Making Room at the Table: Expanding the MCAT Fee Assistance Program in Canada via Student and Trainee Representation

To the Editor:

The Association of Faculties of Medicine of Canada (AFMC) Future of Medical Education in Canada report in 2010 sets out diversity goals for medical school admissions. ¹ One such goal was to increase representation of students from low socioeconomic status backgrounds. To advance this goal, the AFMC collaborated with the Association of American Medical Colleges to pilot a Medical College Admission Test (MCAT) fee assistance program (FAP) for Canadian applicants beginning in 2018. Unfortunately, this initiative was underused due to its inaccessibility (e.g., lack of effective student outreach, few instructions on how to apply). To address this issue, the AFMC partnered with 2 student/trainee-led groups, Price of a Dream (POD) and Community of Support (COS), on a quality improvement project to increase applicant utilization of the MCAT FAP during the 2020–2021 application cycle.

The results were astounding. Within a year, there was a 39% increase in applicants to the MCAT FAP and a 46% increase in the number of awardees. What changed? The inclusion of students and trainees on the outreach committee.

POD members include trainees who, as former medical school applicants, understand the impact of financial barriers. COS members include premedical students who have successfully applied to the MCAT FAP. POD and COS leveraged their proximity to applicants and understanding of barriers to develop and implement an applicant engagement plan focused on increasing MCAT FAP accessibility. This plan included (1) hosting informational webinars, (2) developing a toolkit to walk applicants through the application, and (3) increasing outreach via social media. The AFMC has been open to students’ questions, but having access to students and trainees made some applicants more comfortable seeking help with their applications. This project also provided role-modeling, helping students from low socioeconomic status backgrounds meet peers in medicine.

The expression “nothing about us without us” (a rough translation of nihil novi nisi commune consensu) was first documented in 1505, ² and it still holds true today. As equity, diversity, and inclusion efforts such as the MCAT FAP continue to gain traction, reflect on the leadership tables at your institutions: Have you engaged students and trainees? If not, it is time to make room.