and Dr. Bwelle's mobile clinic and I wanted to share! Check it out here.

AMCAS 2014 - Submitted!

Boom. I am already having separation anxiety. I hope everything goes through smoothly!

Me from now until I (hopefully!!) get into medical school

Ascovime USA

I can't believe it's taken me this long to write about such a fantastic project! I've been involved with Ascovime USA for several years through one of their former volunteers who still works closely with the organization. Together we've worked to publicize and raise support for the work that's being done by this wonderful non-profit. Here is a link to their website that I help to maintain where you'll find a history of the project along with more recent information about plans for the future
To provide a little background: Ascovime was started by a Cameroonian surgeon, Dr. Georges Bwelle, who wanted to serve the people in rural villages around his country by providing much-needed healthcare. Every weekend during the rainy season, joined by several volunteers, Dr. Bwelle loads up his van with medical supplies and travels to areas that don't have access to a doctor to set up improvised clinics where he treats patients.
Over the years Ascovime has grown to provide more than just healthcare and has started several off-shoot endeavors to support the development and independence of the Cameroonian people. Their latest enterprise, Project Education, is an effort to provide birth certificates for children so they can attend school (in Cameroon a birth certificate is required to receive an education but many families can't afford the $16 US equivalent that it takes to get one).
Volunteers are warmly welcomed on the project and are given the amazing opportunity to work with Dr. Bwelle in the field. I've personally wanted to go to Cameroon ever since I first found out about the possibility  and am hoping that next year I may finally get to go (I'll definitely need to brush up on my French)!
In closing, Ascovime is amazing and deserves your support for so many reasons, the people involved work tirelessly to help the poor and destitute with no thought of recognition or reward. They do it because they care and because they're helping make the world a better place. I am thrilled to be able to help them in a small way by getting word out about this very special cause. I can't wait to volunteer myself and experience the ability to make a difference in a real and tangible way.
If you want to contribute, please consider donating to Ascovime through the website linked to above. If you are unable to donate financially then please repost or retweet  a link to this story so that we can get the word out. Every little bit helps enormously!

Thanks!

1500 Pageviews!

Yesterday I hit 1500 pageviews thanks to YOU awesome readers. It's so exciting to see that people are actually checking out my posts. So THANK YOU ALL for reading, sharing links, and telling friends about this blog :)

Poster for BWH Clinical Innovation Day!

Here is my masterpiece! This little baby took a veeeerrryy long time to get it to look as pretty as it is now so I hope y'all appreciate!

The information presented can be confusing if you don't work with EHRs or in informatics currently so hopefully this brief summary helps. Basically, this was a multi-center project to evaluate the efficacy of the little alerts that pop up in electronic medical record systems when a physician is ordering drugs and there is an interaction. Most systems have interruptive alerts which require action from the user before they can proceed. These measures are implemented on most EMRs so that physician error can be reduced. You can't expect doctors to remember every drug their patient is allergic to or all the drugs that interact adversely so this information is logged in the system. The problem is that many physicians simply ignore the alerts because they get so many of them. Our job is to find an alert design that adheres to a set of guidelines that determine easy uptake by the user. For example, alerts that are color coded based on the level of danger are more useful than alerts that are all one color. This study evaluated alerts from 14 different systems and then ranked them based on how well they did and the result is this poster!

Let me know if you have any questions or comments! I always enjoy talking about my project (probably too much, actually. I must really bore people but oh well, they're learning something!).

BWH Clinical Innovation Day Event!

Ah I know I have been sadly neglectful but I'm taking time from my stupidly busy schedule to write about a fantastic event I was lucky enough to be a part of yesterday so I hope this will serve as my apology.

Brigham & Women's Hospital put on an Clinical Innovations Day yesterday which consisted of an afternoon of panel discussions and a poster session. The poster session was really the highlight because my PI and I submitted an abstract for a poster and it was accepted! Since I was the one who really pushed for us to submit in the first place, I was graced with the responsibility for sending everything in and then revising and getting our poster printed (which turned out to be a lot more time-consuming than I had expected). I'll post a little summary and graphic of our finished product tomorrow because I don't have as much time as I want now to go into the gory details).

At the event I was able to attend all of the afternoon talks which focused on innovation and were all extremely exciting. Some highlights included connected health ideas such as using devices and IT innovation to improve patient care, a talk on support for high-risk pregnant women, a genetics mapping program that provided mutational profiling for every BWH cancer patient, and a recently developed app for the Longitudinal Medical Record at Brigham that allows doctors to add pictures to patient health records.

There was also a panel titled "The Innovator's Journey" that I felt was able to dole out some wisdom that could be applied to many endeavors, including getting into medical school. The panel consisted of four doctors who had made considerable contributions to the clinical field and each stood for a few minutes to discuss how they had gotten to their final product. It was enlightening to see that for many of them, the road to success was a rocky one. Dr. Orgill, who had worked on developing a breakthrough synthetic skin replacement for use by plastic surgeons was very frank when he explained that, had he known how long and how difficult it would be to get to where he was today, he would have given up long ago. He went on to say that maybe that is the saving grace of focusing on the now. If you only concentrate on one thing at a time, you don't get overwhelmed by the big picture. He argued that doing things logically wasn't an option because when you look at a difficult goal overall you see how crazy it is. I think this struck a chord with me because this is the attitude I try to have about becoming a doctor. The idea is kind of far-fetched, there are lots of deterrents and if I looked at it with a calculating eye then my chances are low. But the point is that you can't think like that, you have to take everything one step at a time, take disappointments or triumphs as they come and forge ahead.

Overall the day was a great learning experience for me, I got to present my first poster (I stood in for my PI which was a lot of responsibility but I think it came off well) and I was able to meet some very interesting new people and discuss my work which I always love to do. During the talks these words resonated with me: "we all became physicians to make a difference...doing research has an impact on a great number of patients' lives." At the end of the day I think it helped me to remember why I'm doing the kind of work I do, why I enjoy being involved in the medical research field and what I'm working towards.