More Than the MCAT: Understanding the Holistic Evaluation of Medical School Applications


You firmly believe achieving anything worthwhile takes hard work and dedication. That’s certainly true of your plans to gain acceptance to medical school. Still, you sometimes worry your academic performance isn’t the best representation of just how capable you are.

The competition is certainly stiff. Some applicants take the Medical College Admission Test (MCAT) again and again to give themselves any advantage — although, there is a limit. Students are allowed to sit the MCAT only three times in a single year and seven times in total. You’ll also hear of students who obtained an additional degree to garner more good grades.

But there’s more to evaluating medical school applications than strictly looking at GPA and test scores. More and more programs are moving toward holistic reviews that consider academic metrics in tandem with your experiences and background. Get ready for a quick lesson in holistic reviews and how they’re being used for medical school applications.

A quick history on holistic reviews

US medical school admissions committees focused heavily on academic metrics when evaluating applicants during the twentieth century. The idea was that students with the best MCAT scores and highest GPAs were the most likely to succeed. A new school of thought began to emerge when the US Supreme Court endorsed holistic reviews in 2003. The ruling spelled out the need to consider each applicant individually, taking into account nonacademic factors.

Medical schools slowly started shifting their approach. Certain programs began making a concerted effort to go this route when the Association of American Medical Colleges (AAMC) formally launched their Holistic Review Project in 2007.

Why the push for holistic reviews? They help improve diversity, for one. Research suggests a diverse physician workforce yields greater patient satisfaction and better access to health care. Some medical schools realize academic metrics only say so much about a student.

“We won’t allow ourselves to be that rigid.”

“We don’t want to say 60 percent of our decision is based on GPA, 20 percent is based on MCAT, and so on,” explains Bob Ryan, dean of admissions at St. George’s University (SGU). “We won’t allow ourselves to be that rigid.”

3 Things programs consider when reviewing medical school applications

According to the AAMC, holistic reviews should consider each applicant’s academic metrics, experiences, and attributes. This means medical schools need to examine essays, letters of recommendation, and more when deciding whether to extend you an acceptance letter.

“We really do look at all aspects of an application,” Ryan says.

Here’s a more detailed look at the lesser-known factors medical schools consider when reviewing medical school applications.

1. Life experiences

One of the most important nonacademic factors all medical schools consider is the amount of experience candidates have in their intended field. Admissions committees want to know that you understand what it’s like to work with patients. In fact, failing to gain enough clinical exposure is one of the biggest mistakes applicants make.

Experiences that affected your performance in the classroom are equally important. Admissions committees may consider whether you were devoting a lot of time to a passion that might have affected your ability to focus on coursework. Ryan also notes some individuals have obligations that go beyond the scope of what’s typical for a college student.

“Maybe you were forced, due to your family situation, to work 40 hours a week."

“Maybe you were forced, due to your family situation, to work 40 hours a week,” Ryan offers. He adds that you’d be able to put that time toward your studies in medical school.

This information is obviously important for medical schools to know. Be sure to make them aware by speaking to those experiences in your personal statement or another essay. You don’t want to miss out on earning an interview invitation by failing to mention anything significant that happened during your undergraduate education.

2. Personal attributes

There are numerous competencies required to succeed as a physician. Some of the most important ones are knowledge of medicine, professionalism, leadership skills, and the ability to work as part of a team. You GPA and MCAT say very little about most of these, so your letters of recommendation, personal statement, and interview are often the best ways to give medical schools a sense of your positive attributes.

“The interview is very important,” Ryan emphasizes. “We’re really trying to find out if the student has the strength to succeed.”

"The interview is very important."

SGU conducts blind interviews where the committee member doesn’t know the student’s academic profile. This is to ensure the interviewer doesn’t have any preconceived notions going into the conversation. The questions are also designed to understand what type of person you are. Keep in mind that not every school chooses to do this, however.

Ryan says some typical talking points are “‘What are your leadership skills?’ or, ‘Tell us of a situation that you found difficult to mediate in a group situation.’” He also mentions that your communication skills are really important during these conversations.

3. Academic performance

Just because academic metrics aren’t the only criteria admissions committees consider doesn’t mean they’re unimportant. Most medical schools still have pretty high MCAT and GPA standards, and you need to be a good student and perform well on tests to obtain your license. Exactly how schools evaluate your scholastic performance will vary, though. SGU focuses on the end of your education.

“GPA is very important, but we look at the trend,” Ryan explains. “Oftentimes, we’ll look at your last 45 credits.”

"GPA is very important, but we look at the trend."

If your GPA took a hit at any point, you might consider bolstering it with additional coursework. There’s a lot of debate about whether there’s any benefit to obtaining a master’s degree. You may be better off taking a few science courses or a post-baccalaureate program geared toward pre-med students.

We already noted the possibility of retaking the MCAT, but it’s worth mentioning again. It could be particularly useful if you feel that nerves got the best of you the first time. Your MCAT performance might not be the most important factor, but a strong score could give your application the boost it needs.

There’s still progress to be made

You should keep in mind that some medical schools may not be fully committed to holistic reviews. A survey of admissions officers published in 2013 highlights one of the major problems: Many programs still base their initial decisions on GPA and MCAT scores. It’s not until they’ve already bypassed a large pool of applicants that they turn to holistic evaluations.

And it’s clear that medical schools have a ways to go when it comes to diversity as well. An analysis from the AAMC shows we’ve only made marginal gains in admitting more minority students. Latino, Native American, and black students are still vastly underrepresented in medical schools.

Know your value

It’s easy to see how comparing medical school applications based on academic metrics alone can be problematic. There are so many other qualities that are essential for becoming a good physician. Medical schools that employ a holistic review understand this. You just need to make sure they see your true potential.

Interviews can help. They’re a crucial part of the admissions process for programs that holistically review applicants. Medical school interviews are your opportunity to share your story and help the admissions committee understand why you would be a great physician.

Pick up some pointers about how to best represent yourself during upcoming question-and-answer sessions by reading our article, “How to Prepare for Medical School Interviews: Steps for Success.”

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