A critical scoping review of the connections between social mission and medical school admissions: BEME Guide No. 47

Abstract

Background: Despite a growing focus on the social accountability of medical schools, there has been no substantive review of admissions related to the social mission of medical schools. This paper reports on a critical scoping review of the connections between social mission and medical school admissions.

Methods: Searches of seven bibliographic databases identified 1258 unique articles. After filtering for relevance, 71 articles were considered for final review. The results of the data extraction were synthesized using a combination of qualitative and quantitative techniques.

Results: Five reviewers conducted 149 data extractions from 71 papers. Social missions tended to focus either on access and equity issues for applicants from underrepresented populations or on the career choices of medical graduates and how they meet particular social needs. The connection between social missions and admissions was often implied but rarely considered or evaluated directly. There was a notable absence of empirical evidence, with calls for reform or program descriptions far outweighing the number of papers based on empirical findings.

Conclusions: Despite the move to social missions in medical education, there remains little direct connection between missions and admissions and little evidence reflecting the efficacy or impacts of making this connection.

Disclosure statement

The authors have no material conflicts of interest to declare with respect to this study. However, as they were trying to connect their social mission with their admission processes they acknowledge that they approached this project from this particular perspective.

Notes on contributors

Rachel Ellaway, PhD, is Professor in the Department of Community Health Sciences and Director of the Office of Health and Medical Education Scholarship (OHMES) in the Cumming School of Medicine, at the University of Calgary in Alberta, Canada.

Rebecca Malhi, PhD, is a Research Associate, Distributed Learning and Rural Initiatives (DLRI), in the Cumming School of Medicine, at the University of Calgary in Alberta, Canada.

Sameer Bajaj, BDS, MPH, is a Doctor of Dental Surgery (DDS) candidate at the University of California San Francisco, USA. He was previously a research associate at the Cumming School of Medicine, at the University of Calgary in Alberta, Canada.

Ian Walker, MD, is Clinical Associate Professor in the Department of Emergency Medicine and Director of Admissions in the Cumming School of Medicine, at the University of Calgary in Alberta, Canada

Douglas Myhre, MD, is Professor in the Department of Family Medicine and Associate Dean Distributed Learning and Rural Initiatives (DLRI), in the Cumming School of Medicine, at the University of Calgary in Alberta, Canada.

Glossary

Selection: The process through which a group of applicants are appraised for first, their suitability for a career in medicine, and second, their suitability for entry to a particular program of medicine. Selection ends with the creation of the final ranked list of which suitable students will be offered admission to the medical school.

Recruitment: The collected processes of attracting and persuading individuals to be applicants to a particular medical education program, or to accept an offer of admission once made.

Admission: The longitudinal and largely administrative process that starts with recruitment to an undergraduate medical education program and ends as the admitted students start their training.

Social mission: The values and concepts adopted by a medical school regarding the expression of their social contract. A social mission may involve one or more of being socially responsible, socially accountable, or addressing the social contract.

Socially responsible: A socially responsible medical school is one that is committed to what faculty intuitively considers as the welfare of society. The intention to produce “good practitioners” is based on an implicit identification of society’s health needs (Boelen et al. 2012).

Socially accountable: A socially accountable medical school takes specific actions through its education, research and service activities to meet the priority health needs of particular community or population. It also works collaboratively with governments, health service organizations, and the public to positively impact people’s health and being able to demonstrate this by providing evidence that its work is relevant, of high quality, equitable, cost-effective (Boelen et al. 2012).

Social contract: Medicine’s relationship with society is based on professionalism. This relationship is termed as a social contract (Cruess and Cruess 2008).

Connection between mission and admissions: Bi-directional relationship between a school’s social mission and its admissions in terms of how the mission translated to admissions practices, values, and policies, and how admissions acted as a mechanism for realizing the social mission.

Additional information

Funding

This was an unfunded study.