Outcomes of Holistic Review in a Medical School Offering a Six-Year Combined Baccalaureate and Medical Degree Program and Traditional Four-Year Medical Degree Program

Abstract

The purpose of this ex-post facto quantitative study was to examine the outcomes of holistic review in the BA/MD program and the MD program at the University of Missouri Kansas City School of Medicine. Outcomes were evaluated based on the type of admission review students received (either pre-holistic review or holistic review) for each separate degree program (BA/MD or MD). Outcomes studied were learning, developmental, and professional outcomes of the graduates as they related to the mission of the medical school and the diversity rationale. Specifically, the outcomes measured included graduating GPA, graduation rate, licensure exam performance, and answers to eight questions from the Association of American Medical Colleges’ Graduation Questionnaire containing survey items addressing diversity-related attitudes, experiences, and perceptions. The sample included BA/MD students admitted in 2007, 2008, and 2009 (pre-holistic review) and 2010 and 2011 (post-holistic review) as well as MD students admitted in 2009 and 2010 (pre holistic review) and 2011, 2012, and 2013 (post-holistic review). Means, frequencies, chi square test for homogeneity, independent samples T-tests, Hotelling’s T2, and two-way ANOVA were used to examine differences between type of admission, and in some cases by race/ethnicity, for each dependent variable and for each degree program. Findings showed that implementing holistic review resulted in an increase in the academic measures of Step 1 and Step 2 CK licensing exam scores for MD students when examined separately, and an increase in graduating GPA, Step 1, and Step 2 CK scores for MD students when examined together. Additionally, significant differences seen in degree attainment for BA/MD students among racial/ethnic identity prior to holistic review were eliminated once holistic review was used. Students’ participation in diversity-related experiences also increased for both the BA/MD and MD programs once holistic review was utilized, and gaps previously seen among racial/ethnic identity in career plans to work with underserved populations were closed. No significant decreases in outcomes measures were found in any of the variables when holistic review was utilized. This study filled a gap in holistic review literature, as few studies exist examining graduation outcomes of holistic review processes in medical schools.