Secondary Logo

Share this article on:

Tracking Indigenous Applicants Through the Admissions Process of a Socially Accountable Medical School

Mian, Oxana, PhD; Hogenbirk, John C., MSc; Marsh, David C., MD; Prowse, Owen, MD; Cain, Miriam; Warry, Wayne, PhD

doi: 10.1097/ACM.0000000000002636
Research Report: PDF Only

Purpose: To describe the admissions process and outcomes for Indigenous applicants to the Northern Ontario School of Medicine (NOSM), a Canadian medical school with the mandate to recruit students whose demographics reflect the service region’s population.

Method: The authors examined ten-year trends (2006–2015) for self-identified Indigenous applicants through major admission stages. Demographics (age, sex, northern and rural backgrounds) and admission scores (grade point average [GPA], pre-interview, multiple mini-interview [MMI], final), along with score-based ranks, of Indigenous and non-Indigenous applicants were compared using Pearson chi-square and Mann-Whitney tests. Binary logistic regression was used to assess the relationship between Indigenous status and likelihood of admission outcomes (interviewed, received offer, admitted).

Results: Indigenous qualified applicants (338/17,060, 2.0%) were more likely to be female, mature (25 or older), or of northern or rural background than non-Indigenous applicants. They had lower GPA-based ranks than non-Indigenous applicants (P < .001) but had comparable pre-interview, MMI, and final score-based ranks across all admission stages. Indigenous applicants were 2.4 times more likely to be interviewed and 2.5 times more likely to receive an admission offer, but 3 times less likely to accept an offer than non-Indigenous applicants. Overall, 41/338 (12.1%) Indigenous qualified applicants were admitted, compared with 569/16,722 (3.4%) non-Indigenous qualified applicants.

Conclusions: Increased representation of Indigenous peoples among applicants admitted to medical school can be achieved through the use of socially accountable admissions processes. Tracking of Indigenous students further through medical education and practice may help assess the effectiveness of NOSM’s social accountability admissions process.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

O. Mian is research associate, Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, Canada.

J.C. Hogenbirk is senior research associate, Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, Canada; ORCID: http://orcid.org/0000-0003-0841-4657.

D.C. Marsh is professor of clinical sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, Ontario, Canada; ORCID: https://orcid.org/0000-0002-8769-1785.

O. Prowse is assistant dean for admissions, Northern Ontario School of Medicine, Laurentian University, Sudbury, Ontario, Canada.

M. Cain is director of admissions and recruitment, Northern Ontario School of Medicine, Laurentian University, Sudbury, Ontario, Canada.

W. Warry is currently director, Rural Health Initiatives, Memory Keepers Medical Discovery Team, and professor of family medicine and biobehavioral health, University of Minnesota, Duluth, Minnesota. At the time of writing, he was Director, Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, Canada.

Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A640.

Acknowledgments: The authors wish to thank Dr. Joyce Helmer, chair of Northern Ontario School of Medicine’s (NOSM’s) Indigenous admissions subcommittee, for reviewing this manuscript for the relevant Indigenous content.

Funding/Support: This study was part of a larger project funded by NOSM with the purpose of understanding how well the admission criteria and process meet the school’s social accountability mandate. The study was conducted by independent researchers (O. Mian, J.C. Hogenbirk) in collaboration with NOSM admissions committee members.

Other disclosures: None reported.

Ethical approval: This study was approved by the Laurentian University and Lakehead University Research Ethics Boards and was compliant with the Tri-Council Policy Statement guidelines on conducting research involving Indigenous Peoples.

Previous presentations Parts of this report were presented at the 2017 Canadian Conference for Medical Education, Winnipeg, Manitoba, Canada, April 29–May 2, 2017; the 2016 International Conference on Community Engaged Medical Education in the North, Sault Ste Marie, Ontario, Canada, June 20–25, 2016; and the 2016 Association for Medical Education in Europe Conference, Barcelona, Spain, August 29, 2016.

Correspondence should be addressed to Oxana Mian, Centre for Rural and Northern Health Research, Laurentian University, 935 Ramsey Lake Rd., Sudbury, Ontario, P3E 5X4, Canada; telephone: (705) 675-1151; e-mail: ox_mian@laurentian.ca.

© 2019 by the Association of American Medical Colleges