Umn Admtaskforce 31oct05

REPORT OF THE DEAN’S TASK FORCE ON ADMISSIONS Submitted October 31, 2005 Introduction The Dean’s Task Force on Admissions was commissioned on June 9, 2005 by Dean Powell. The charge given to the task force was to: I. Assess the process and effectiveness for recruitment of the most highly qualified students to the Medical School II. Assess the current relationship and effectiveness of recruitment strategies between the Office of Admissions and Health Careers Center, the University of Minnesota, Office of Admissions, and other colleges of the University of Minnesota III. Assess the relationships and coordination of recruitment of medical students to dual degree programs IV. Assess the relationships and coordination of recruitment strategies with other colleges, universities, and potential sources of medical student applicants V. Assess the process and criteria for recruitment and selection of medical students VI. Assess the effectiveness and efficiency of the admissions process, including communications, technological infrastructure and staffing in the Office of Admissions VII. Assess the effectiveness of the communications between the Offices of Admissions, Minority Affairs and Diversity (MAD), and the Center for American Indian and Minority Health (CAIMH). VIII. Assess the current coordination and oversight of the admissions processes of the unified Duluth and Twin Cities campuses AND Recommend a strategy to optimize all of these processes. The composition of the task force is found in Appendix A. This report contains the findings of the task force and is submitted in good faith. The Task Force would like to acknowledge the outstanding administrative assistance of Theresa Baultrippe; Krista Gallagher and Tammy Pederson also provided valuable technical and administrative support. The task force wishes to state up front its high esteem for the commitment and integrity of the admissions staff and committee members at both campuses. It is apparent that all of the admissions staff and committee members work very hard in the service of our institution, and they are to be commended for their diligence and commitment.

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Forward: The task force reviewed all the charges from the Dean, and has made many specific and general recommendations based upon review of data, strenuous deliberations, and advocacy for the medical school and profession. As we began to collect data, some of the stories—the qualitative data—became central to the task force’s discussion. These stories came from alumni, faculty and students, and the task force members felt strongly that they articulated some of the greatest challenges to the admissions process at the University of Minnesota Medical School: 1) integration of the Duluth and Twin Cities’ campuses; 2) separate but mutually supportive admissions mission statements for the two campuses; 3) comparisons of the responsiveness, timing and processes of admissions by applicants; 4) the need for accountability and transparency of admissions standards with the applicants, community and faculty; and 5) the need to devote resources to the recruitment and scholarships for highly qualified students to the medical school. For example, the comments of one underrepresented minority student who chose the University of Michigan over Minnesota are illustrative of the effects of the lengthy admissions process, the relative lack of resources devoted to recruiting, and our high costs: “The University of Michigan responded quickly with copious amounts of information; and I completed my application for Michigan after the Minnesota application. I completed my application for Michigan after Minnesota because Minnesota was number one on my list. Somewhere between January 5 and May 1 my interest in Minnesota started to wane and Michigan became my first choice. Three things happened during that period: 1) Michigan contacted me for an interview first. Although this did not change my ranking of the schools it did show that a quick response was possible. 2) After my interview with the University of Michigan, I was informed about their admission decision within two days. Therefore, I found out I was admitted to Michigan before I learned that I would interview at Minnesota…I received numerous publication materials from Michigan. I received at least 20 pieces of correspondence by mail; at least seven phone calls from students; and over 40 e-mails from students; admissions staff, and professors. After all of this, Michigan flew me back to Ann Arbor for a second look. If Minnesota had been as quick to respond as Michigan, I might have received this extra attention from Minnesota as well. 3) The University of Michigan offered me a $15,000 scholarship. Because Minnesota is one of the most expensive public medical schools in the country, this scholarship brought the financial burden of attending medical school out of state within reach.” The members of the task force accepted these challenges. This report and its recommendations represent our best effort to address them.

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Table of Contents

Part One.

Description of the Current Situation; Strengths; Areas of Concern

Section

4 Page

I.

Process and effectiveness for recruitment of the most highly qualified students to the Medical School

4

II.

Current relationship and effectiveness of recruitment strategies between the Office of Admissions and Health Careers Center, the University of Minnesota Office of Admissions, and other colleges of the University of Minnesota.

8

III.

Relationships and coordination of recruitment of medical students to dual degree programs.

9

IV.

Relationships and coordination of recruitment strategies with other colleges, universities, and potential sources of medical student applicants

10

V.

Process and criteria for recruitment and selection of medical students.

11

VI.

Effectiveness and efficiency of the admissions process, including communications, technological infrastructure and staffing in the Office of Admissions.

16

VII.

Effectiveness of the communications between the Offices of Admissions, Minority Affairs and Diversity, (MAD); and the Center for American Indian and Minority Health (CAIMH).

17

VIII.

Current coordination and oversight of the admissions processes of the unified Duluth and Twin Cities campuses.

18

Part Two.

Recommendations of the Task Force

20

Appendices A.

Admissions Task Force Membership

29

B.

Comparison of Prerequisites for the University of Minnesota and Peer Medical Schools

30

C.

Admissions Student Sub-Committee Recommendations

32

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Part One. Description of the Current Situation; Strengths; Areas of Concern

I.

Process and effectiveness for recruitment of the most highly qualified students to the medical school

Description Process of Recruitment. Recruitment activities are conducted through the Office of Minority Affairs and Diversity (MAD), the Center for American Indian and Minority Health (CAIMH), the Health Career Center (HCC), and the Office of Admissions (OA) at the Twin Cities (TC) campus, and primarily through the CAIMH and OA at the Duluth (DU) campus. The CAIMH is primarily funded by competitive renewable federal grants; this maintains programs, personnel and infrastructure. Promotional material is distributed through websites, hard copy publications such as the Medical School Catalog, and presentations at a number of scheduled activities such as Pre-Med Day, pre-admissions workshops, career fairs, and the rural pre-med summit. Students in the application process at DU are further recruited through a rich interview day experience where they have two interviews conducted by members of the Duluth Admissions Committee and have lunch with current medical students. Interview day recruitment activities for students applying to the Twin Cities campus include the following: a coffee hour with Admissions Ambassadors the evening before the interview, alumni and student host programs, class visits, Interview Day Program, and lunch and a tour of the medical school by Admissions Ambassadors. URM applicants receive specific recruiting efforts through CAIMH and MAD through activities like the CAIMH summer enrichment and academic year programs and the First Fridays Program. In contrast, for all other students, there appear to be no specific recruitment strategies for students who are rated to be the most highly qualified following initial evaluations (i.e., after the supplemental application is received at DU and after a Step I review at TC). Effectiveness of Recruitment. By the somewhat crude outcome measures available at this school and available to most medical schools, we recruit highly qualified students to this medical school who go on to productive careers in medicine. There are extremely low drop out rates of students recruited to each campus after they are matriculated, passing rates for board exams are high, and students perform very well in the Match Program. Survey data of residency program directors indicate that our graduates perform very strongly in their first year of residency. The performance of our medical school indicated by these measures of effectiveness on are on a par with many other medical schools, including peer schools such as Iowa, Wisconsin, and Michigan. A. Strengths 1. The holistic selection process, in which students’ entire set of qualifications are evaluated, fosters the recruitment of an accomplished and diverse student body. (Addressed in Recommendation R.2.b) Admissions Task Force Final Report

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2. MAD and CAIMH are valuable resources for recruitment, particularly of URM applicants. (Addressed in R.1.b and R.6) B. Areas of Concern 1. Extensive prerequisite course requirements may pose barriers to recruitment. The prerequisite course requirement is different for both campuses. At each campus the requirements are far more extensive and prescriptive when compared to other peer schools (See Appendix B, “Comparison of Prerequisites for the University of Minnesota and Peer Medical Schools”). The Task Force feels that the extensive list of prerequisites has the potential to inhibit highly qualified applicants, particularly those who have pursued atypical or alternate pathways in their academic and nonacademic careers, rather than to ensure breadth among the applicants. Specific requirements for calculus, social science, behavioral science, humanities, and biochemistry are atypical when compared to other medical schools’ admissions requirements, and could serve to exclude highly qualified applicants. For example, a student with a masters degree in public health, including extensive background in statistics, would certainly possess the mathematical aptitude to become a fine physician; yet, to successfully apply to this medical school, such a student would have to complete a course in calculus. (Addressed in R.5.a) 2. The overall coordination of recruiting efforts across both campuses could be improved. There have been difficulties in communication between MAD, CAIMH, and the OAs at each campus. Occasionally recruitment efforts sponsored by two different offices have been scheduled at the same time. This problem has been recognized and there are plans in place to develop a shared calendar of recruitment events and to have the offices meet regularly to discuss recruitment activities. (Addressed in R.1.b and R.6) 3. High tuition and lack of modern facilities are increasingly significant barriers to recruitment. Each year, the TC OA conducts a survey of applicants who have withdrawn after being accepted to the medical school. In this survey these applicants are asked to rank the factors that were most important in their decision to attend another medical school. In 2001, only nonresident applicants identified “cost of attending” as one of the top five reasons, while neither residents nor nonresidents cited “facilities.” However, in each of the past four years, both cost of attending and facilities have appeared on the list of the top five factors for both Minnesota and non Minnesota residents. In 2005, cost of attending was the number one reason cited by Minnesota residents and the number two reason cited by non residents. For perspective, US News and World Report has ranked Minnesota’s in-state medical school tuition as fourth most expensive of all public schools in the nation for each of the past two years. Facilities were the second most important reason cited by Minnesota residents to matriculate elsewhere. The fact that peer schools such as Iowa and Wisconsin have new medical education buildings with state-of-the-art classrooms presents a specific challenge for recruitment to this school. (Addressed in R.1.c) 4.

The lengthy admissions process at the TC campus may prompt applicants to look elsewhere. See Section VI.B for further details of the TC application duration. Several

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students who were interviewed by the Task Force members and on the student subcommittee described delays in the application process at Minnesota compared to other schools to which they had applied. These delays were reported to occur in initial contact after application via AMCAS, scheduling of interview day, and admission decision. (Addressed in R.3) 5. The evaluation markers described may not be so sensitive as to allow an in-depth, thorough assessment of the effectiveness of the recruitment process. The overall perception is that quality of the accepted student remains high but the question remains: are there students that we are not able to recruit to our school for yet unidentified reasons? Are we truly able to recruit the best students? (Addressed in R.1.b) 6. The basic recruiting message at the Twin Cities campus needs to be honed and publicized. Admittedly, as a large land grant institution, the mission of the Twin Cities campus is quite broad, and this mission is reflected in its mission statement and in documents such as the 2004 LCME Self Study report. However, recruitment could be potentially aided by a further honing of the Twin Cities campus message as it relates to the school’s mission, and this recruiting message could be more consistently promulgated by publications, faculty, and staff. For example, at the Duluth campus, all publications mention the Duluth mission of rural family practice or primary care, with emphasis on service in American Indian communities. This message is repeated over and over again in every Duluth publication, and is very consistently quoted by virtually any faculty or staff who has interviewed at Duluth. At the Twin Cities, there is no such corresponding succinct and widely quoted message. The LCME report mentions the school’s identity as a “full service” medical school befitting a land grant institution, and also highlights its particular strengths in primary care and (particularly) basic research. The medical school catalogue publishes the Medical School Mission Statement on page 2, outlining its “two campuses serving diverse populations in rural and urban Minnesota, [and] dedicated to preeminence in primary care medicine, exemplary specialty care, and innovative research”; on page 4 of the catalogue, a Medical Student Education Vision Statement is printed, outlining the goal of the educational program as preparing “future primary care providers, clinical sub specialists, researchers, educators, and health care leaders.” This section is followed by the Duluth campus mission statement, once again succinctly outlining the points mentioned above, but then there is no corresponding Twin Cities campus mission statement. Additionally, the Medical School does not sufficiently advertise its strengths. The students reviewed the “points of pride” page from the website and suggested the following improvements: •

Our rankings in U.S. News and World Report, for example for primary care and as a top three research institution.

•

Flexible M.D. Program

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•

•

Points of pride for the Twin Cities campus include: o Primary care o Global health o Basic sciences o Inter-professional educational opportunities o Diversity of clinical experiences o Diversity of students o Enormous diversity of faculty interests from primary care to subspecialty clinical care to applied and basic science o Camaraderie among students, eg. students assisting each other academically through the knowledge co-op and informal tutoring, and a strong sense of class success o Camaraderie among faculty and students o Flexibility and the availability of a large number of electives Points of pride for the Duluth Campus include: o Primary rural and Native American health care. These are usually well captured in promotional materials, but for both, as with the Twin Cities, the students want to be able to tell stories. They suggested, for example, website postings of pop-up videos or examples of conversations with students about their experiences in the Twin Cities or Duluth. o Availability of inter-professional experiences o Both campuses should include RPAP as a strong point of pride

(Addressed in R.1.a, R.1.e, R.2.a, and R.9) 7. Without compromising the integrity of the selection process, there needs to be more intensified recruitment of the most highly qualified applicants. While it is illegal to bestow privileges to individual applicants in the selection process, there is nothing wrong with targeting certain applicants for special recruitment, such as through increased communication of promotional messages or through facilitation of recruiting visits to the school. As the applicant pool shrinks and competition for the highest qualified students increases (see Section III), successful matriculation of the truly extraordinary applicants becomes more crucial. A related issue concerning targeted recruitment is the extension of special admissions consideration for spouses and significant others of the most highly desired applicants, current students, or faculty. Currently no preference is given for spouses/significant others. To acquire some normative data on the topic, an e-mail inquiry was sent by the TC Director of Admissions to solicit the policies of other medical schools. Of thirty medical schools who responded: • 21 indicated that no spousal preference was given • 2 replied that no preference was given, but there was an impression that spousal consideration may enter unconsciously into selection decisions • 1 school currently did not give spousal preference but was considering giving it a “discretionary point” in the consideration of invitation for an interview Admissions Task Force Final Report

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•

6 stated that some type of consideration was given (though all mentioned that the spouse/SO would have to meet admissions standards or be a “strong candidate”). (Addressed in R.1.g and R.1.h)

II.

The current relationship and effectiveness of recruitment strategies between the Office of Admissions and Health Career Center, the University of Minnesota Office of Admissions, and other colleges of the University of Minnesota.

Description The Health Careers Center (HCC) provides the TC campus with recruitment enhancement activities across all of the University of Minnesota undergraduate colleges. Core recruitment activities are the responsibility of the Medical School. The HCC is a very active office with six full time and two part time faculty and staff. The HCC conducts a number of career exploration activities for all health profession schools with prospective pre-health students. Customized activities for pre-med students include information sessions on application, interviewing, and experiential preparation. High ability pre-medical students are targeted with a course focusing on the roles of future physicians. Coaching on internships and volunteer activities is pivotal in developing the critical decision making skills of these students. The Health Careers Center has an interactive web site which offers workshops on assessment, career exploration and strategies for being a successful pre-health student. The HCC has become expert in monitoring data about prospective pre-health students in collaboration with the Office of Admission and other state agencies such as the Department of Education and the Department of Health. The trends that are important in designing a core recruitment plan for the Medical School are the decreasing pool of college students, the increased diversity of the students in the pipeline, and the general erosion of the K-12 system. These factors combined will create increased competition for upcoming college students in Minnesota who are able to master high ability math and science in the collegiate system. This smaller pool of well prepared students will be targeted for recruitment by career options other than medicine in the health professions, and by non-health careers as well. Education costs along with lifestyle demands will also be factors in recruiting prospective medical students. There should be a resource for undergraduates seeking opportunities to work in laboratories, shadow faculty, or in other ways establish relationships in the Medical School. Accomplishing this goal with faculty is an important consideration since requests for enrichment experiences are common and faculty do not have time or resources to deal with them presently. Failure to satisfactorily address these requests may be a marketing and recruitment opportunity lost.

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A. Strengths 1. The HCC is a valuable resource that reaches many students throughout the University of Minnesota Twin Cities campus and the state. (Addressed in R.1.b) 2. Programs like the TC Pre-Medical Scholars program and the DU EARS program have helped to recruit very highly qualified, “home grown” matriculates to the medical school. (Addressed in R.1.d) B. Areas of Concern 1. Recruitment at the high school and baccalaureate level will become increasingly important and challenging over the next ten to twenty years given the projections regarding the applicant pool. (Addressed in R.1.d) 2. There is a strong perception, based upon conversations with the Associate Dean of Students for the College of Biological Sciences (CBS), Robin Wright, that highly qualified applicants from CBS are not being optimally recruited. Although she acknowledges that there no hard data to back it up, Dr. Wright emphatically states that the general feeling among CBS students is that they are not made to feel welcome at the TC campus, and that they are greatly predisposed to seek medical school admission elsewhere. CBS is one of the most competitive colleges at the University and provides a reservoir of potential highly qualified applicants to our own medical school. Approximately two-thirds of the CBS students are Minnesota residents, and the vast majority of the remainder are from neighboring states, particularly Wisconsin. (Addressed in R.1.f) 3. There needs to be a thorough discussion of fast track programs to capture talented prospective students into medical school. The Medical School will also have to deal with high school students who are starting on campus with credits that make them juniors. There will be more of this type of student with the financial constraints that students experience. It will become increasingly more attractive to use the PSEO program to have college courses in high school for free. (Addressed in R.1.g)

III.

The relationships and coordination of recruitment of medical students to dual degree programs.

Description The U of M offers five different dual degree programs: MD/PhD, MD/JD, MD/MPH, MD/MBA, and MD/MHI. The MD/PhD Program is by far the biggest of these, with federal funding and an excellent reputation. MD/PhD admissions are handled primarily through the MD/PhD office. MD/PhD candidates turned down by the MD/PhD Program are informed that they need to contact MD Admissions if they are interested in being considered for the MD Program. Admission to the other dual degree programs is handled Admissions Task Force Final Report

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individually by the respective schools. The TC OA arranges individual appointments at the specialty schools for interested applicants as part of their Interview Day activities. Application to the second degree program is made after matriculation into the medical school. After matriculation, recruitment to each of these programs is handled by the Medical School Office of Student Affairs and each specialty school. A. Strengths 1. All of the dual degree programs are actively serving to prepare students for specific future challenges in health care. The large array of dual degree offerings illustrates the protean resources that can be brought to bear by this University to individualize health care education. (Addressed in R.1.i) B. Areas of Concern 1. The dual degree programs could be used more as a generalized recruiting tool. Not only would further recruitment help to attract students of unique qualifications and interest, but it would also help to “sell” the University’s resources to all medical school applicants. (Addressed in R.1.i)

IV.

The relationships and coordination of recruitment strategies with other colleges, universities, and potential sources of medical student applicants

Description Recruitment activities consists of activities such as participating in recruitment and career fairs, visiting other college and university campuses, presenting to classes and pre-med student groups, communicating with pre-medical advisors, hosting pre-medical groups, and hosting the annual pre-medical students day. OA, CAIMH, and MAD faculty and staff perform many of these activities, some with the assistance of the HCC. In the past six years, the colleges providing the most matriculates in addition to those from the University of Minnesota are St. Olaf, University of Wisconsin-Madison, Carleton, St. Thomas, Gustavus, Macalester, Notre Dame, Northwestern, St. John’s, St. Ben’s, College of St. Scholastica, UMD, U of MN Morris, U of MN, and Concordia.. The vast majority of medical school applicants who are Minnesota residents apply to the U of M medical school (614 out of 639 MN residents in 2004). A. Strengths 1. Recruitment from outstanding undergraduate institutions within the state has been successful. (Addressed in R.1 various subsections)

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B. Areas of Concern 1. Could we do better in attracting students attending outstanding undergraduate institutions in other states? We have done well in recruiting students from schools in Minnesota such as Carleton, St. Olaf, and Macalester, but could we do better in recruiting students from out of state similar schools such as Ripon and Grinnell? Are we successful in recruiting students from Minnesota who have attended elite undergraduate institutions outside of the mid-west? Of the highest qualified Minnesota resident applicants to our medical school, how successful are we at matriculating them? (Addressed in R.1.b)

V.

The process and criteria for recruitment and selection of medical students

Description The process of recruitment is described in Section I. The process of application and selection is as follows: 1. Applicant is verified by AMCAS as having applied to the U of M. Once this notice is received, an e-mail is sent to the applicant with some promotional material; a second “welcome” e-mail is sent from the Director of Admissions. At TC, OA staff verifies that the applicant is on track for a degree and updates her or his racial/ethnic minority status. It is then checked to see if the student is planning on taking the August MCAT. If so (about 40% of students) the application is put on hold until the scores from the August MCAT are available in mid-October. Once these steps are completed: 2. The application is sent to the Admissions Committee (AC). It is put into a pool of applications and AC reviewers electronically access them randomly. At the TC, an experienced reviewer (at least one year of experience on the AC) performs a Step 1 review which determines whether the application will continue on or be rejected. If the student is deemed to have potential, they are sent onward. At DU, there is no Step 1 review by the AC; if an applicant is a U.S. citizen he or she proceeds to the next step. 3. A request for a Supplemental Application (SA) goes out to the applicant. At TC, the SA consists of 9 short essay questions; 4 letters of recommendation, which have a unique format to this medical school; a form attesting to technical standards; a photograph; and a $75 fee. At DU the SA consists of 17 questions, three letters of recommendation using a similar format as the TC, and a $75 fee. The applicants are given 30 days to complete the SA. TC applicants are sent an e-mail each time an application material is received and once the application is complete. Applicants can access a checklist online at any time to see what materials have been received and if their supplemental application is indeed complete. DU is implementing a similar online checklist this year. If the TC OA notes that all materials are not received within 30 days, the student is contacted and encouraged to complete them. However, at the TC or DU, there is no fail-safe method for reminding students toward the end of this 30-day period if they have not yet finished completing all of the components of the supplemental application. At DU, applicants are encouraged to Admissions Task Force Final Report

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complete the SA in 30 days; if they do not, their application remains on hold until it is completed. In January, DU applicants whose files are not complete are informed of an ultimate application deadline of March 1. 4. Once the supplemental application is complete, a Step II review is assigned. A staff person assigns an applicant’s completed file to two members of the Admissions Committee. This is done at random. It is usually done to ensure an equal number of files for each committee member. Both reviewers can not be new members of the committee (at least one of the pair must have at least one year of experience on the Admissions Committee). There also can be no relationship between a committee reviewer and the applicant. 5. A Step II review occurs. At the TC, this is carried out by two members of the TC Admissions Committee. Staff checks daily to see if these reviews have been completed. Once both reviews have been completed, the possible outcomes are as follows: 2 yes — the applicant is asked for an interview; two no — the applicant is rejected; and split-vote — the applicant’s file is assigned to a third reviewer. Prior to this year, the three reviewers were notified of the majority decision, and each could accept the decision or request a final review before by the Admissions Committee. In September 2005, the TC AC revised this policy, making the majority decision the final decision. In DU, a standing 3-person subcommittee of the DU AC performs the Step II review and decides (by 2 positive votes) if an applicant is invited for an interview. 6. Interviews are arranged by OA staff, primarily through e-mail at TC and by phone at DU. At the TC, interviews are conducted by a variety of AC members and non-members; at DU, all the interviews are conducted by AC members. At TC, applicants receive 1 interview; at DU they receive 2. At DU, interviews are usually scheduled and completed within 2 weeks, while at TC there are longer lags until completion of the interview, due to a variety of factors, including applicant circumstances (eg. out-of-state applicants pursuing low-cost airfares or scheduling interviews to coincide with other travel plans) or recruitment efforts (eg. First Fridays). At TC, interviews are only conducted in the morning. Interview days are usually Monday and Friday, and occasionally on Tuesday and Thursday. At TC, applicants are offered interview dates from which to select (typically 1-3 weeks from date of interview invitation), but if a minority applicant wishes to participate in the First Fridays program, the applicant needs to wait until the next First Friday for her or his interview. It is thus possible for minority applicants to have a longer lag between an invitation for an interview and the actual interview itself. The MAD has added additional “First Fridays” this year to shorten any lags that may have occurred in the past. 7. The actual interview takes place and interview report forms (available in hard-copy and electronic form for the past few years) are requested within 48 hours. Virtually all report forms are returned within one week, but there are some exceptions. 8. A Step III review is conducted, incorporating all of the information gathered through and including the interview. At the TC, the applicant is given a numerical score by each of the two primary reviewers. Scores correspond to categories of Accept, Committee Admissions Task Force Final Report

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Review, and Reject. If both reviewers independently assign a score warranting the Accept or Reject categories, summary applicant information and reviewers’ comments and ratings are provided to the Committee for review. There may be comments and/or discussion on the applicant; and then a Committee vote is taken to accept the reviewers’ decision. In the event that the reviewers’ rating fall in different categories or both reviewers’ ratings are in the Committee Review category, then the reviewers present the applicant’s file to the Committee. Following discussion, Committee members vote on the applicant by each assigning a rating to the applicant. An Olympic style system is utilized in which the top and bottom scores are thrown out and the average of the remaining scores calculated. The final rating will then determine the outcome of accept, reject, or wait list. At DU, all of the AC committee members score each applicant, and the average score is used to determine acceptance. Both campuses employ a “holistic selection” process, in which all of each candidate’s qualifications are considered for selection. No one criterion is given preferential weight across all candidates in the selection process. There are no relative values assigned to various selection criteria – one accepted candidate may be outstanding in criterion A and adequate in criterion B, while another accepted candidate may be very good in both A and B criteria. Both campuses also use rolling admissions. The TC and DU maintains the same acceptance standards throughout the year. This usually means that toward the end of the application season, there is a higher applicant/acceptee ratio. Thus, the competitiveness for acceptance is higher at the end of the admission year than at the beginning; however, this phenomenon yielded only 2 TC applicants in 04-05 that were deemed acceptable candidates late in the admissions season but not offered admission. A. Strengths 1. The two campuses of the University of Minnesota Medical School, integrated in 2004 by the LCME, have a powerful opportunity to strengthen admissions to both campuses by understanding and advertising the breadth of educational and training experiences. The unique mission of the Duluth campus to recruit and train primary care physicians and American Indian physicians for rural practice is invaluable to the Medical School’s overall mission. (Addressed in R.1.a and R.2.c) 2. Overall, the current system functions to select a well-prepared class who go on to become good physicians. Virtually all of our matriculates graduate, score well in standardized evaluations, match in competitive residencies, perform well as first year residents, and pursue a variety of career paths. The DU campus has been particularly effective in matriculating students who practice in rural settings, choose Family Medicine or primary care for their career focus, and serve American Indian communities. (Addressed in R.1.b, R.2.b, and R.2.c)

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B. Areas of Concern 1. Integration of the medical school campuses in Duluth and the Twin Cities poses a particular challenge in maintaining the momentum of each school’s mission. Specific concern emerged from the members of the task force regarding the potential diminution of the mission of the DU campus and the need to articulate that mission within the university and to the greater community. (Addressed in R.1.a and R.2.c) 2. Many constituents – some applicants, some faculty, some members of the admissions committee, and some community physicians – perceive that the selection process is mysterious, inconsistent, and flawed. There are more than a few cases where applicants have been mystified over being rejected at Minnesota while being accepted at other highly competitive schools. (This is a situation that is undoubtedly present to varying degrees at other medical schools; there are no data to determine the relative occurrence of this phenomenon at Minnesota). Faculty and community physicians, particularly U of M medical alumni, hear anecdotal stories from rejected (and ostensibly highly qualified) applicants, fueling a perception of mistrust in the selection process. Of course, what outsiders are never privy to is the actual performance of the applicant and the actual deliberative process of the AC. Thus, it is possible that an applicant with outstanding MCAT scores and GPA who was rejected on basis of a poor interview performance at Minnesota (but perhaps interviewed well at Harvard) becomes, to the outsider, the applicant who was accepted at Harvard but inexplicably rejected at Minnesota. The vast majority of AC members and staff possess a strong conviction to and confidence in the fairness and integrity of the selection process. However, a minority of members of the TC AC have expressed frustration that the selection process appears to be inconsistent across applicants, with inconsistent weight given to varying selection criteria. Again, anecdotes supporting opinions such as these tend to find their way to faculty and medical alumni. Whether or not the perceptions cited above reflect real flaws in the selection process, these perceptions nonetheless constitute a significant problem reflecting on the school’s overall image. Widespread confidence in the selection process needs to be instilled. (Addressed in R.2.a, R.2.b, and R.9) 3. The stated criteria for selection is somewhat inconsistent across pertinent documents at the TC site, and don’t clearly reflect evaluation forms for selection used by AC members. For example, while there are 5 “significant qualifications” listed at beginning of the TC AC manual and on its website, there are then 12 additional “non-cognitive selection factors” listed in AC manual. It is unclear how these criteria are prioritized in the selection process (and they may not be, given the holistic selection strategy). There is not a clear alignment of these criteria with the various missions of the medical school (see Section I.B.6). Nor is there a clear match between these criteria and the various forms used by the TC AC members to evaluate applicants – the questions answered by the applicants on the Supplemental Application; the Guidelines for Admissions Committee Reviews in the AC Manual; the Step 1, 2, and 3 Review Forms; and the Interview Report Form. The information and items in these documents swirl around but Admissions Task Force Final Report

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are not specifically congruent with the stated selection criteria. In sum, there is no clear “connect the dots” between published mission statements, selection criteria, and evaluative forms. The lack of clear consistency among these documents has the potential to fuel a perception that the selection process is likewise inconsistent across candidates. At DU, the stated mission of the campus, the published selection criteria, the questions on the Supplemental Application, and all evaluative forms clearly address themes of service to the state in rural family medicine or primary care, with an additional emphasis on service in American Indian communities. (Addressed in R.2.a and R.2.b) 4. The interview process and quality could be improved. The Task Force members believe that the interview serves as both a tool of recruitment and as a method of validation of the qualities sought in medical school applicants. Interviews are an opportunity for clarifying dialogue between an astute faculty member and an applicant about those qualities. Whereas at DU, all of the interviews are conducted by AC members, and each member conducts approximately the same number of interviews, the interviews at the TC are conducted by a much larger number of AC and non-AC members. Interview questions are not standardized at either campus, though interviewers are provided with suggested questions. At the TC, there is no formal instruction or standardization on how an interview should be evaluated; interviewers complete a report form with written impressions under various categories of applicant characteristics and performance. DU interviewers use a more directed interview evaluation form corresponding to specific selection criteria. With only one interview conducted at the TC campus, the large number of interviewers increases the potential for inconsistent interviewer quality and evaluation. Applicant survey data indicate that the TC interview day overall is highly rated (mean of 1.65 on a Likert scale where 1=excellent), with good ratings for interviewers (e.g. mean ratings of 1.55, 1.54, and 1.83 for items of “put me at ease,” “communicated well with me,” and “was able to get a fair and accurate picture of me as an applicant.”) At DU, 99% of applicants state on an applicant that they are satisfied with their interviews. (Addressed in R.4) 5. The actual holistic evaluative process needs to be demystified. In explanations of our selection process to applicants, students, faculty, and alumni, more information needs to be provided on: • How the reviewer translates review form data into a numerical score. • The qualifications for medical school. • The steps taken to assure integrity of holistic evaluation across different reviewers. The last study of inter-rater reliability was apparently done in 03-04. Interviewer report forms have somewhat crude rating anchors, leading to possible rating inconsistencies among the interviewers. • The role of state residence on selection – currently 28% of incoming TC class are from out of state, and 5% are from out of the country. The 92% of the applicants who matriculate at DU are from in-state with a few from bordering states. The Admissions Task Force Final Report

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proportion of out-of-state residents in the class is of paramount interest to several important constituents of the medical school, most notably its alumni. (Addressed in R.2.a, R.2.b, and R.9)

VI.

The effectiveness and efficiency of the admissions process, including communications, technological infrastructure, and staffing in the Office of Admissions.

Description The TC OA consists of a Director, a Principal Administrative Specialist, a Word Processing Specialist, an Information Technology Specialist (all the preceding are full time, with the exception of the Director who also provides advising on learning and performance issues for medical students and residents), and one student worker providing clerical and administrative support. The DU OA consists of an Associate Dean for Admissions and Student Affairs and a Principal Administrative Specialist. The TC has placed major effort on establishing online application and review processes. DU will be phasing in online reviews over the next 2 years. A. Strengths 1. Level of commitment by AC staff and members is excellent. On both campuses, admissions staff expressed an ardent pride and devotion to their work. (Addressed in R.3.b and R.7) 2. The TC online Supplemental Application (available since 2001-2002 application cycle) is consistent with standard practice for major medical schools. Online reviews have helped to speed up reviewer time and are consistent with the increased use of technology in medical schools/by faculty. (Addressed in R.3.b) 3. CQI process has been implemented and is working on some known problems. (Addressed in R.3.c) B. Areas of Concern 1. There are concerns about the speed of processing of applications, especially at the TC campus. Online reviews have improved this somewhat (though it has added to staff work burden), but there are still significant delays in processing. The average time from receipt of an AMCAS application to issuance of an acceptance letter is 10 weeks at DU and over 20 weeks at TC. Some factors that are involved in delays are: • The Step II application letter of recommendation form. This 3-page form, utilized by both TC and DU, is unique to the U of M application and requires extra work by the recommender. • The length of the Step II application. There are 9 questions in the TC supplemental application, 17 in the DU. How much does the AC use these in

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determining selection? DU AC members use the answers to these questions to determine fit for the mission of the school. • Length of Step II reviews. These take varying amounts of time, but can be lengthy – the mean time at the TC is 60 days. About half of this time (mean of 28 days) is due to staff processing of the application – scanning documents and preparing it for online submission to AC reviewers. • Length of Step III reviews. These can take as long as 29 days. • There have been significant difficulties with interviewer time restrictions, inhibiting timely scheduling of interviews. For example, interviews are only conducted in the morning. Interviews days are usually Monday and Friday, and occasionally on Tuesday and Thursday. (Addressed in R.3.a-c) 2. OA staff feel very strongly that there is inadequate staffing (in numbers, not in quality!) for efficient processing. On-line reviews have added work for staff, while improving efficiency and ease for AC. Staff feel they need more help to speed up the application processing activities or to further aid in recruitment activities. Significant staff time is needed to prepare for the Wednesday TC AC meetings. There should be a way to improve the efficiency of the Wednesday meetings to decrease staff time. (Addressed in R.3.a and R.3.b) 3. There have been communication breakdowns with applicants, particularly at the TC campus, which processes 2 ½ times the number of applications than at DU. These communication breakdowns have occurred sporadically with different applicants at different places in the admissions process. Addressing these processes is a high priority for the TC OA with its CQI process. (Addressed in R.3.c)

VII.

Effectiveness of the communications between the Offices of Admissions (OAs), Minority Affairs and Diversity (MAD) and the Center for American Indian and Minority Health (CAIMH)

Description See Section I Description. A. Strengths 1. MAD (in the TC) and CAIMH (in both DU and the TC) are valuable resources in the recruitment of a diverse student body. (Addressed in R.1.b and R.6, and R.8) 2. We have an outstanding record of recruiting American Indians at both campuses. (Addressed in R.1.b and R.6, and R.8)

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3. There is a collegial, effective working relationship between CAIMH and both the DU and TC OAs. (Addressed in R.1.b and R.6, and R.8) B. Areas of Concern 1. At the TC campus, recruitment and admissions appear less linked both in philosophy and administrative structure. The TC OA appears much more focused on selection than recruitment, whereas these two functions appear more integrated at DU (facilitated greatly by the smaller size and narrower mission at DU). (Addressed in R.1.a, R.1.b, and R.1.e) 2. The current administrative structure does not facilitate coordination of recruitment and admissions activities. The CAIMH director, Joy Dorscher, and the DU Associate Dean for Admissions and Student Affairs report directly to Dean Ziegler at Duluth; the MAD director, Mary Tate, and the TC admissions director report to Dean Watson at TC. (Addressed in R.6.a and R.8.b) 3. Better communication across the OAs, MAD, and CAIMH are needed. Conflicts have occurred due to the offices scheduling various events without checking with each other. There is no formal meeting schedule between MAD, CAIMH, and OA staff or administration. (Addressed in R.1.b and R.6.b) 4. In the past, there appears to have been less sharing of applicant information by the TC OA with MAD and CAIMH than occurs at DU. The ability of MAD personnel to access data electronically became available in July, 2005 with the development of the new 2.0 AMCAS system. Prior to that MAD staff had to ask TC OA staff for certain data, leading to delays in processing applications (due to tying up OA staff time) and hindering recruiting activities by MAD staff. With the introduction of the new AMCAS 2.0 system in June 2005, TC OA is now able to provide and has provided electronic access on all multicultural applicant information to MAD. (No recommendation needed if full information sharing continues)

VIII. The current coordination and oversight of the admissions processes of the unified DU and TC campuses Description During the process of LCME unitary accreditation, the decision was made that each campus should retain separate admissions personnel and processes, given the differing missions of each campus. However, unitary accreditation mandated some type of central oversight of admissions across both campuses. The Executive Admissions Committee (EAC) was thus created in 2003 to provide central oversight of admissions across both campuses. The EAC consists of the DU Associate Dean for Admissions and Student Affairs, the TC Director of Admissions, the chairs of each campus’s Admissions Committee, and the Director of the MD/PhD program. The EAC formally meets twice a

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year. There is weekly phone contact between the DU Associate Dean of Admissions and the TC Director of Admissions. A. Strengths 1. There is excellent communication between the admissions administrators at both campuses. Drs. Becker and Repesh feel that communication is complete, respectful, and built on mutual trust. The EAC meets twice a year and coordinates the processes on both campuses. (Addressed in R.8) B. Areas of Concern 1. The Task Force agrees that admissions processes should be tailored at each campus to reflect its mission. However, there are several procedures handled differently at each campus that would appear to have no relation to their respective missions. Have such procedures addressed differently across campuses could create confusion among prospective applicants and other potential problems for admissions. These procedures include: • The Step I review. The TC performs a formal Step I review while DU does not (at DU, all applicants who are verified U.S. citizens receive an invitation to complete a Supplemental Application). Thus, it is possible that a student applying to both campuses could be rejected at TC and continued in the application process at DU after only submitting the AMCAS materials. • The requirement of a photograph. The TC requires a photograph with the Supplemental Application while DU does not. Although the photograph at the TC is used strictly for identification purposes, this inconsistency across campuses could potentially send misleading messages to applicants applying to both. • Prerequisite course requirements. Though similar, they are slightly different for each campus. See Section I.B.1 for further discussion of prerequisites. (Addressed in R.5) 2. There is a strong perception, particularly among former and current AC members, that admissions and recruitment activities are undervalued at the TC campus relative to DU. AC membership is extremely time consuming, with an average of 200 hours/year commitment for each member. While membership on the DU AC is meted out uniformly across faculty as an expectation of regular duties, TC AC membership (established by means of the FAC Nominating Committee) is more ad hoc, with few provisions for equal representation across departments and disciplines. The head of admissions at the TC is the Director of Admissions, while the corresponding position at DU is Associate Dean for Admissions. Some members of the Task Force feel that these differing titles further reflect a disparity in value across campuses. (Addressed in R.7) 3. Although communication between the two OAs is excellent, there could be better communication between the OAs and senior management. There is no formal communication between the EAC and top medical school administrators, particularly the Senior Associate Dean For Education, the DU Dean, and the Dean. (Addressed in R.8.b)

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Part Two. Recommendations of the Task Force

R.1. ENHANCE RECRUITMENT ACTIVITIES. R.1.a. Develop an overall marketing plan. The marketing plan should include the development and dissemination of a recruiting message for the Twin Cities campus, and further refinement of how the TC and DU campuses complement each other. Similar to the situation at the DU campus, the TC campus needs to develop a succinct recruiting message that is consistently promulgated by faculty, students, mission statements, and all promotional material. Similarly, a succinct message regarding how the two campuses complement each other needs to be further refined. R.1.b. Hire a professional Recruitment Coordinator. An experienced professional devoted exclusively to recruitment should be hired. This individual would work with the offices of admissions at the two campuses, the Health Career Center, MAD, and CAIMH to coordinate all recruiting activities. The Recruitment Coordinator could be housed in the medical school or the HCC (models exist of similar recruiters for the Schools of Public Health and Pharmacy who are housed at the HCC). The Recruitment Coordinator should consult with other U of M professional schools noted for recruitment innovation and success, such as the Law School. The recruitment coordinator would respond to undergraduate requests for information or mentoring and engage medical student volunteers more actively and intentionally. The Recruitment Coordinator would also be charged with the collection and reporting of key outcome data, including not just the profiles of applicants and matriculates, but also evidence that we are recruiting the best candidates out of high school, college, and beyond, particularly from applicants who are Minnesota residents or who are likely to settle in Minnesota. Additionally, this person would be responsible for tracking the subsequent activities and successes of our matriculates as they pursue their medical careers into the future (the career choices, professional profiles, and geographic placement of our graduates in residency and beyond need to be reliably measured.) R.1.c. Address problems of rising tuition and outdated facilities. While it is easy for a task force to make recommendations such as “reduce tuition” and “build new buildings”, it is important to recognize that these two problems have become serious barriers to recruitment. As a start, these problems could be addressed by: • Publication to senior university administration and state government the evidence that lack of medical school financial support has contributed to these problems and now serves to threaten the quality of students we can recruit. • Assemblage and reporting of data regarding average student debt on graduation for our schools compared to other schools. In lists of tuition alone, Admissions Task Force Final Report

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• • •

our school tends to look much worse than peer schools; this may not be in fact the case if the more meaningful comparison of average student debt is consistently compared and reported to potential applicants. Further work with the Minnesota Medical Foundation to enhance scholarships as much as possible. Exploration, through legislative lobby, of a loan forgiveness program for graduates and residents who remain in Minnesota after residency if they provide service to underserved communities in the state. Further upgrading of existing classrooms and student life facilities if erection of a medical education building is out of the question.

R.1.d. Expand existing successful recruitment programs. Programs such as the Premed Scholars Program, Early Decision Program, Early Admissions Rural Scholars Program, the Life Sciences Summer Undergraduate Research Program, and various high school pipeline programs have shown some success in recruiting outstanding students. Strong consideration should be given to expanding these programs and even to formalizing required faculty participation in these programs. The medical school should be a resource for undergraduates seeking opportunities to work in laboratories, shadow faculty, or in other ways establish relationships in the Medical School. Perhaps departmental and faculty involvement in recruiting activities could be built into the compact process. R.1.e. Bring recruitment to the forefront of all admissions and outreach activities. Every encounter with an applicant or potential applicant—through university and school websites, publications, telephone calls, written correspondence, formal interviews, and casual conversations—should include a recruitment message. A culture of recruitment needs to be suffused into activities at the TC campus similar to the way it has been done at DU. R.1.f. Determine, and if necessary improve, the reputation of medical school with the College of Biological Sciences and other UMTC undergraduate colleges. The marketing plan mentioned in Section R.1.a should include a specific plan for elevating the stature and attractiveness of the medical school to CBS students. The new Recruitment Coordinator, the TC Director of Admissions, and the CBS Associate Dean of Students should formulate and implement a plan to collect reliable data regarding CBS students’ opinions of the medical school and admissions process, including data about the choices of career and postbaccalaureate education, especially medical school, that the CBS students are making. The medical school should rectify any negative viewpoints or misperceptions of the medical school that are uncovered, and create a marketing plan to specifically recruit the highest qualified BCS students. Similar activities should be conducted with other colleges on the UM campus, particularly the College of Liberal Arts and the Institute of Technology). R.1.g. Target extra recruiting activities for the most highly qualified applicants. The Recruitment Coordinator should work with the OAs, CAIMH, MAD, the Medical Alumni Association, the faculty, and the students to provide extra recruiting efforts Admissions Task Force Final Report

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for applicants or potential applicants who are identified (through holistic review or some other reliable process) as being truly extraordinary. R.1.h. Maintain no special selection consideration for spouses/significant others of applicants, students, faculty, and alumni. This policy should be articulated to all applicants. R.1.i. Prominently feature dual degree programs in recruitment activities. A formalized process of application to dual degree programs should be developed and instituted. These programs promote the vast resources of the AHC and help to distinguish us from other schools. In addition, they are addressing the unique health professional roles that will need to be filled in the decades to come. R.1.j. Update and improve the admissions websites on both TC and DU campuses. The website should include: • A link for information about the current status of a student’s application beyond that available on AMCAS. This should be supplemented by telephone calls, postcards, etc. • Links for student ambassadors or other volunteer students who might provide additional personalized information and contacts. (Ideas to improve student contacts are listed separately below.)

R.2. CLEARLY ALIGN SELECTION CRITERIA AND PROCESS WITH MISSION STATEMENTS, RECRUITMENT MATERIALS, APPLICATION MATERIALS, AND APPLICANT EVALUATION INSTRUMENTS, PARTICULARLY AT THE TC CAMPUS. R.2.a. Revise recruitment materials, mission statements, selection criteria, application materials, and applicant evaluation instruments to make them more consistent. The message developed in recommendation R.1.a. should clearly be reflected in all promotional literature, publicized selection criteria, items on the supplemental application, and instruments used to evaluate each applicant by the admissions committee. Each criterion for selection should reflect an element of the recruiting message and should have a clear linkage to an evaluation item in the application materials and/or interview. Theses materials should reflect the unique missions of the Duluth and Twin Cities campuses, in order to highlight for applicants the distinctive opportunities that our two campuses provide. R.2.b. Preserve the principle of the holistic selection process. While selection criteria need to be more tightly aligned with specific evaluation items and recruitment materials, the Task Force does not recommend assigning established weights to each selection criterion. The principle of the holistic selection process ensures that all of an applicant’s qualities will be factored into an admissions decision. Maintaining the spirit of the holistic selection strategy has advantages and disadvantages. The advantages include facilitating greater diversity in our matriculates by considering particularly extraordinary individual qualifications, by Admissions Task Force Final Report

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enhancing recruitment through assuring applicants that we judge “the whole person” in our admissions decisions, and by attracting highly qualified students who might otherwise be rejected due to a strict selection formula based on explicit criteria. The principal disadvantage of the holistic selection process is its potential to appear imprecise or capricious to persons not intimately involved with selection decisions. Such perceptions have fueled mistrust in the admissions process. This mistrust can be ameliorated by establishment of tighter, more consistent selection processes which correlate directly with recruitment and application materials (see R.2.a above), and by straightforward explanations of the selection process with interested parties (see R.9). R.2.c. Maintain separate selection criteria and application materials for each campus. The missions of each campus are distinct and should remain reflected in each campus’ admissions process. There are however, certain elements of admissions that should be the same across campuses (see R.5).

R.3. STREAMLINE APPLICATION PROCESS. R.3.a. Review and revise application materials to remove barriers to completion by applicants. In particular, the evaluative merits of the following application items should be carefully scrutinized: • The questions on the supplemental application. These questions should be kept to a minimum without compromising the evidence they provide for making selection decisions. • The form used for letters of recommendation. The utility of the information provided by this form needs to be carefully weighed against its capacity to hinder completion of the application. If at all possible, the letters of recommendations we request should be in a similar format to those of other medical schools. R.3.b. Accelerate application processing. Many of the following strategies are currently being implemented, and should be further applied: • Use of technology. Information technology should be developed maximally to obviate time-consuming processing activities such as copying of application materials and hard-copy voting processes for Admissions Committee meetings. • More stringent review deadlines. This year a requirement has been established for Admissions Committee members to complete Step II reviews within 11 days. • Moving up application deadlines further in the calendar year. • More flexible and timely interview scheduling at the TC campus (see R.4.). • Appropriate staffing to ensure speedy processing. Currently staff is overtaxed at the TC campus, hindering timely application processing. Decreasing the volume of application materials and full implementation of information technology capabilities in the admissions process may reduce some of these burdens on staff time, but until these strategies are implemented, more staff help is needed on the Twin Cities campus to speed these applications; according to Admissions Task Force Final Report

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•

TC Director of Admissions, a .75 time staffing position for the TC OA has been approved. Continue to provide holistic evaluation but develop a more efficient model for admissions processes. Examples include but are not limited to sending supplemental applications to all Twin Cities applicants without a Step I screen and moving the deadline for application and/or notification of acceptance to earlier in the application timeline. It is recommended that a specific timeline be in place to assess these changes and evaluate their effectiveness in terms of recruitment and impact on admission committee workload.

R.3.c. Focus CQI process on speed of application processing and evaluation.

R.4. IMPROVE INTERVIEW PROCESS AND EVALUATION. R.4.a. Standardize questions and interview scoring method. The Task Force agreed that the interview should be a tool for recruitment as well as a method of validating an applicant’s qualifications for medical school. The Task Force did not seek evidence supporting a highly structured interview process, but felt that the interview process was an opportunity to reliably assess an applicant for predetermined qualities. Interviewers should be trained to ask specific questions, each of which is linked to predetermined and specific selection criteria, and applicant responses to these items should be used in admissions decisions. The Task Force recommends that the admissions offices of each campus consult with other admissions deans, such as Laura Molgaard of the School of Veterinary Medicine, for assistance in developing this strategy. R.4.b. Establish a set team of interviewers at the Twin Cities site. Rather than relying on the largesse of individual faculty, the Twin Cities campus should formally establish a core of highly trained interviewers. Each member of the interview team should conduct approximately the same number of interviews; for example, if six hundred interviews are conducted each year, a team of thirty interviewers could conduct twenty interviews apiece. The team of interviewers could be formally drawn from departments (perhaps proportionally based on size of department and enforced through the compact process) and community physicians (possibly through the involvement of the medical alumni association and various other medical societies). R.4.c. Provide cultural sensitivity training for all interviewers and admissions committee members. R.4.d. Incorporate a recruiting message into each interview. Admissions offices should consider tailoring the interview day to recruit particular audiences of applicants, such as those interested in primary care, biomedical science, public health, international medicine, etc. Students suggested that the faculty interviewers in different disciplines could perhaps be matched with interviewees’ interests. Such a strategy would be a way for the applicants to not only be identified by faculty as Admissions Task Force Final Report

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good prospects, but also to begin a relationship with our faculty and a heightened understanding of our institution’s strengths. R.4.e. Create more flexibility in interview scheduling. The Twin Cities campus should provide more flexibility and capacity in scheduling interviews in order to accommodate faculty and applicants throughout the week. R.4.f. Increase medical student contact on Interview Day. The best interview day experience for most current students was meeting with second year students on both campuses. Students have suggested that volunteers be further recruited to provide overnight housing, tours, and an introduction to the culture of the Twin Cities. Above all, students on both campuses felt that the strongest selling point of our medical school was the deep camaraderie that exists among students. They suggested updating resources for access to culture and outdoor and sports activities in the Twin Cities on the website (students also volunteered to help with this).

R.5. WHILE MAINTAINING SEPARATE IDENTITIES OF ADMISSIONS OFFICES AT EACH CAMPUS, STANDARDIZE CERTAIN ELEMENTS OF THE ADMISSIONS PROCESS ACROSS CAMPUSES. R.5.a. Review prerequisites and establish a single set of prerequisites for admission at both campuses. The Medical School faculty and/or the Education Council should perform the review and establish this single set of prerequisites, which would effectively address the diversity of pertinent educational and experiential backgrounds of applicants and would make the number of our prerequisites more in line with other competing medical schools. Guidelines for waiving specific course requirements in lieu of documented expertise and/or experience in certain fields should be established. For example: • A course requirement in humanities or social and behavioral sciences would be waived for every six months of continuous full-time service in a well established human service organization such as the Peace Corps. o Dissenting view from TF member Leon Satran: I do have one strong objection to the recommendation suggesting the waiver of a course in humanities for 6 months of human service in an organization such as Peace Corps. The 2 activities are really exclusive. One is service driven and the other represents academic exposure to great works of literature. I believe that requirement should remain. In addition, the Medical School faculty and Education Council should deliberate on how prescriptive course requirements should be for admission. For example, if it is deemed essential for applicants to have formal training in mathematics, one might presume that this could be fulfilled through several different types of mathematics courses such as statistics rather than a strict requirement of a semester of calculus.

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R.5.b. Omit applicant photograph for the Supplemental Application. However well intentioned, the requirement of a photograph at the Twin Cities campus and no requirement of a photograph at the Duluth campus may convey inconsistent and even damaging messages to potential applicants. The Task Force recommends that there be no requirement of a photograph at both campuses for the Supplemental Application. If a photograph is needed to assist in final deliberations, it can be obtained on the interview day.

R.6. ALTER ORGANIZATIONAL STRUCTURE OF CAIMH, MAD, AND OAs TO FACILITATE MORE COORDINATED RECRUITMENT ACTIVITIES. R.6.a. Establish a coordinated reporting structure. The directors of MAD,CAIMH, and the Recruitment Coordinator (see R.1.b) should report to the same person, such as the Senior Associate Dean for Education. Integration of the activities developed by these programs should include collaboration and communication between both campuses. Our desire is to retain the strengths and avoid the fragmentation of proven successes such as the CAIMH. R.6.b. Establish master calendar of recruitment events. A common calendar should be used by CAIMH, MAD, the OA at each campus, and the recruitment coordinator. This is being implemented in 05-06.

R.7.

IMPROVE VALUE OF ADMISSIONS SERVICE AT THE TWIN CITIES CAMPUS. R.7.a. Change the culture regarding admissions work at the TC campus. The value and stature of service on the Admissions Committee and work for the Office of Admissions needs to be elevated. Some of the methods in which this could be accomplished would include: • Creating faculty incentives for AC service. Service on the Admissions Committee should constitute strong evidence of a service requirement for promotion in both tenure and clinical scholar tracks. Financial incentives and/or release time for AC service, administered to faculty or departmentally through the mission-based management system, should be explored. Also, more public recognition, for example through appreciation dinners, certificates of thanks, and the like may help in elevating the stature of admissions service. • Formalizing admissions services equitably across faculty. The principle of proportional service by departments and institutes to admissions should be strongly considered. Perhaps a system by which departments contributed faculty to serve on the Admissions Committee, with the amount of contribution based on the size of each department, should be considered.

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• •

R.8.

Doing so would ensure an equitable and sufficient membership on the Admissions Committee. Considering change of the title of TC Director of Admissions to Associate Dean for Admissions to make it consistent with the corresponding title at the Duluth campus and most (if not all) U.S. medical schools. Public acknowledgement by the Dean for the work of the committee (this would go a long way to increasing the value of the work).

ESTABLISH MORE FORMAL OVERSIGHT OF ADMISSIONS ACROSS CAMPUSES. R.8.a. Expand Executive Admissions Committee to include the directors of MAD and CAIMH. Consideration should also be given to adding the proposed recruitment coordinator to the EAC. R.8.b. Establish a formal reporting structure of EAC to senior administration. The EAC should provide an annual written report to and meet semiannually with the Twin Cities Senior Associate Dean for Education, the Duluth Dean, and the Dean.

R.9.

ONCE CHANGES HAVE BEEN INSTITUTED, IMPLEMENT PUBLIC INFORMATION CAMPAIGN TO EXPLAIN ADMISSIONS POLICIES AND PROCESS TO APPLICANTS, STUDENTS, FACULTY, AND THE COMMUNITY, PARTICULARLY U OF M MEDICAL ALUMNI. This is perhaps the most critical recommendation of the Task Force. Each of these groups possesses an important stake in admissions and needs to have an accurate understanding of and a robust confidence in our admissions operations. The public information campaign should have the following elements: •

The development and dissemination of an admissions fact sheet. In addition to basic admissions data such as number of applicants and matriculates from in- and out-of-state, the fact sheet should also provide data regarding important outcomes of the admissions process such as the career choices, professional profiles, and geographic placement of our graduates in residency and beyond (see R.1.b). In addition, the fact sheet should contain our basic recruiting message, including a clear description of the missions of the two campuses and how they complement each other.

•

A straightforward explanation of the holistic selection process. The basic features of the holistic selection process should be publicly articulated. The merits of the holistic strategy along with the provisions in place to ensure its rigor and integrity need to be concisely stated (see R.2.b).

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•

A clear message of our policies regarding diversity and addressing the needs of the state. There is a perceived conflict among various interested constituents between promotion of diversity and allegiance to state service in the recruitment and selection of applicants. Proponents of diversity cite the need to recruit and matriculate students of all types of backgrounds to best address the health care needs of the future, pointing out that active recruitment of out-of-state residents is crucial towards fulfilling this goal. Other groups emphasize the land grant mission of our medical school, expressing concern that the declining number of matriculates who are Minnesota residents will result in fewer graduates practicing in Minnesota. This perceived conflict between promotion of diversity and service to the state needs to be publicly reconciled. To do so, the public information campaign should include a clear message from the Dean about how the percentage of out-of-state and international matriculates is established, how its effects are monitored, and how our admissions policies reflect the future health workforce needs of the state. The justification for our admissions policies should be reinforced with key data, such as the number of in-state and out-of-state matriculates who choose residencies in Minnesota and ultimately practice in the state.

•

Presentations to important constituents. Admissions staff, recruitment staff, and more importantly, senior administration should present the recruitment and admissions activities of the medical school. Target audiences should include applicants, current students, faculty, and medical alumni.

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Appendix A DEAN’S TASK FORCE ON ADMISSIONS COMMITTTEE MEMBERS Admissions Committee TC: Marilyn Becker, PhD, Director of Admissions Lynn Hassan, MD, MN Association of Black Physicians Gerald Hill, MD, Association of American Indian Physicians Leon Satran, MD, Pediatrics Admissions Committee DU: Lillian Repesh, PhD., Associate Dean for Admissions and Student Affairs Raymond Christensen, MD, Family Medicine/Community Health, UMD Joy Dorscher, MD, Family Medicine/Community Health, UMD Affiliated Sites: Elie Gertner, MD, Medicine, Regions Hospital Robert Petzel, MD, Medicine, Veterans Administration Medical Center David Williams, MD, Medicine, Hennepin County Medical Center Richard Zera, MD, PhD, Surgery, Hennepin County Medical Center Consultant Alex Johnson, Jr. Dean, U of Minnesota Law School Lin Aanonsen, Ph.D., Chief Health Professions Advisor, Macalester College David C. Anderson, MD, Neurology Karen Armbrust, MD/PhD Student Judy Beniak, RN, MPH, Director, Health Careers Center Colin Campbell, PhD, Pharmacology Richard Carlson, MD, Alumni (Suburban Radiologic Consultants) Gareth Forde, Medical Student, Twin Cities Fred Hafferty, PhD, Behavioral Sciences, UMD Alan Johnson, Medical Student, Twin Cities Cornelius Lam, MD, Neurosurgery June LaValleur, MD, OB/GYN Steven McLoon, PhD, Neuroscience Steven Miles, MD, Professor of Medicine Stacey Mollis, MD, General Medicine, VA Medical Center Laura Molgaard, DVM, Associate Dean for Education, Veterinary Medicine Manoj Monga, MD, Urologic Surgery James Pacala, MD, Family Medicine, Committee Chair Benjamin Phillips, MD, Medicine-Pediatrics Resident Linda Reilly, Assistant Director, Student Support Services Mary Tate, Administrative Director, Minority Affairs & Diversity John Tymoczko, Towsley Professor of Biology, Pre-med Advisor, Carleton College Erik Vilen, Medical Student, UMD Kathleen Watson, MD, Medicine Admissions Task Force Final Report

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Appendix B. Comparison of Prerequisites for the University of Minnesota and Peer Medical Schools Courses Inorganic Chemistry Behavioral Sciences Biochemistry Biology Biology/Zoology Calculus College English College Mathematics Computer Science Genetics Humanities Organic Chemistry Physics Psychology Other X =required/+=recom. 1. 2. 3. 4. 5.

6.

7.

8. 9.

TC X X* X X

1 X

2 X

3 X

4 X

X X

X

+ X

+ X

X X

+ X* X X X* Social Sc.* Stats rec.

5 X

6 X

7 X

8 X

9 X

X

+

+ X

X

X

X X

X X

X X

*one or the other

X

X

X X

X

X X

X X

X X

X X

X X +

X X

+ X X X

X

+ + X X Social Sc. other

Albany Medical College, The mission of Albany Medical Center is a simple one: to provide the region with excellence in medical education, biomedical research, and patient care Baylor College of Medicine, Baylor College of Medicine is committed to being a national leader in advancing human health through the integration of patient care, research, education, and community service Case Western, U.S. News and World Report repeatedly has ranked the Case School of Medicine as one of the top medical schools in the country, particularly noting our research, primary care, family medicine and pediatrics programs. Dartmouth, dedicated to advancing health through the dissemination and discovery of knowledge. Our chief responsibility is to select students of exceptional character and accomplishment and prepare them to become superb and caring physicians, scientists and teachers (highly recommended-Spanish, Humanities and computer skills) George Washington University, Leader in education and research, The George Washington University Medical Center strives to set standards of excellence by: valuing a diverse and dynamic community that encourages life-long learning ; striving for, refining, and defining quality in all endeavors; providing exemplary and innovative teaching programs that produce astute, highly competent, and compassionate health professionals and scientists trained and prepared for the future ; generating and expanding health knowledge through superior research programs ;enhancing the delivery of compassionate and high quality health care through our education and research activities; improving the health and well-being of our local, national, and international communities Medical College of Wisconsin, dedicated to leadership and excellence in: Education: Teaching the physicians and scientists of tomorrow while enhancing the skills of today's health professionals. Research: Creating new knowledge in basic and clinical science through biomedical, behavioral and health services research. Patient Care: Caring humanely and expertly for patients and providing leadership in health services. Service: Forging local, regional, national and global partnerships in education, health care and research for the betterment of human health University of New Mexico, Our mission is to provide added value to health care through leadership in: providing innovative, collaborative education; advancing the frontiers of science through research critical to the future of health care; delivering health care services that are at the forefront of science; and Facilitating partnerships with public and private biomedical and health enterprises. University of North Dakota School of Medicine, The mission of the University of North Dakota School of Medicine & Health Sciences is to educate and prepare North Dakota residents as physicians, medical scientists and other health professionals for service to the people of North Dakota and the nation, and to advance medical and biomedical knowledge through research. The School of Medicine of The University of North Carolina at Chapel Hill is dedicated to improving the health and life quality of North Carolinians by (1) educating medical students, residents, practicing physicians, and pre- and post-doctoral basic and allied health science students; (2) providing care to all patients presenting to UNC Health Care System regardless of their ability to pay; (3) conducting scholarly investigation in biomedical, behavioral, and social sciences; (4) stimulating economic development in the state through bio-technical innovation; and (5) providing leadership in all of these areas.

X=required +=recommended Courses Inorganic Chemistry Behavioral Sciences Biochemistry Biology Biology/Zoology Calculus College English College Mathematics Computer Science Genetics Humanities Organic Chemistry Physics Psychology Other 1.

2. 3.

4. 5. 6.

Duluth X X X X

1 X

2 X

+ X

X X

X X

X X +

X X X

X X Communication Skills

X X

3 X + + X + + X + + X X

4 X

5

+ X

+ X

X + X X +

X

X X

6 X

X

+ X X

X X

East Tennessee State University Quillen College of Medicine, The primary mission of the Quillen College of Medicine is to educate future physicians, especially those with an interest in primary care, to practice in underserved rural communities. In addition, the college is committed to excellence in biomedical research and is dedicated to the improvement of health care in Northeast Tennessee and the surrounding Appalachian Region. Florida State University, educate and develop exemplary physicians who practice patient-centered health care, discover and advance knowledge, and are responsive to community needs, especially through service to elder, rural, minority, and underserved populations. The University Of South Dakota School Of Medicine has earned a reputation as one of the best medical schools in the nation emphasizing family practice. Most recently, U.S. News and World Report listed the School of Medicine as 13th in the country in recognition of its strong achievements in Rural Medicine. The mission of The University of South Dakota School of Medicine is to provide the opportunity for South Dakota residents to receive a quality, broad-based medical education with an emphasis on family practice. The curriculum is to be established to encourage graduates to serve people living in the medically underserved areas of South Dakota, and is to require excellence in the basic sciences and in all clinical disciplines. Case Western, U.S. News and World Report repeatedly has ranked the Case School of Medicine as one of the top medical schools in the country, particularly noting our research, primary care, family medicine and pediatrics programs University of Washington Medical School, dual mission reflecting a commitment to maintain a balance between: meeting the health-care needs of the region, especially by recognizing the importance of primary care and providing service to underserved populations and advancing knowledge and assuming leadership in the biomedical sciences and in academic medicine. UCLA/Drew/Riverside, seeks student who will be future community leaders, have distinguished careers in clinical practice, teaching, research and public service. The school strives to create an environment in which students prepare for a future where scientific knowledge, societal values and human needs are ever-changing.

Appendix C. DEAN’S TASK FORCE ON ADMISSIONS Student Subcommittee Meeting, August 30, 2005 Present: K. Watson, T. Baultrippe, B. Brandt-Griffith (UMC), Libby Clark (TC), Megan Clinton (TC), Stephanie Davison (TC), Ramsey Peterson (UMD), Amery Robinson (UMD), Neil Shah (TC), Erik Vilen (UMD) Our agenda was to (1) review the Dean’s charge to the Task Force on Admissions, (2) Twin Cities, Duluth and national data provided to the students, and (30 discuss their experiences with admissions, and the opportunities to improve the admissions and recruitment processes in the medical school in Duluth and the Twin Cities Medical. Summary of key recommendations 1.

There was consensus that the admissions offices on both campuses need to update and improve their websites. Each campus should maintain separate admissions web sites with links for both campuses’ admissions offices. Website should include: • A link for information about the current status of a student’s application beyond that available on MCAS. This should be supplemented by telephone calls, postcards, etc. • Links for student ambassadors or other volunteer students who might provide additional personalized information and contacts. (Ideas to improve student contacts are listed separately below.)

2.

The Medical School does not sufficiently advertise its strengths. The students reviewed the “points of pride” page from the website and suggested the following improvements: • • •

Our ranks on U.S. News and World Report, for example for primary care and as a top three research institution. Flexible tuition For the Twin Cities campus, enormous diversity of patients, clinical experiences, and faculty; Special strengths: o Primary care o Global health o Basic sciences o Inter-professional educational opportunities o Diversity of clinical experiences o Diversity of students o Enormous diversity of faculty interests from primary care to subspecialty clinical care to applied and basic science

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o Camaraderie among students, as well as students and faculty o Examples should be included on the web site such as the fact that there is a knowledge co-op, that students distribute materials to each other to help each other academically, and there is a strong sense of class success o Flexibility and the availability of a large number of electives o On-line courses should be listed •

For the Duluth Campus, the points of pride include: o Primary rural and Native American health care were captured, but in both, as with the Twin Cities, the students wanted to be able to tell stories. They suggested, for example, pop-up videos or examples of conversations with students about their experiences in the Twin Cities or Duluth. o Duluth also has inter-professional experiences, and both campuses wanted to include RPAP as a strong point of pride.

3.

Increase medical student contact on Interview Day. The best experience for most current students was meeting with second year students on both campuses. This group suggested that there may be volunteers to provide overnight housing, tours, and an introduction to the culture of the Twin Cities. Above all, students on both campuses felt that the strongest selling point of our medical school was the deep camaraderie that exists among students. They suggested updating resources for access to culture and outdoor and sports activities in the Twin Cities on the website (students also volunteered to help with this).

4.

Admissions offices should consider tailoring the interview day to a particular audience of students. For example, those interested in primary care medicine of any type, biomedical science, public health, international medicine, etc. Students thought that the faculty interviewers could be selected to coincide with the theme for particular interviewing, for example basic science versus primary care interviewers. This would be a better way for the applicants to not only be recruited and identified by faculty as good prospects, not only to better understand the strengths of the University of Minnesota Medical School, but also to begin a relationship with those faculty.

5.

It is important to maintain the identity of the separate campus admissions statement. Duluth students expressed concern that the processes of admissions remain distinct

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