The AAMC Should Not Sacrifice Merit for Ideology

In 2020, the Association of American Medical Colleges (AAMC) unveiled a new test, the PREview exam, aimed at measuring skills and competencies related to professionalism for students applying to medical schools. As of the 2024-2025 application cycle, nine medical schools had made submission of PREview scores mandatory. 

The AAMC’s justification for the exam is that medical schools should consider factors other than an applicant’s academic achievement (e.g. MCAT scores and GPA) when making admissions decisions, echoing the “holistic” review practice that the AAMC has promoted.

“The PREview exam provides medical schools with a more complete view of each applicant by assessing skills such as resilience and adaptability, service orientation, ethical responsibility to self and others, empathy and compassion, cultural awareness, cultural humility, and teamwork and collaboration, among others,” the AAMC states.

In a vacuum, the idea that these skills are relevant to the practice of medicine isn’t particularly uncontroversial.

But a cursory understanding of the AAMC’s institutional position on medical school admissions should provoke considerable skepticism as to the purpose of the PREview exam.

The AAMC has long been a staunch advocate for DEI and race-conscious admissions, urging the Supreme Court to uphold affirmative action in 2023. Do No Harm’s landmark 2024 report further exposed how the AAMC has injected DEI into nearly every facet of medical education. 

Indeed, as the AAMC itself admits, one of the purposes of the PREview exam is to promote “inclusivity”; the exam was even assessed by “experts” in DEI.

“In discussing the exam with our DEI constituents, the sentiment has always been that it would help level the playing field for applicants,” said David Acosta, MD, AAMC chief diversity and inclusion officer, in a 2022 statement.

It’s hard to think of what “level the playing field” could mean or entail except the devaluing of traditional metrics of merit. Indicators of academic achievement and competency such as GPA and MCAT scores already do level the playing field.

These ideological positions are hinted at in public materials concerning the PREview exam.

For instance, one question included in a practice version of the exam presents a scenario in which a male student exhibits sexist behavior.

You and a group of medical students are shadowing a surgeon as part of a clinical experience. The surgeon mentions that they need a volunteer to assist with an operation. You overhear a male student ask the female students if he can volunteer because he believes most women are not interested in surgery anyway. After the clinical experience, one of your classmates complains to you about the male student’s comment.

Another question implicitly extols the virtues of diversity, with a scenario reinforcing the notion that medical schools are not sufficiently considering different racial groups.

You are taking a course that requires you to conduct interviews with actors portraying patients. Several weeks into your course, you realize that every patient you have interviewed is White. When you suggest to the course instructor that the actors lack diversity, your course instructor responds that the patients have been successful for years and there is no need to make changes.

It’s apparent that the PREview exam is just another way for the AAMC to devalue traditional metrics of merit and competence in favor of admissions methods that allow medical schools to pursue the DEI agenda.

Out of reckless ideological zeal, the AAMC continues to champion factors less relevant to the actual practice of medicine.

Clinical practice is not a game, and decisions as to who medical schools admit should not be taken lightly.

The AAMC should take its position more seriously, and abandon its ideological commitment to DEI; the future of medical education very much depends on it.