A8 FOLIO O THEGLOBEANDMAIL | TUESDAY,JULY30,
H
ave you ever used a food bank?
Were you raised by a single parent?
What was your family income in
the second decade of your life? And
how should the answers to those questions
influence who gets into medical school?
Medical schools used to say their job was
to find the best and the brightest. But the
selection method, based on grade-point av-
erages, the Medical College Admission Test
(MCAT) and a face-to-face interview, has re-
sulted in classes that fall short of some uni-
versities’ goals for racial and socio-economic
diversity.
Now, some schools are asking if the proc-
ess is truly fair, and if not, how it ought to
change. Across Canada, medical schools are
taking steps to shape incoming classes by of-
fering advantages to applicants from certain
demographic groups.
In a given year, only 10 per cent to 20 per
cent of applicants are admitted. Many
schools could probably choose a similarly ca-
pable cohort from among the applicants
they reject. But finding the right demograph-
ic mix is increasingly an important concern.
Medical schools in Canada exercise over-
whelming influence over admission to the
profession. About 75 per cent of physicians inthis country are Canadian graduates, so the
process by which admissions decisions are
made is crucial not only to the applicants but
to society as a whole. They shape the future
of health care.
At the University of Manitoba, the admis-
sions committee studied years of data and
found a pretty clear pattern: Wealthy white
students from big cities were more likely to
be interviewed and more likely to get in,
partly because of built-in advantages. As un-
dergrads, they don’t have to work part-time
to pay for school, they’re able to pay for
MCAT prep courses and, in interviews, they
can cite an impressive range of travel and
volunteer experiences.
The result is that a public university’s sys-
tem seems to ensure opportunity for the al-
ready fortunate.
Bruce Martin, the U of M’s dean of admis-
sions, set out to tinker with the crucial first
stage of the admissions process so that more
applicants from different backgrounds got
through. He knew he could do so by system-
atically boosting scores based on certain at-
tributes or experiences. But which attributes
to target?
He convened a panel of people from out-
side the university with experience in race
relations and alleviating poverty and asked
them to consider how the medical school
could diversify its student body.
They decided to add a section to the appli-cation that would elicit the information they
sought. They came up with more than 30
questions, many of them deeply personal
and revealing, including factors such as vis-
ible-minority status, sexual orientation, in-
volvement with the child-welfare system and
living with family members who suffer from
addiction.
The committee then ranked each question
based on the perceived level of disadvantage
suffered by the applicant. Should having a
family member with a disability be a greater
consideration than whether your parents
graduated from university, or having a child-
welfare file?
The numerical values assigned to each an-
swer are combined to create an arithmetic
modifier meant to reflect the degree to which
the applicant’s background would put them
at a disadvantage in the application, Dr. Mar-
tin said. (It turns out that a history of sub-
stance abuse moved the needle more than
being a visible minority, while needing stu-
dent aid rated well below using a food bank.)
The goal was relatively modest: a 5-per-
cent increase in the number of medical stu-
dents with diversity attributes.
“We didn’t want to have a quota system.
But we want to increase the number of di-
verse individuals on an incremental basis,”
Dr. Martin said.
Other schools have set a similar goal, but
have taken a different approach. The Univer-
sity of Saskatchewan, for example, now re-
serves six of its 100 seats for applicants
whose families earn less than $80,000 a year.
At the University of Toronto, a special stream
has been created for black applicants. At Dal-
housie University in Halifax, the medical
school says it recognizes that affirmative ac-
tion is required to increase admissions of
African-Nova Scotians and Indigenous peo-
ple. And at the University of Calgary, appli-
cants from underrepresented groups are
asked to “highlight their background and ex-
periences.”
Many schools have the same goals as the
University of Manitoba, Dr. Martin said, but
are not as transparent about how they aim to
achieve a diverse incoming class.
At Newfoundland’s Memorial University,
for example, acting dean of admissions Paul
Dancey said the school takes a “holistic ap-Thepictureofhealth:
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