Increasing the Diversity of Medical Students with an Admissions Test

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New research from Altus Assessments shows how a new medical school admissions test, CASPer, can be a path to increasing student diversity

Diversity in Medicine

Schools have and still continue to rely predominantly on GPA and the MCAT, which have been shown to restrict diversity as they have been shown to be related to race, ethnicity, and socioeconomic status.

In a joint effort with leading researchers from McMaster University and New York Medical College, Altus Assessments has published new research in an academic journal, Academic Medicine, demonstrating how the inclusion of a new admissions test, CASPer, can have the potential of increasing the racial and ethnic diversity of incoming medical students.

Although the promotion of diversity has been an important goal across medical schools for quite some time, racial and ethnic minorities remain underrepresented in medicine relative to their proportion of the U.S. population. According to data from the American Association of Medical Colleges in 2015, African-Americans comprise 13 percent of the U.S. population but only account for 5.6 percent of 2016-17 medical school graduates. The gap is even wider for Hispanic/Latino-Americans who represent 18 percent of the U.S. population, yet represent only 5.1 percent of 2016-15 medical graduates. In order for us to tackle the health disparities that continue to persist in society, we must ensure that the diversity of the physician workforce reflects the increasing diversity of the patient population they serve.

Part of the problem lies in the medical school admissions process, which disproportionately admits few underrepresented racial/ethnic minority (URM) and lower socioeconomic status (SES) students. Schools have and still continue to rely predominantly on GPA and the MCAT, which have been shown to restrict diversity as they have been shown to be related to race, ethnicity, and socioeconomic status. With increasing costs of education, test preparation courses, and application fees, students from disadvantaged backgrounds have a growing hurdle to overcome to pursue a career in medicine.

In a recent study based on 9,096 applicants to New York Medical College, we demonstrated that the inclusion of a non-cognitive or soft skills assessment, CASPer, can alleviate some of the issues with traditional academic assessments. CASPer complements the existing admissions process by providing schools with insights into the applicants’ people skills alongside their cognitive abilities. By the end of the 2018-2019 application cycle, over 70% of all medical school applicants in the U.S. have completed CASPer at some point during their application process.

An additional advantage of non-cognitive assessments like CASPer is that they tend to have less of a harmful impact on diversity than cognitive assessments, making them an attractive avenue for medical schools to increase diversity. In the study, we demonstrated that the differences in scores on CASPer across various racial/ethnic groups and SES backgrounds were substantially smaller than was observed for GPA and the MCAT. Additionally, a subsequent simulation study demonstrated that the inclusion of CASPer in the decision process alongside MCAT and GPA can increase the number of racial and ethnic minority applicants who are invited to the interview, which will ultimately impact the demographic composition of the student population.

In response to legislation restricting the consideration of race and ethnicity in the admissions process across multiple states and most recently, in Texas, medical schools are seeking ways in which they can increase the diversity of their student population without having direct access to applicant race and ethnicity. Our study suggests that one such avenue is to include assessments of non-cognitive attributes in the medical school admissions process to mitigate the harmful impact of traditional academic metrics on diversity.

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Christopher Zou
Altus Assessments
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Diana Ibranovic
since: 05/2015
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