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Am I Disadvantaged? How Applicants Decide Whether to Use the Disadvantaged Status in the American Medical College Application Service

Lowrance, Adam M. MM, MA, PhD; Birnbaum, Matthew G. MA, PhD

doi: 10.1097/ACM.0000000000002798
Research Reports

Purpose To add to the limited research on the Disadvantaged Status, a component in the American Medical College Application Service (AMCAS) primary application, the authors explored how applicants to a medical school between 2014 and 2016 determined whether they were disadvantaged and whether to apply as such.

Method The authors used case study methodology to explore the experiences of students at a medical school in the Northeast. The authors derived data from transcripts of semistructured interviews with students and the students’ AMCAS applications. Transcripts and applications were analyzed using a constant comparative approach and considered in the context of social comparison and impression management theories.

Results Overall, the 15 student participants (8 used the Disadvantaged Status) had difficulty determining whether they were disadvantaged and how applying as such would affect their prospects. Contributing factors included ambiguity around both the term disadvantaged and its use in the admissions process. Simply experiencing hardship during childhood was insufficient for most participants to deem themselves disadvantaged. Participants’ decision processes were confounded by the need to rely on social comparisons to determine whether they were disadvantaged and impression management to decide whether to apply as such.

Conclusions The ambiguous nature of the Disadvantaged Status, comparisons with even more disadvantaged peers, and uncertainty about how shared information might affect admission decisions distorted participants’ understandings of identity within the context of the application. The authors believe that many applicants who have experienced significant hardships/barriers are not using the Disadvantaged Status.

A.M. Lowrance has worked as a data analyst in medical school admissions and screened applicants since 2013; ORCID:

M.G. Birnbaum is associate professor of higher education and student affairs leadership, University of Northern Colorado, Greeley, Colorado; ORCID:

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: Ethical approval was granted by the University of Northern Colorado Institutional Review Board [840352-2] on February 5, 2016.

Previous presentations: The data in this article come from a doctoral research study previously presented by the corresponding author (A.M.L.) to fulfill the requirements of a PhD program. With the exception of the doctoral defense and the published dissertation in May 2017, none of the findings from this research have appeared in presentation or print.

Correspondence should be addressed to Adam M. Lowrance; email:

Copyright © 2019 by the Association of American Medical Colleges