The application process can be a long and arduous process, and programs are constantly updating their admissions process to make sure they are getting a more holistic view of their applicants. Many programs have begun incorporating new and innovative tools like the multiple-mini interview (MMI), the Defining Issues Test (DIT), and CASPer®, to make sure that students are not only intelligent but also possess the suitable characteristics of someone who will likely succeed on the job.
Although it costs more time and money for applicants and programs, it is helpful to incorporate a variety of different tools in the admissions process to gather a more holistic view of the applicants. We know academic metrics like GPA and MCAT scores assess the cognitive competencies, which do a good job in predicting performance in medical school, particularly in the earlier years when the focus is on the completion of coursework. However, the personal competencies are just as important. In fact, one seminal study in the New England Journal of Medicine found that 74% of disciplinary action taken against physicians are actually due to issues in professionalism, and only 1% of cases were due to inappropriate treatment or diagnosis of patients or malpractice. This highlights the dire need for programs to screen applicants on not only their cognitive but also their personal domains.
However, many of the tools that are meant to assess the important non-cognitive aspects of applicants are not very useful. Reference letters are known to have poor reliability and no utility in predicting any outcome in medical school. Personal statements eat up a lot of time from applicants, yet research has shown time and time again that they do not predict anything useful. MMIs have been shown to be reliable and predict future performance, but they are extremely costly to administer, and so the majority of applicants have to be filtered out without ever having had the chance to showcase their personal qualities. CASPer®, on the other hand, is a cost-effective tool that can be administered to all applicants, providing everyone a chance to display their people skills. Research has demonstrated that CASPer® is reliable and also predicts future success in medical school, so the scores derived from the test seem to tell us something meaningful about the applicants.
Not only do medical schools care about selecting applicants with the highest potential for success, they also want to ensure that they are selecting a diverse group of students to reflect the increasing diversity of the patient population. Health disparities continue to persist among racial and ethnic groups, and individuals with lower socioeconomic status are also at a higher risk of facing health problems. There is increasing evidence that promoting student diversity in medical school could help address some of the disparities. Underrepresented minority (URM) students are more likely to help in underserved areas and patients generally prefer to be seen by doctors of their own race/ethnicity. Studying alongside a diverse group of peers also help better prepare all students in the program to serve patients from different backgrounds.
While we all want to see a more diverse pool of medical students, there is still much more work to be done. For instance, African Americans make up 13% of the population, yet they only make up 4% of physicians. Part of this is attributed to the admissions process, which focuses primarily on cognitive assessments like GPA and MCAT scores that are known to show substantial differences across SES and racial/ethnic groups. This is much less of a problem for non-cognitive assessments, like the MMI and SJTs, as they tend to show smaller subgroup differences. A study from New York Medical College has shown that CASPer® has much less of an adverse impact on URM applicants compared to the traditional measures like GPA and MCAT, which can help promote the diversity of students. Additionally, the costs associated with CASPer® are much lower in comparison with other tools, to ensure that the test is accessible to all applicants and will not be overly burdensome to what is already a costly application process – the average cost of a medical school application is estimated to be $7,520!
So programs adopt CASPer® for primarily two reasons: to obtain a more reliable and meaningful assessment of applicants’ personal competencies and to promote the diversity of entering medical students. The path to medicine can be tough, and there are already many things required from you to complete your application. But programs adopt CASPer® to help streamline the admissions process, to make sure that they are doing a better job in gathering a more holistic view of their applicants. We have always recognized that being smart is not the only important attribute of a good doctor, and the admissions processes around the world are now beginning to reflect that.