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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 Report: PDF Only

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 one 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 semi-structured interviews with students and these 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 (eight used the Disadvantaged Status) had difficulty determining if they were indeed disadvantaged and how applying as such would affect their prospects. Simply experiencing hardship during childhood was insufficient for most participants to deem themselves disadvantaged. Contributing factors included ambiguity around both the term disadvantaged and its use in the admissions process. Participants’ decision processes were confounded by the need to rely on social comparisons to determine if they were disadvantaged and impression management to decide whether to apply as such.

Conclusions: The ambiguous nature of the Disadvantaged Status option on the AMCAS application, comparisons to even more disadvantaged peers, and uncertainty about how shared information might affect admissions confounded participants’ understandings of identity within the context of the application. The authors believe 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.

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 comes 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 has appeared in presentation or print.

Correspondence should be addressed to Adam Lowrance; telephone: (970) 222-9977 (mobile); e-mail:

© 2019 by the Association of American Medical Colleges