History and Background

Purpose

The purpose of the Holistic Review Project is to develop, distribute, promote, and assess the impact of information and tools for use by medical schools in their efforts to create and sustain medical student diversity. The project's specific focus is on the application and admissions process and how it links to medical school mission and goals, as well as to the constellation of functions that support diversity, such as outreach, recruitment, financial aid, and retention.

Background

For more than three decades, the AAMC has provided leadership and engaged in an array of activities to increase the presence of individuals from underrepresented populations in medicine. These activities have ranged from public policy advocacy to research to programs.

The Holistic Review Project is one such program that has its roots in the AAMC's Expanded Minority Admissions Exercise (EMAE) workshops. EMAE focused on helping medical school admission committees take personal factors into account in addition to academic factors when assessing minority (but not majority) applicants. In 2002, the AAMC undertook to update the workshop materials, which had not been revised since the mid-1990s. Events overtook that effort with the U.S. Supreme Court rulings in the 2003 University of Michigan cases (Grutter and Gratz) that upheld the legality of race-conscious admissions policies within prescribed limits. Among the limitations is that schools with race-conscious admissions policies conduct a competitive review of all their applicants and consider each applicant individually in a holistic, flexible framework. During the same period, the plight of populations experiencing health care disparities became more apparent, along with the understanding that these same populations are underrepresented in medicine.

With considerable input from constituents and AAMC staff across the association, a constituent Working Group was convened to establish the parameters for the content, design, and delivery of a new workshop that would address how to increase diversity among medical students in a changing legal environment. The Working Group included medical school staff members involved in student affairs, admissions, minority affairs, and curriculum, as well as prehealth advisors and medical students. In the course of its deliberations, it became clear that a workshop, while necessary, would not be sufficient to support medical school efforts to enhance access for students from underrepresented groups and achieve the benefits associated with diversity (broadly defined) among students and graduates.

The Working Group identified the following key issues and challenges facing medical schools:

• A lack of awareness among school leaders about the practical implications of the U.S. Supreme Court's decisions in support of diversity goals, including
  • An inconsistent understanding and application of the holistic review principles
  • Gaps in applying the Court's guidelines specifically to medical schools
• The absence of a forum for inter-school discussion or comparison, or opportunity to articulate effective practices
• A desire to evaluate and assess outcomes to support rebalancing academic criteria with personal factors in applicant selection
• An ongoing need to provide professional development for medical school leadership, admissions committee members and officers, and others engaged in the admissions process

They also developed corresponding recommendations to address the issues and challenges:

• Provide additional opportunities to educate medical school leaders and those engaged in the admissions process (e.g., new deans' orientation, management education seminars, Council of Deans meetings, professional development conferences, annual and regional meetings)
  
• Develop recommended protocols to help medical schools initiate holistic review practices
  
• Provide implementation tools for medical schools (e.g., centralized resources that integrate and update existing materials, training materials for those engaged in the admissions process, examples of materials that schools have developed in support of holistic review)
  
• Provide technical support
  
• Promote inter-school collaboration on evaluation of holistic review outcomes
  
• Assist schools in conducting research on the educational benefits of diversity
  
• Continue collaborating with other organizations to provide advice and counsel to medical schools
  
• Provide the necessary resources in support of the recommendations

Status

The Holistic Review Project is now in an implementation phase. Based on the working group's findings and recommendations, the AAMC has begun producing tools and information that medical schools can adopt or adapt to suit their institution-specific missions and goals, culture, and constraints.

To assure that the tools and information created for the Holistic Review Project meet the needs of constituents, the AAMC has convened an advisory committee to guide development. The committee is led by a medical school dean. The members include experts in medical school student affairs, admissions, minority affairs, outreach, financial aid, curriculum, and the law, as well as in diversity research in higher education and the physician workforce. The AAMC has also contracted with Art Coleman to assist the project. Mr. Coleman is a nationally recognized legal expert on helping educational institutions implement educationally sound, legally viable diversity policies and programs.

The project rolled out its first resource and set of tools in March 2008 with the publication of Roadmap to Diversity: Key Legal and Educational Policy Foundations for Medical Schools. The publication provides medical schools with the foundations for creating educationally sound, legally defensible diversity policies and programs. It also contains an institutional diversity self-assessment and action plan template.

In addition, a pilot is underway to develop workshops, an approach for providing legal technical support, and other resources designed to help medical schools carry out the principles presented in "Roadmap to Diversity." Other undertakings include publications and tools on admissions policies and enrollment management considerations, a centralized Web resource, and learning opportunities.

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