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Is medical school for rich kids?

Medical schools in Canada set their own admission criteria. Collectively they are the guardians to the gateway of the profession. This is an important aspect of their social accountability mandate.

Faculties of medicine in Canada have worked to increase the diversity of successful applicants to medical schools and thus influence the type of physicians that will provide care to Canadians. Since 1998, over 50% of medical students are female. Indigenous programs exist in all of our medical schools, and as of 2016, 2.7% of first year medical students identified as indigenous, an increase of 1% compared to 2003. This is still a far cry from the 4.3% of Canadians who are Indigenous, based on the 2011 Census.

Where we have even more work to do is in recruiting students from low socioeconomic households. The Canadian Federation of Medical Students indicate that medical students are far more likely than the average Canadian to come from families with a high household income. Data from the CFMS’s national medical student survey revealed that “only 13% of current medical students come from the low household income quintile” and “at some schools, only 3% come from the low household income quintile”.  This data aligns with the AFMC National Graduation Questionnaire Report which revealed that the percentage of medical students graduating with no debt increased to 15% in 2017.  However, for those students with debt, the median debt increased to $94,000. So more students are fully supported by their families and for those who are not, their debt is increasing. This is a significant equity issue.

Medical schools must recruit and select a diverse cohort of future physicians that is reflective of the diversity of our Canadian population. They must ensure that sociocultural and socioeconomic groups that have been historically underrepresented in medical school cohorts have equitable access to and success in the admissions process.  A group of experts has been established by AFMC to look at diversity and inclusion in medical school admissions. The Future of Admissions in Canada Think Tank (FACTT) has been meeting since January 2018 and is tasked with identifying areas of highest need and concern, and how pan-Canadian collaboration can occur. FACTT will be looking at a national definition of diversity, a centralized system for improved data gathering and diversity principles that could be applied nationally.  AFMC has also partnered with the Association of American Medical Colleges (AAMC) to support a fee assistance program (AFMC MCAT® FAP) for students taking the Medical College Admission Test® (MCAT®).

Determining who successfully enters medical school is the most important role of our faculties of medicine. It is our collective duty to ensure that medical school is accessible to a wide diversity of students, not just rich kids. This is how we will shape the future of health care by ensuring not only that our patients receive care from great physicians but also physicians who will have the capacity to ensure that all patients, no matter their background or status, receive quality compassionate care.