Treat Medical School Applicants as People, Not Pawns

Over the past few years, Do No Harm has documented the Association of American Medical Colleges’ (AAMC) various initiatives aimed at advancing discriminatory and divisive practices in medical education. These include efforts to inject the consideration of race into the medical school admissions process.

Yet the use of race in admissions is ultimately downstream from the more innocuous – but nonetheless problematic – view that the medical school admissions process should not simply select for the most accomplished and meritorious applicants, but should instead advance particular ideological goals.

An applicant’s character is relevant to their future medical career, and considering such factors isn’t necessarily worrying. Concerns arise, however, when the admissions process is geared toward achieving social goals (distinct from excellence in medicine) and applicants are viewed for their contributions toward those goals, rather than on their own merits as future physicians. 

The AAMC is quite explicit about the fact that it does view the admissions process as a means to achieve certain desired social and political goals, as evidenced by its resources on its “holistic review” philosophy.

For instance, it lauds the UC-Davis School of Medicine for using strategies “to increase enrollment of historically underrepresented and excluded students and to achieve institutional community health goals.”

And, although the AAMC has moved to distance itself from its more explicit endorsements of racial discrimination, its 2023 amicus brief in support of race-conscious medical school argued that “diversity in the education of the Nation’s physicians and other healthcare professionals is a medical imperative.”

This admissions philosophy is further reinforced by the actual application materials students submit when applying to medical school, and is reflected in the AAMC’s application workbook, which is designed to prepare students to submit applications through the American Medical College Application Service (AMCAS), the AAMC’s centralized medical school application processing service.

The workbook encourages applicants to submit information about themselves that is not relevant to their qualifications as applicants, or for any related administrative purpose.

For instance, applicants have the option to list their “gender identity,” with options including “Genderqueer/Gender non-conforming” and “non-binary” and “agender.”

Applicants can also choose to list their preferred pronouns, with options including “They/Them/Theirs” and “Ze/Hir/Hirs.”

Applicants are further asked a series of questions about their background, including whether they grew up in an area they “believe” was “medically under-served.” There is not an objective metric of “medically under-served” included in the workbook.

The workbook further asks applicants about their family income levels and whether their immediate family ever used federal or state assistance programs.

This interest in applicants’ background extends to questions about “impactful experiences” applicants have undergone, which the AAMC justifies on the basis of promoting “holistic review.”

The ideological flavor to these questions is best crystallized in a question allowing students to submit their experiences engaging in “social justice” advocacy.

Why one’s social justice advocacy is relevant to their ability to practice medicine, or their quality as an applicant, is not explained.

The workbook further reminds applicants to submit their scores on the PREview exam, a test ostensibly aimed at measuring skills and competencies related to professionalism, which is increasingly becoming mandatory at more and more schools.

As Do No Harm previously reported, one of the goals of the PREview exam is to promote “inclusivity” and “level the playing field” for applicants. The exam was also 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.

All these facts together paint a compelling picture: the AMCAS application (and the AAMC more generally) appears less interested in recognizing individual achievement than in engineering outcomes through “holistic review.” By burying schools in layers of subjective social data, the process dilutes focus on what truly matters: intellectual ability, clinical promise, and dedication to patient care.

The comprehensive nature of the application is not neutral; it is a deliberate attempt to elevate social and political factors above merit. Medical education – and ultimately, patient care – will suffer if the next generation of doctors is chosen on the basis of activism rather than excellence.