End of Year Message

As the calendar year draws to a close, I have taken some time to step back and reflect on both the accomplishments and challenges of the past 12 months for DGSOM. In service of an ambitious mission one does not come without the other. We cannot strive for the goal of healing humanity without expecting it to be at times difficult. But it is through the commitment, compassion, creativity, collaboration and hard work of all of you that we have achieved so much this year. Through all the complexities, there is one thing I am unflinchingly confident about: DGSOM is in a better place at the end of this year than we were at the beginning. And we will be better off at the end of 2019 than we are today. Progress day by day, week by week, month by month and year by year is the path to tackling big important change.

With change comes uncertainty, tension and anxiety. This month, discussions have crested around a particularly complex and charged issue for the school – MD admissions policies. Admissions sits at the heart of success for our mission at DGSOM and at the same time it is a multi-faceted process with many goals to achieve.

The admission process starts with 14,000 applicants and through a fair, transparent, and timely evaluation needs to find the best 175 within. And right there is one of the biggest challenges-defining “best”. For some, best is the applicant who has always wanted to be a physician as reflected in the focus and accomplishments of their academic record. For others, best is the applicant whose life experiences sparked a passion for medicine later in their education. For some it is the aspiring surgeon, for others the aspiring physician-scientist, and for others those who seek to end inequities in health care delivery. Some look for those seeking to have an impact in academic medicine, while others seek those whose impact would be felt in the community they would serve.

For me as Dean, any definition of best has to embrace all of these. We need an admissions policy that recognizes a diversity of abilities, experiences, and backgrounds to be able to identify students who embody all these “bests”. This is aligned with the ongoing vision that is guiding the medical school curriculum redesign “to empower students to become physicians committed to excellence and leaders in innovation, research, health, education, advocacy and humanistic care”. Currently DGSOM is recognized as one of the most diverse medical schools in the country – a badge we wear proudly. Diversity has been and must continue to be at the heart of DGSOM.

The oversight of admissions at DGSOM has a unique and complex governance structure. In brief, the Faculty Executive Committee sets policies for MD admissions, advised by their Admissions Policy Oversight Committee (APOC), and we in the Dean’s Office implement them. There have been some significant improvements in the admissions processes this year, such as enhancing holistic review by having files read by two professionally-trained readers, moving the admission offer process much earlier in the season, and offering travel awards to encourage candidates to travel for interviews. In parallel, FEC voted in new policies regarding criteria for selection, specifically related to minimum grade point average (GPA) and score on the Medical College Admissions Test (MCAT). In recent weeks, the rationale and impact of these metrics have been the focus of spirited dialogue and deep disagreement. Dissent can be constructive in the growth and development of any community. Reflections on the unintended consequences of decisions must be continually reviewed and changes made in order to improve our climate and enhance our culture.

Addressing our admissions policies and implementation will be a focus for me personally and for DGSOM more generally in the beginning of 2019. One issue at the core of the debate is whether it is appropriate to make the first evaluation of the thousands of applicants based on metrics of MCAT scores and GPAs. Intuitively it seems that some initial selection should be possible to allow for greater holistic review of a subset of the 14,000 applicants. But then the question immediately becomes what metrics can define those who will thrive in medical school? How do we take into account the many other factors that confound the relationship between a metric like MCAT and someone’s ultimate success as a physician? We know, for example, that performance on MCAT, like many standardized tests, is confounded by socio-economic status and privilege. Fortunately, there is a large body of national data that can inform our approach.

In 2019 through dialogue informed by data, hearing all voices openly, we will work together with respect and professionalism to do what’s right and we will make our admissions policies and implementation align with what we stand for as an institution.

Please take time over the next few weeks, as I will, to carve out time for yourself, to reflect and refresh, to spend time with family and friends and to reenergize for the new year. We have a lot to accomplish together in 2019!

Kelsey Martin

Dean, David Geffen School of Medicine