How Incoming Student Experiences, Attributes and Metrics are Related to Academic Performance in a Combined-Degree Medical Program: A Comparison of Holistic and Non-Holistic Admissions Practices

Abstract

This study was conducted at the University of Missouri – Kansas City School of Medicine, where students enter medical school directly after graduating from high school rather than follow the more traditional path of four years of undergraduate education followed by four years of medical school. This study examines incoming student experiences, attributes and metrics and their relationship to student academic performance and retention in the combined-degree medical program. This study also investigated differences in outcomes for students admitted after holistic admissions policies were implemented. The sample included all students admitted between 2005 and 2013, and involved an analysis of outcomes for all students admitted, students admitted pre-holistic admissions (2005 to 2009) and students admitted post-holistic admissions (2010 to 2013). Correlations, comparison of means, chi-square analysis, linear regression and multinomial logistic regression were used to analyze the relationship between experiences, attributes and metrics and academic performance and retention in medical school. Results indicate that students who earned higher ACT scores and a higher high school GPA demonstrated a higher medical school GPA and were more likely to demonstrate success in the program. Additionally, students with a more rigorous high school curriculum were more likely to demonstrate a higher medical school GPA and success in the program. Gender, status as an underrepresented minority, geographic origin and parent level of education were all statistically significant in either predicting medical school GPA or in increasing or decreasing the odds of success. Furthermore, holistic admissions practices had a direct effect on retention rates and diversity in the medical school. In fact, holistic admissions practices resulted in a statistically significant increase in retention and a statistically significant increase in the number of students underrepresented in medicine who entered the School of Medicine. The importance of this study lies in the need to understand what incoming student experiences, attributes and metrics predict student retention, and how we might identify and address those experiences, attributes and metrics at the point of admission and beyond. In addition, demonstrating that holistic admissions practices are achieving the goals of increased diversity and increased retention reaffirms its use in medical school admissions.