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A Reflection Upon the Impact of Early 21st-Century Technological Innovations on Medical School Admissions

Hanson, Mark D., MD, MEd, FRCPC; Eva, Kevin W., PhD

doi: 10.1097/ACM.0000000000002590

The authors describe influences associated with the incorporation of modern technologies into medical school admissions processes. Their purpose is not to critique or support specific technologies but, rather, to prompt reflection on the evolution that is afoot. Technology is now integral to the administration of multiple admissions tools, including the Medical College Admission Test, situational judgment tests, and standardized video interviews. Consequently, today’s admissions landscape is transforming into an online, globally interconnected marketplace for health professions admissions tools. Academic capitalism and distance-based technologies combine to enable global marketing and dissemination of admissions tests beyond the national jurisdictions in which they are designed. As predicted by disruptive business theory, they are becoming key drivers of transformative change. The seeds of technological disruption are present now rather than something to be wary of in the future. The authors reflect on this transformation and the need for tailoring test modifications to address issues of medical student diversity and social responsibility. They comment on the online assessment of applicants’ personal competencies and the potential detriments if this method were to replace admissions methods involving human contact, thanks to the ease with which institutions can implement them without cost to themselves and without adequate consideration of measurement utility or contextual appropriateness. The authors advocate for socially responsible academic capitalism within this interconnected admissions marketplace: Attending to today’s transformative challenges may inform how health professions education responds to tomorrow’s admissions technologies and, in turn, how tomorrow’s health professionals respond to their patients’ needs.

M.D. Hanson is child and adolescent psychiatrist, Hospital for Sick Children, and professor, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; ORCID:

K.W. Eva is associate director and senior scientist, Centre for Health Education Scholarship, and professor and director of education research and scholarship, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; ORCID:

Funding/Support: None reported.

Other disclosures: Mark D. Hanson holds an Associated Medical Services (AMS) Phoenix Fellowship Award to examine a New Health Professions Admission Model Grounded in Patient Defined Application Attributes, Processes and Policies.

Ethical approval: Reported as not applicable.

Previous presentations: Ideas and components of this article were included in Dr. Hanson’s professorial lecture titled “The Future of Medical School Admissions” presented on February 2, 2017, at the Hospital for Sick Children, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Correspondence should be addressed to Mark D. Hanson, Department of Psychiatry, Hospital for Sick Children, 555 University Ave., Toronto, Ontario, Canada M5G 1X8; telephone: (416) 813-7530; e-mail:

© 2019 by the Association of American Medical Colleges