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Should Efforts in Favor of Medical Student Diversity Be Focused During Admissions or Farther Upstream?

Reiter, Harold I. MD, MEd; Lockyer, Jocelyn MHA, PhD; Ziola, Barry PhD; Courneya, Carol-Ann MSc, PhD; Eva, Kevin PhD; for the Canadian Multiple Mini-Interview Research Alliance (CaMMIRA)

Academic Medicine:
doi: 10.1097/ACM.0b013e318248f7f3
Medical School Admission

Purpose: Traditional medical school admissions assessment tools may be limiting diversity. This study investigates whether the Multiple Mini-Interview (MMI) is diversity-neutral and, if so, whether applying it with greater weight would dilute the anticipated negative impact of diversity-limiting admissions measures.

Method: Interviewed applicants to six medical schools in 2008 and 2009 underwent MMI. Predictor variables of MMI scores, grade point average (GPA), and Medical College Admission Test (MCAT) scores were correlated with diversity measures of age, gender, size of community of origin, income level, and self-declared aboriginal status. A subset of the data was then combined with variable weight assigned to predictor variables to determine whether weighting during the applicant selection process would affect diversity among chosen applicants.

Results: MMI scores were unrelated to gender, size of community of origin, and income level. They correlated positively with age and negatively with aboriginal status. GPA and MCAT correlated negatively with age and aboriginal status, GPA correlated positively with income level, and MCAT correlated positively with size of community of origin. Even extreme combinations of MMI and GPA weightings failed to increase diversity among applicants who would be selected on the basis of weighted criteria.

Conclusions: MMI could not neutralize the diversity-limiting properties of academic scores as selection criteria to interview. Using academic scores in this way causes range restriction, counteracting attempts to enhance diversity using downstream admissions selection measures such as MMI. Diversity efforts should instead be focused upstream. These results lend further support for the development of pipeline programs.

Author Information

Dr. Reiter is professor, Division of Radiation Oncology, Department of Oncology, McMaster University, Hamilton, Ontario, Canada.

Dr. Lockyer is associate dean, Continuing Medical Education, and professional development professor, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.

Dr. Ziola is professor, Clinical Division, Microbiology, and director of admissions, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

Dr. Courneya is associate professor, Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, British Columbia, Canada.

Dr. Eva is associate professor and senior scientist, Centre for Health Education Scholarship, University of British Columbia, Vancouver, British Columbia, Canada.

The Canadian Multiple Mini-Interview Research Alliance members are listed at the end of this article.

Correspondence should be addressed to Dr. Reiter, McMaster University, 1200 Main St. West, MDCL 3105, Hamilton, Ontario, Canada L8N 3Z5; e-mail:

First published online February 22, 2012

© 2012 Association of American Medical Colleges