Holistic Review

Core Principles

1. Selection criteria are aligned with the program’s curriculum, mission, community health needs, and the needs of the physician workforce. These criteria, including competencies and other characteristics, are assessed and supported by each applicant’s experiences, attributes, and metrics. Selection criteria are:
   1. Clearly defined and transparently communicated to applicants and advisors as well as faculty, staff, and leadership.
   2. Equitably applied and appropriately chosen for each stage of selection to create a qualified, broadly diverse, mission-aligned candidate pool.
   3. Defined, evaluated, and informed by performance data, educational expectations, and available support services to ensure success.
2. Programs consider the context of each applicant to understand how their unique educational opportunities, financial resources, communities, and lived experiences may contribute to the program and the practice of medicine.
3. Programs review interviewed applicants to select/rank a cohort of learners encompassing the complementary experiences, qualities, and characteristics needed to achieve their institutional and program mission and goals. While programs may not make selection decisions based on protected applicant characteristics (e.g., race, sex, disability, etc.) schools can consider an applicant's discussion of any personal experience - even those related to race, sex, or other protected characteristics - to illustrate examples of mission-aligned experiences or qualities sought by the program.
4. At the conclusion of each selection cycle, programs review, evaluate, and refine recruitment, screening, application review, interview, selection, and entry policies, processes, and practices, to ensure they are equitable, effective, and valid.

Tools and Resources

The AAMC has compiled tools and resources to assist admissions officers and program directors in applying holistic review to their selection processes.

• Holistic Considerations for the Admission Cycle
• There is No Admission without Mission
• Socially Accountable Admissions: Using a different lens to evaluate medical school applicants and promote workforce diversity
• Mitigating Bias in the Admissions Process
• Holistic Student Support
• Holistic Review Primer for Admissions Officers
• Holistic Review Primer for Program Directors
• Scholarly Publications About Holistic Review
• Roadmap to Excellence
• Who we are

This tool will help you identify holistic strategies you can implement across all phases of the admission cycle. The strategies were developed in collaboration with innovators and leaders in medical school admissions and are applicable in all states regardless of ability to consider race and ethnicity. To make it easy to use, we've provided both a PDF and Word version of the checklist tool; the PDF includes additional contextual information.

• Holistic Admissions Considerations for the Admission Cycle (PDF)
• Holistic Admissions Considerations Checklist (Word)

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This presentation is an excerpt from the 2023 AMCAS Opening Cycle for Schools webinar held on June 14, 2023. This segment showcases two schools, the University of Kansas School of Medicine and the University of Maryland School of Medicine, that have actively identified their institutional mission and the health concerns of their community or region and aligned their admissions policies and criteria accordingly.

This webinar highlights effective strategies UC-Davis School of Medicine has used to increase enrollment of historically underrepresented and excluded students and to achieve institutional community health goals. Admissions tools, recruitment policies and practices, community partnerships, innovative pathways programs, mission-focused school tracks, and the use of a socio-economic disadvantage score in a race-neutral admissions process are all described. 

This presentation is an excerpt from the 2022 AMCAS Cycle Opening and Mitigating Bias in the Admissions Process webinar held on June 10, 2021. The purpose of this segment is to raise awareness of how bias can influence the admissions process as well as steps individuals, their committees, and reviewers can take to mitigate bias. The presentation featured 3 speakers who focused on different aspects of bias in admissions. Below you will find information about each speaker, as well as their area of focus for the presentation.

Bias Breakers: Continuous Practice for Admissions and Selection Committees

This training goes beyond onetime awareness of unconscious bias and focuses on bias recognition and mitigation strategies for admissions committees. Through active learning, the curriculum incorporates committee comments and highlights admissions structures to illustrate what bias can look like and sound like. Each bias type is illustrated with original graphics designed by medical students and is accompanied by concrete strategies for illuminating and mitigating the bias. There is also a review deck that can be incorporated into committee meetings, briefings, and trainings to encouraged space repetition and continuous practice.

2023 AMCAS Cycle Opening and Mitigating Structural Bias in the Admissions Process

These two recordings are excerpts from the 2023 AMCAS Cycle Opening and Mitigating Structural Bias in the Admissions Process webinar that took place on June 14th, 2022.

Holistic Student Support recognizes the interconnected aspects of a student's life and provides resources and interventions that support and promote students’ overall wellbeing and success in navigating medical school. Learn more about holistic student support below.

Holistic Student Support Webinar Series

Join our Holistic Student Support webinar series running through January 2025, as we delve into the critical junctures students face in their educational journey and explore the support structures that ensure student success.

Considerations for Holistic Student Support

This Considerations document serves as a launching pad for identifying holistic strategies you can implement across all the critical junctures at your institution.

Holistic Student Support Virtual Community

The Holistic Student Support Community is a space for forward-thinking student affairs and medical education professionals to engage, collaborate, and share resources and strategies. To join the community, follow this link and search for “Holistic Student Support”.

These tools and resources provide an overview of holistic review in admissions. This primer is designed to quickly help you 1) review the criteria you are prioritizing and 2) define and assess if your materials and processes reflect your priorities.

These tools and resources provide an overview of holistic review in residency selection. This primer is designed to quickly help you 1) review the criteria you are prioritizing and 2) define and assess if your materials and processes reflect your priorities.

The following publications provide information about the effectiveness of holistic review as well as promising practices in the field.

• Nakae S, Palermo A-G, Sun M, Byakod R, La T. Bias Breakers: Continuous practice for admissions and selection committees. MedEdPORTAL. 2022. doi:10.15766/mep_2374-8265.11285
• Harris TB, Jacobs NN, Fuqua CF, et al. Advancing Equity in Academic Medicine Through Holistic Review for Faculty Recruitment and Retention. Academic Medicine. 2022;97(5):631-634. doi:10.1097/ACM.0000000000004568
• Aibana, O., Swails, J., Flores, R. and Love, L., 2019. Bridging the Gap. Academic Medicine, 94(8), pp.1137-1141.
• Conrad, S., Addams, A. and Young, G., 2016. Holistic Review in Medical School Admissions and Selection. Academic Medicine, 91(11), pp.1472-1474.
• Grabowski, C., 2017. Impact of holistic review on student interview pool diversity. Advances in Health Sciences Education, 23(3), pp.487-498.
• Grbic, D., Morrison, E., Sondheimer, H., Conrad, S. and Milem, J., 2019. The Association Between a Holistic Review in Admissions Workshop and the Diversity of Accepted Applicants and Students Matriculating to Medical School. Academic Medicine, 94(3), pp.396-403.
• Harris, T., Thomson, W., Moreno, N., Conrad, S., White, S., Young, G., Malmberg, E., Weisman, B. and Monroe, A., 2018. Advancing Holistic Review for Faculty Recruitment and Advancement. Academic Medicine, 93(11), pp.1658-1662.
• Harrison, Leila E. PhD, MA, MEd; Nandagopal, Radha MD; Garcia, David MEd; Tomkowiak, John MD, MOL, 2024. Impact of Masking Academic Metrics on Enrolling a Broadly Diverse and Mission-Aligned Student Body. Academic Medicine ():10.1097/ACM.0000000000005737, April 10, 2024. | DOI: 10.1097/ACM.0000000000005737
• Nakae, S., Porfeli, E., Davis, D., Grabowski, C., Harrison, L., Amiri, L. and Ross, W., 2020. Enrollment Management in Undergraduate Medical School Admissions: A Complementary Framework to Holistic Review for Increasing Diversity in Medicine. Academic Medicine, 96(4), pp.501-506.
• Grieco CA, Currence P, Teraguchi DH, Monroe A, Palermo A-GS. Integrated Holistic Student Affairs: A personalized, equitable, student-centered approach to student affairs. Academic Medicine. 2022;Publish Ahead of Print. doi:10.1097/acm.0000000000004757

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This publication will guide you through the evaluation of your holistic admissions process.

• Roadmap to Excellence: Key Concepts for Evaluating the Impact of Medical School Holistic Admissions (2013)

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Advancing Holistic Principles Advisory Committee

• Jonathan Baines, MD, PhD, Medical Director Native American Pathway Programs, Member, Mayo Clinic Cancer Center, Department of Family Medicine, Mayo Clinic
• Julie A. Chanatry PhD, (NAAHP Liaison), Chairperson, Health Sciences Advisory Committee, Department of Chemistry, Colgate University
• Linda H. Chaudron, MD, MS, Vice President and R.G. Bing-You Chair, Department of Medical Education, Maine Medical Center and Professor, Department of Psychiatry, Tufts University School of Medicine
• Joanna R. Fair, MD, PhD, Senior Associate Dean of Graduate Medical Education and Designated Institutional Official, Professor and Vice Chair of Academic Medicine, University of New Mexico School of Medicine
• Leila E. Harrison (GSA Liaison), PhD, MA, MEd, Vice Dean for Admissions, Student Affairs, and Alumni Engagement, Assistant Professor, Office of Student Experience, Elson S. Floyd College of Medicine, Washington State University
• Stephanie Mann, MD, MS HPEd (MESL Liaison), Senior Associate Dean for Academic Affairs, Methodist University College of Medicine/Cape Fear Valley Health School of Medicine, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Methodist University
• LeeAnna Muzquiz, MD, Associate Dean for Admissions, University of Washington School of Medicine, Clinical Assistant Professor, Department of Family Medicine, UW Medicine
• Kristin F. Nalls, PhD, Assistant Dean for Community, Lead Director for Admissions, University of Mississippi Medical Center, School of Dentistry
• Luckson Omoaregba, MS, Director, Pathway Programs, Office of Belonging and Equity, Diversity and Inclusion, Alpert Medical School of Brown University
• Steve Paik, MD, EdM, Associate Dean for Student Affairs and Admissions, Associate Professor of Medical Sciences, Frank H. Netter MD School of Medicine, Quinnipiac University
• Erik Porfeli, PhD, (Vice Chair), Professor and Chair of Human Sciences, Human Sciences Administration, The Ohio State University
• Tanisha N. Price-Johnson, PhD, Associate Dean for Student Affairs, Keck School of Medicine, University of Southern California
• Will Ray Ross, MD, MPH, (Chair), Associate Dean for Diversity, Principal Officer for Community Partnerships, Alumni Endowed Professor of Medicine, Division of Nephrology, Washington University School of Medicine
• Colin E. Stewart, MD, Program Director, Child and Adolescent Psychiatry; MS3 Psychiatry Clerkship Director; Associate Professor of Clinical Psychiatry, Georgetown University Medical Center
• Monica Vela, MD, FACP (GDI Liaison), Professor of Medicine, Department of Medicine, Director, Hispanic Center of Excellence, University of Illinois College of Medicine
• Brigham C. Willis, MD, MEd, FAAP, Founding Dean, The University of Texas at Tyler School of Medicine
• Mark B. Woodland, MS, MD, FACOG, Chair and Clinical Professor OBGYN, Reading Hospital/Tower Health; Interim Academic Chair, OBGYN Drexel University College of Medicine

AAMC Staff

• Amy Addams: Director, Student Affairs Alignment and Holistic Review, AAMC
• Benita Kornegay-Henry: Senior Holistic Review Specialist, AAMC
• Michelle Shader: Director, Holistic Initiatives and Learning, AAMC
• Raechel Timbers: Manager, Holistic Initiatives and Learning, AAMC

Contact us for more information.

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