Less Fantasy, More Reality: A Call for Humanistic Change in Medical School Admissions

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Outside the workplace, my guilty pleasure has long been fantasy football. Succeeding in fantasy football requires a deep dive into sports analytics, perusing spreadsheets not only for touchdown and yardage statistics but also more obscure figures like defense-adjusted yards above replacement (DYARs). Eventually, the faces of the players tend to evaporate as the numbers take hold. Fantasy owners too easily ignore an athlete’s practice effort or ability to mentor teammates; fantasy owners are all about that in-game numerical edge. Sadly, this experience seems to ring true in medical school admissions as well.
Having deferred my formal medical education for one year to help the Penn State College of Medicine curate a new curriculum for the regional campus at University Park, I have lived admissions from both perspectives. I have seen firsthand that, like fantasy football, medical school admissions focus overwhelmingly on the numbers. I have seen undergraduates choose easier courses to protect their grade point average, leave service organizations to allow for more Medical College Admission Test cramming time, and dispassionately spend summers pantomiming just enough research to pad their CV. It seems this trend continues with residency applications, where United States Medical Licensing Examination Step 1 scores and Alpha Omega Alpha status often haunt students and keep them from pursuing opportunities to more actively help patients. Is it such a surprise that an empathy gap exists in medical education, with idealistic fledglings losing their compassion, their patience, and their joy as they are crushed by this numbers-heavy system?
Acquiring standardized competency in medical knowledge is doubtlessly vital to a future physician’s success, but so is intrinsic motivation, collegiality, and genuine care. Capable applicants are receiving passion-stifling messages. Just as fantasy football has spawned a generation of divas who care more about individual statistics than team wins, our culture of reductionist algorithms creates an environment where learners often value test scores over patient care. Curricula frequently aim to teach patient-centered medicine, but this is not fully possible without overhauling the hidden curriculum that exists in admissions, the origin step of medical education. Emphasizing collaborative group problem-solving challenges, behavioral interview questions where applicants navigate realistic multidimensional scenarios, or audiovisual introduction essays allowing for enhanced personal detail could support this evolution. Additional effort will be required to implement more humanistic admissions processes, but these changes can both help discover those hidden gem candidates and catalyze the moral growth of entering learners. Unlike fantasy football, medicine is no mere game, and we need to consider applicants as humanistically as we hope they will consider their patients.
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