Competency-Based Admissions: Numbers Alone Don’t Predict the Best Doctors

A few years ago, the Association of American Medical Colleges encouraged medical schools to adopt a holistic approach to admissions, the goal being the acceptance of students who might bring a different kind of intelligence to medicine beyond that which can be measured by the usual metrics of grades and MCAT scores.

What is that intelligence, and how can we recognize it? It’s emotional intelligence, evidenced by the ability to work as a member of a team, to show leadership skills when necessary, to appreciate and be sensitive to the myriad cultures with which we now intermingle and to listen, empathize and communicate with patients and their families in a manner that is professional and compassionate. Grades and MCATs do not provide us with a look into the heart and mind of an applicant.

Albert Einstein College of Medicine has been practicing holistic admissions for as long as we can remember, and we suspect many of our colleagues have too. The difference now is that Einstein wants to make it clear to applicants that humanism is as important as learning the Krebs cycle, and that co-curricular activities, relevant clinical experiences, communication skills and personal and professional development are now requirements.

Many students who are sincerely motivated to be good doctors never get the chance because of a historical emphasis on grades that might foretell only a student’s possible USMLE scores, not his or her potential to practice compassionate and empathic medicine. Students who may have underperformed at the undergraduate level for any number of reasons may show evidence at the time of application that medicine is their niche, and may become excellent physicians as a result of their extraordinary motivation. Moreover, many students do not have the financial wherewithal to take prep courses that provide a leg up on standardized exams, and some cannot finish a degree because of the cost of tuition.

To provide those students with a 21st-century solution, Einstein will accept online courses, courses taken abroad and real-life laboratory experience in lieu of course work taken in a college. (See Einstein’s website for specific information.) While this new approach appears to relax the old boilerplate requirements, applicants still need to be up to the task of medical school and come well prepared with a strong foundation in biochemistry, genetics, computer science, public health and statistics.

The competency-based admissions approach goes hand in hand with our educational competencies, which include seven precepts: healer, scientist, advocate, educator, colleague, role model and lifelong learner. We will continue to look at grades and MCAT scores, but our decision regarding each applicant will be made alongside his or her life experiences, and we will try to determine who, among more than 8, 000 yearly applicants, will be the kinds of people we would want for our own doctors.

To view the original blog entry, check out “”The Doctor’s Tablet”” here.