Kondo DG, Judd VE. Demographic Characteristics of US Medical School Admission Committees. JAMA. 2000;284(9):1111-1113. doi:10.1001/jama.284.9.1111
Author Affiliations: Karl Menninger School of Psychiatry and Mental Health Sciences, The Menninger Clinic, Topeka, Kan (Dr Kondo); Office of Medical School Admissions and Diversity and Community Outreach and Division of Pediatric Cardiology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City (Dr Judd).
Context Although concerns continue to be raised about the diversity of the US
physician workforce, there has never been a nationwide survey of both the
sex and underrepresented minority (URM) composition of medical school admission
Objective To document US medical school admission committee membership in several
demographic domains, including sex and URM (African American, Mexican American,
mainland Puerto Rican, Native American, Native Hawaiian, and Native Alaskan)
Design Mailed survey.
Setting and Participants Deans or directors of admission at 85 US medical schools that were members
of the Association of American Medical Colleges (response rate, 70%).
Main Outcome Measures Prevalence of 1999-2000 school-year committee members in demographic
categories, such as sex, URM status, physician or medical student status;
Results The overall ratio of men to women on admission committees was 1.77 to
1. On average, 16% of committee members were from URM groups. Physicians with
URM status comprised 8% of committee membership; 51% of committees had 1 or
0 URM physicians. Seventy-four percent of committees had at least 1 medical
student; medical students comprised 15% of total membership. Ninety-one percent
of committees operated on a volunteer basis.
Conclusion Although representation of women and persons with URM status on medical
school admission committees has improved since 1972, URM membership, in particular,
Medical school admission committees are charged with selecting the next
generation of physicians. The methods and results of the selection process
are well studied, but the demographic characteristics of the committees have
not been frequently examined. The most recent nationwide surveys were published
in 19721 and 1984,2
and a more recent study3 was limited in scope.
Since the publication of the earlier comprehensive studies, a number
of new issues have confronted medical educators. Among these are the growing
incentives to train primary care physicians, the rise of managed care and
evidenced-based medicine, and the desire to produce greater racial and ethnic
diversity in the physician workforce, as evidenced by the Association of American
Medical Colleges' (AAMC's) Project 3000 by 2000 initiative.4
However, there has never been a nationwide survey of both the sex and underrepresented
minority (URM) composition of US medical school admission committees.
We mailed a survey questionnaire with 19 questions regarding the demographic
characteristics of the admission committee to the director or dean of admissions
at the 122 AAMC member medical schools within the continental United States.
A second mailing was sent to those institutions that did not reply within
60 days. The survey asked respondents to report on their committee with respect
to total membership, sex ratio, URM membership (African American, Mexican
American, Mainland Puerto Rican, Native American Indian, Native Hawaiian,
and Native Alaskan), the academic career track of members, committee compensation
status, medical student membership, allied health professions membership (those
with PA, NP, RN, LCSW, PT, or OT degrees), and at-large or community membership.
The survey and accompanying cover letter specified that the investigators
were seeking information specifically regarding the "voting members" of admission
committees, ie, those individuals who are involved in the final selection
process for applicants who are offered admission. In completing the survey,
we asked respondents to refer to the committee that was convened to select
the incoming first-year class for the 1999-2000 school year.
Admissions directors were assured that their responses would be kept
confidential and that data analysis would be anonymous.
Of the 122 medical schools surveyed, 85 replied to either the first
or second mailing for an overall response rate of 70%. A summary of the data
is shown in Table 1. A composite
portrait of the average US medical school admission committee appears in the
first column of the table.
On average, there were 4.1 URM members (16%) per committee. Eleven schools
(13%) had no URM members, 13 had 1, and 17 had 2, ie, 29% have 1 or fewer
URM members, and 49% have 2 or fewer. One survey respondent did not provide
data for this category.
The URM physicians comprised 54% of total URM committee membership,
with a mean of 2.2 (8%) per institution. The range was 0 to 18, with a mode
of 0. Fifty-seven committees (69%) had 2 or fewer, 42 (51%) had 1 or fewer,
and 21 (25%) had no URM physician members. Non-URM physician members comprise
the majority of admission committee members, averaging 14.5 members (55%)
per committee. They comprised 65% of non-URM membership. This is statistically
significant when compared with the 54% of URM committee members who are physicians
The mean number of physicians (MD or DO degrees) per committee was 16.7
(63%), with a range of 3 to 51. Of these, on average 8.3 (32%) were tenure-track
faculty, 5.3 (20%) were clinical faculty, and the remainder were either volunteer
or retired or emeritus faculty. Primary care physicians (defined for survey
purposes as general internal medicine, family practice, or pediatrics) comprised
6.6 (40%) of physician membership and 25% of overall committee membership.
The mean number of female physicians per committee was 5.5 (21%), with
a mode of 4. More than one third of medical schools (36%) have 3 or fewer
female physicians, and more than two thirds (70%) have 5 or fewer female physicians.
The ratio of men to women was 1.77 to 1, with an average of 9.5 women (36%)
and 16.8 men (64%) per committee. Each medical school had at least 1 woman
on the admission committee. Women constituted a majority at 6 schools (7%)
and were represented in equal numbers at 2 (2%).
Medical student membership averaged 3.9 (15%) per committee, with a
range of 0 to 21. Nearly three quarters (74%) of institutions have at least
1 medical student on their admission committee. Seventy-seven (91%) respondents
reported that their committee provided no compensation to its members.
The mean number of members with PhD degrees (without an MD or DO degree)
was 5 (19%) per committee. Of these, 3.7 (14%) on average were basic scientists,
and 1.3 (5%) were clinical and/or social scientists.
The number of nonphysician, non-PhD dean's office personnel who hold
voting positions on admission committees averaged 0.64 (2%) per committee.
The range was 0 to 5, with a mode (58% of respondents) of 0 and a total of
54 members in this sample. Allied health professionals may represent some
overlap with the dean's office category. They average 0.11 members (0.4%)
per committee, with a mode (89% of respondents) of 0, a range of 0 to 2, and
a sample total of 9. Community membership on committees averaged 0.45 members
(2%), with a mode (75% of respondents) of 0, a range of 0 to 9, and a sample
total of 38.
The final category in the survey was "other," and respondents were asked
for a brief description of the members so designated. The mean for this category
was 0.21 (0.8%), with a mode (86% of respondents) of 0 and a range of 0 to
4. Twelve institutions (14%) had at least 1 committee member in this category.
A single university had a director of disabled students, an assistant professor
of English, the director of a center for academic excellence, and the assistant
director of alumni development on its admission committee. Other responses
included 1 director of minority affairs, 3 pastoral care service members,
1 dentist (DMD), 1 member with an EdD degree, 2 with combined JD-MPH degrees,
1 with a combined JD-RN degree, 1 with an MA degree, and 1 with an MEd degree.
Finally, 1 institution has created the position of visiting clinician, a role
filled from a pool of community physicians who precept medical students and
conduct applicant interviews and in return receive continuing medical education
This is the first study in 28 years to report a comprehensive survey
of the composition of admission committees in US medical schools. One focus
of this study was URM membership in medical school admission committees. We
found that on average 16% of committee members have URM status and that 87%
of schools have at least 1 member with URM status on their committee. These
statistics represent substantial gains since 1972, when just 55% of medical
schools had 1 or more URM committee members, and African Americans, Mexican
Americans, Puerto Ricans, and American Indians comprised just 6.1% of admission
committee members.1 A more recent study surveyed
the 15 AAMC schools with the greatest percentage of URM students and found
that URM representation on admission committees at schools that are not traditionally
African American ranged from 10% to 25%.3
One trend that is reflected in the survey is the rise in the number
of women in medicine. In 1982, women comprised 23% of committees and 31% of
medical school freshmen2; today those percentages
have grown to 37% and 44%,5 respectively. In
1972, women comprised just 8% of admission committees,1
reflecting an increase of more than 300% during the past 28 years.
Medical students currently hold positions on 74% of admission committees,
the same percentage as in 1982.2 Prior surveys
had shown that students were represented on just 56% of committees in 1972
and virtually none in 1957.6 Further study
is needed to assess the effect of medical student membership on admission
The arguments in favor of working toward racial and ethnic diversity
in the US physician workforce have been made elsewhere.7- 11
In the present climate, a reversal of historical gains in URM medical school
matriculation is taking place,12,13
and the barriers to the promotion of diversity in medical education continue
to grow.14 Investigators have concluded that
the composition of a medical school class reflects the composition of the
admission committee, particularly in terms of selecting students with an interest
in primary care.15,16 This leads
us to speculate that recruitment of people with URM status to sit on admission
committees is a potential method of promoting diversity in the physician workforce.
Our own experience at the University of Utah confirms that URM committee members
are frequently able to offer salient interpretations and clarifications of
the cultural factors relevant to an applicant's life history. Further study
is needed to examine the relation between URM admission committee membership
and the outcome of the admissions process.
Our study has some limitations. The 3 AAMC member institutions located
in Puerto Rico were not surveyed because we anticipated that they would have
a disproportionately large number of URM (Mainland Puerto Rican) committee
members. In contrast, traditionally African American medical schools were
included in the sample. A separate statistical analysis controlling for their
inclusion is not feasible, because survey respondents were assured anonymity.
We believe that medical school admission committees in our sample would appear
even less diverse than they do if such an analysis were performed. The data
ranges collected for some aspects of committees are large (Table 1). There are several possible explanations for this. First,
respondents may have mistakenly provided data that represent all the individuals
who are involved in the admission process. This seems unlikely, because both
the cover letter and the survey instrument contained reminders that the survey
pertained only to those involved in the "final selection process." It seems
more likely that admission committee practices are not standardized with regard
to committee size and structure.
In summary, we found that there is a wide variety among medical school
admission committees in terms of both the size and character of their membership.
The representation of women and people with URM status on medical school admission
committees has improved but may not be optimal. Committee members with URM
status are less likely than their counterparts to be physicians. Further study
is required to elucidate what effect committee composition, especially in
regard to URM membership, has on the outcomes of the admission process.