Abstract
Background
Medical school admission practices vary globally, with China and the US representing two mainstream models: post-secondary and post-baccalaureate. The former relies on a single standardized test score, while the latter evaluates candidates holistically. In this study, we aim to delineate the distinct advantages of each model by examining the experiences of matriculating medical students from both countries and analyzing their perspectives on these divergent admission models.
Methods
The authors conducted individual semi-structured interviews with first-year medical students from two highly ranked higher-education institutions in China and the US: Peking University Health Sciences Center (PKUHSC), Beijing, and David Geffen School of Medicine (DGSOM) at UCLA, Los Angeles, California. The authors interviewed twenty students from each institution, performed inductive thematic analysis on interview transcripts, and conducted descriptive quantitative analyses of medical student survey data.
Results
PKUHSC participants were younger and less exposed to clinical medicine before application; many cited external factors that influenced their decision to pursue medicine, and some stated that medicine was not their top choice field of interest. DGSOM participants had more clinical experiences; many took gap years before committing to medical school. Altogether, participants desired medical school admission practices that allow for 1) adequate opportunity for career exploration, 2) consideration of non-cognitive skills and non-academic achievements, and 3) flexibility in the journey before medical school and diversity in the student body. Participants also cautioned about the impact on finances and personal lives, bias in standardized test scores, and limitations to a holistic evaluation in medical school admission.
Discussion
Striking a balance between selectivity and equity in medical school admission is challenging. The post-baccalaureate model excels in identifying candidates demonstrating preparedness for career in medicine, while the post-secondary model offers accessibility to applicants from disadvantaged backgrounds. Further research is essential to inform best practices in medical school admission.