Selecting the best future physicians is an enormous burden.

For some medical schools, academic metrics are the answer. Scores from MCAT exams and undergraduate GPA’s can make for easy student selection. The best scores mean the best physicians, right? Not so fast, says the Texas A&M Health Science Center College of Medicine.

[pullquote align=”full” cite=”” link=”” color=”” class=”” size=””]Texas A&M’s medical school began using a formal “holistic” review process in 1996. The hope was to find brilliant minds, but also find caring and competent physicians capable of providing the best possible care to patients. In 2010, Texas A&M was selected as the alpha pilot site for the development of a workshop, a major outreach effort for the AAMC’s Advancing Holistic Review Initiative.[/pullquote]

The Association of American Medical Colleges (AAMC) began a holistic review project in 2007 to help medical schools develop and implement a holistic admissions process that uses multiple criteria to screen, interview and select students and future physicians. In 2010, Texas A&M College of Medicine was selected as the alpha pilot site for the development of a workshop, a major outreach effort for the AAMC’s Advancing Holistic Review Initiative.

Texas A&M was not only the first in the state to offer this learning experience to its admissions committee and staff, but the first in the country to do so. As a leader in this field, Texas A&M now helps other medical schools across the United States find ways to implement a holistic review process in their own selection process.

So what is a holistic review process?

A holistic review process examines all aspects of an applicant. Rather than just looking at metrics and scores, it takes into account experiences and attributes that contribute to an applicant’s ability to enrich the learning experience for all and be a sound physician.

This process doesn’t discount metrics; in fact it looks at scores, experiences and attributes in a balanced way. “It actually makes our job much more difficult but also much more rewarding because we are getting to know the whole applicant while assessing if they are the right fit for our mission,” said Leila Diaz, assistant dean for admissions and instructor in medical humanities at the Texas A&M College of Medicine.

Holistic review is implemented through each stage of the admissions process: advising, screening, interview and selection. Interviewers and admissions committee members are trained to assess applicants holistically.

“Not every medical school has the same review process,” Diaz said. “Our process is unique because it reflects our mission, which is to educate and produce competent, caring professionals, who are strongly service oriented.”

“A great deal of thought and consideration goes into who we choose to interview and make offers to,” said Filo Maldonado, associate dean of admissions and joint assistant professor. “We look for a heart of service, students who can excel in our curriculum and ultimately be humble physicians. With about 5,000 applicants it would be easy to just follow a formula and select students based on scores, but we do it the hard way. Getting down to 200 students isn’t easy, but we’re confident that our process finds the best physicians for patients – and the patients are the reason we do this, it is what drives us.”

Rather than just looking at metrics, holistic review takes into account experiences and attributes that contribute to an applicant’s ability to enrich the learning experience for all students and their ability to be a sound physician.

Maldonado and Diaz lead the admissions process at Texas A&M College of Medicine, and they believe in the holistic process so much that each has served as part of a small cadre of facilitators who deliver the AAMC’s Holistic Review in Admissions workshop nationwide.

As facilitators they serve alongside 8-12 other experts from medical colleges across the nation to help other health professions schools integrate the principles of the holistic review framework in to their own process in service of their school’s mission.

In the five years since the workshops began, admissions committees from 65 institutions have been formally trained in holistic review, of which Maldonado and Diaz had a significant role.

“We walk them through the AAMC holistic review framework and exercises that provide feedback on what they’re doing to help them find the best process for them,” Diaz said.

But is it really helping?

“The holistic review process has been successful as we are seeing wonderfully diverse classes. When we discuss diversity, we are talking about it at the broadest level,” Diaz said.

For example, our current first-year class includes an age range of 20-52 (22 percent are over the age of 25 at the time of enrollment), 15 percent were first-generation undergraduates, 14 percent earned a graduate degree prior to starting medical school, 46 percent are multilingual, 3 percent have military service, and over 50 percent had gap years between undergrad and medical school.

“All of this means that we have medical students who bring experiences with them that have helped develop them as leaders, and they will learn from one another and become better doctors because of it,” Diaz said.

[pullquote align=”full” cite=”” link=”” color=”” class=”” size=””] This idea of camaraderie is nothing new to Texas A&M, the University as a whole supports the values and tradition of the Aggie Family. All first-year students attend their first 12 months of training together on the Bryan/College Station campus, helping to foster this enthusiasm and support network among students. The selection process is crucial to find students who will help their fellow student, and thus enhance the learning experience. The path of the holistic review is difficult, but students like Mike Weipert are proving that, for Texas A&M, it is the right process. [/pullquote]

The review process has helped Texas A&M choose some exceptional student leaders and future physicians. It was instrumental in choosing Tillman Scholar, Michael Weipert. Weipert is a U.S. Army veteran and has proven to be an excellent medical student and has been nationally recognized for his dedication to service and future as a physician. Texas A&M was the only medical school willing to interview him.“There are countless stories like Mike [Weipert] and it is precisely why we utilize the holistic review process,” said Diaz. “He’d taken a non-traditional path to medical school, and because we fully examined his experiences, attributes and academics we saw an opportunity to provide the world with another great doctor, and we made him an offer of acceptance. The path of the holistic review is difficult, but students like Mike [Weipert] are proving that, for us, it is the right process.”

— Katherine Hancock

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