Is medical school admissions basically a lottery?
If you’re an avid reader of this blog, you can probably guess what my answer is. But to me, the answer itself isn’t as important as understanding how we get that answer, because it is only by knowing the process of finding the answer that we will be able to answer similar questions correctly in the future.
In short, the answer is pretty clearly a no, despite what many frustrated applicants might think. Comparing the medical school admissions process to a lottery is not only an insult to the intelligence and efforts of medical school admissions committees, but it shows a problematic perspective to the process overall.
Why this is problematic
I think we can agree that a lottery refers to anything that is a purely chance event. So when we buy lottery tickets in hopes of becoming the next millionaire, it’s a lottery because besides buying the actual ticket, nothing we do can increase the chance of our ticket winning more than anyone else’s. Why? Because the winning numbers are picked completely randomly. However, this also means that there is nothing we can do to decrease our chances of winning either.
So to compare medical school admissions to a lottery is essentially proposing that not only are admissions decisions made by chance, but also, that nothing can be done to increase or decrease your chances of being accepted relative to all of the other applicants.
However, this notion can be dispelled quite easily. For instance, if I had gotten a 21N on my MCAT, I would not have received an interview at Queen’s in the first place, because they have certain MCAT requirements. And so in the grand scheme of things, it is true that you can increase your chances of getting into medical school by doing well on the MCAT, because the higher your score, the more medical schools whose MCAT requirements you will meet. Given all this, medical school admissions as a whole can’t be a lottery.
Of course, I expected someone to reply that while the pre-interview assessments may not be a lottery, the post-interview assessments can be. For instance, this past year Queen’s interviewed 760 candidates and accepted only 100 in the first round. Because of that, some applicants were especially adamant about calling the process a lottery.
And again, we can dispel such a notion quite easily. I believe I can say quite confidently that a candidate who walked into their interview and just sat there silently, never speaking a word or answering a question, who be immediately rejected. I believe I could say the same for a candidate who walked in and started swearing randomly or harshly insulting the interviewers. If you agree with me that these would lead to automatic rejections, clearly there must be ways we can affect our chances of acceptance during the interview, and thus, the interview process cannot be a lottery.
At the same time, it would be narrow-minded for anyone, including the admissions committees themselves, to claim there is no variance, luck, or chance involved in the process. But they shouldn’t have to admit that there is, and it should be common sense that it exists. Variance exists in all parts of our life, so it shouldn’t be weird that we also find it in the admissions process.
No one “deserves” anything
Yet for some reason it’s a concept that we struggle with. We often seem to think that we “deserve” things, and become upset when we don’t get it. For example, someone who has a 4.0 GPA, 40T MCAT, and is on the front cover of Nature magazine might think they “deserve” to get into medical school and start calling the process a lottery if they don’t. Now, I’m sure it’s obvious what’s wrong with this thinking, in terms of believing that doing X, Y, and Z would guarantee anyone a spot in medical school, let alone being proof that this person would make a better doctor than someone else.
But the bigger problem lies in the idea of believing you actually deserve anything in situations like this. Imagine you are a safe driver, and you do everything right, but some drunk idiot runs a red light and smashes into your car. You might be frustrated and complain, and say “I am a safe driver, I don’t deserve to have this happen to me”. But that’s wrong. Being deserving has nothing to do with it. The fact is that when you take your car for a ride, you accept the fact that you might get into an accident today, regardless if the fault is your own. No one “deserves” to be hit and no one “deserves” not to be hit. The idea of deserving in a process of incomplete certainty is irrelevant and more of some sort of personal comfort tool than anything.
It would be different if there was a direct relationship, in which case, you might be deserving and get screwed. For instance, if you gave a restaurant 5 dollars, you deserve to get your meal in return. That’s because both sides are engaged in a relationship where the system is already established.
But medical school admissions is not like this. Committees don’t say “if you get this GPA, volunteer this many hours, get this MCAT score, and say this in an interview, you will automatically get in”. There is no magic formula for getting into medical school. And because of this, no one “deserves” anything.
Understanding that you don’t “deserve” to get in more than anyone else is an important hump to get over. You can say that person A is more likely to get in than person B, but it would be irrelevant to analyze whether one is more deserving than the other. The admissions committees don’t look at it that way, so why would you?
Of course, this doesn’t mean the best candidates are the ones who get in
I kept feeling this article was a bit incomplete, but I couldn’t put a handle on it until this morning. I forgot one of the major reasons why some people think the process is like a lottery – because sometimes certain individuals who seem like great candidates to become physicians don’t get in, and some individuals who don’t seem like great candidates do.
The fact is that the admissions process is inevitably imperfect, and I don’t think any medical school thinks that they always get it right. I’m sure you’ve come across physicians who you think aren’t doing a good job, and that’s the product of not only an imperfect admissions process, but also an inability to predict future circumstances. All medical schools can do is hope that they’ve picked the right people from the applicant pool that year, and work with what they’ve got.
The problem with medical school admissions is that they’re working with limited information. All they get are some numerical scores, an essay, some letters, and a relatively short interview – not to mention the subjectivity involved with evaluating some of these. All they can do is come up with a process that they think will select for candidates with potential to be competent physicians, with no guarantee they actually will be.
In addition, and it’s something I’ve stressed countless times - it’s not the best physician candidates who get in, but the individuals who do the best in the admissions process. Of course, the hope of the admissions committees strongly believe there is a correlation between the two, or else they wouldn’t have the process that they do – but this doesn’t mean the two always co-exist within a person. There will always be individuals who would make fantastic physicians who may simply not be good at marketing themselves through essays, and there of course will be individuals who are fantastic at the application process but would make relatively worse physicians.
I’ll be honest – I’m sure there are people who applied but didn’t get in this year who would make better a physician than I would. There are so many qualified applicants for fewer spots. However, my hope would be that with enough attempts, those who would make great physicians will eventually get in.
Related Posts:
- Medical School Admissions: How important are non-academic components really?
- Mastering the University of Toronto Medical School Essay – Part 1: The Secret
- Mastering the University of Toronto Medical School Essay – Part 3: Why Medicine and How Did You Prepare
- Mastering the University of Toronto Medical School Essay – Part 2: Background, Interests, and Experiences
- Mastering the University of Toronto Medical School Essay – Part 4: How Your Premedical Studies have Prepared You for Medicine
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Comments
does it mainly not depend on yourself? its more of a lottery with a head start to people who actually spend time to research and think ahead, correct?
You’re welcome? Oh, and just so it’s clear, it wasn’t supposed to be a mean comment.
The other bit you added was quite important. It’s practically evident everywhere with an application process- scholarships, jobs…
I should definitely work on my communcation skills. A lot of people, including me, think that English class is useless and it shouldn’t be mandatory. I still think that because it’s a highly subjective course, and for some reason, I never really get into an English teacher’s “circle of favourites.” Maybe it’s just that I’m naturally better at Science, hence why I’m here.
But when you think about it, high schoolers aren’t given that many chances to practice formal doing oral presentations. With job interviews, you’re given one shot. I must admit, I did blow up some of my interviews this past year, including Shad internships. If they had hired based on resume only, I might have actually had a chance.
So I agree on that it really depends on how well you “market yourself.”
That’s what the “career’s” course is supposed to do, but apparently, it turned out to be one of the “birdiest” courses in high school.
I think the problem is when every presentation you do at school is for marks, which is why clubs that help you improve your public speaking are important. Marks just take the fun out of everything and turns everything into a competition and a reputation thing.
well josh, choosing courses that are do-able would only apply to limited students such as people who would want to go to med school. Grad schools usually require a B, so i dont see why alot of students wouldn’t choose courses that they like. And i guess, you can choose what ever course you want in med school since you dont have to worry about those really high marks anymore 
i dont know, i would find it really hard to learn a course if there were no marks. In physics, i am only practicing questions because i want an A+. If there were no marks, I wouldn’t care of practicing, i would just get the basic idea and since i did not repeat what i learned for the exam, there are more chances for me to forget that material by next year :S
hey rebecca, i’m going to shadvalley too which campus r u going to? i didn’t get the internship either, there was only one position and alot of of ppl were interviewed. but hey the company was involved in a recent scandal anyway.
yes joshua i agree with u on”the best physicians don’t always get in” aspect of medical school interviews. sometimes i compare these things to reality tv shows such as amazing race, project runway, stylista etc, where a gropu of 3 judges decide who to eliminate and often the audience’s favourite “susan boyle and such personels” don’t alway win. sometimes it really bothers me when the contestant that most people believe “deserves it” gets eliminated and i sometimes compare this to the medical school admission process. i just wanna know what you think about this?
I agree about what you said about the worst part about marks- people learn just for the sake of learning. Recall how many students, even in the high school level, memorize verbatim the teacher’s notes or textbooks. If the teacher’s notes are wrong, they don’t notice it.
And then there’s the subjectivity with marks…
It’s funny how back in elementary school, I was dying to get real averages, (with actual numbers on them, rather than grades) but now I sorta wish the opposite. Getting letter grades could still separate “the good and the bad” and still give motivation for people. It’s sorta like how AP exams work, which is why I love studying AP exams a lot more than school evaluations. Plus, AP exams are standardized, so it takes the subjectivity out and you can’t exactly complain you had a harder teacher that year. The biggest difference for me is probably that schools evaluations are more of an obligation, while AP exams are more voluntary.
Truthfully, if I didn’t have to worry about marks at school, I would’ve self-studied for 3+ AP exams this year. There are other motivations to learning… like co-op is good too. As much as every person thinks co-op is a birdy course, it is a good chance to learn how life works in the real world without the expectations being too high.
Grad schools only require a B? Isn’t it like the higher grade if you want a chance at it?
Actually, chocofusion, I opted out of Shad once I found out that I didn’t get the internship. Maybe I overreated… Plus, I wonder how everyone else got better financial aid even though I put a really low income on the financial aid sheet.
To be honest, I don’t really know if it was me who actually blew it up or something else. They asked me how long I could work for, and I was like 5 weeks (after Shad) and then the interview was over. It was going well before that, so it might be because I told them I would only be available for 5 weeks?
Haha… it’s like The Apprentice hosted by Donald Trump? Sometimes, the guy (or girl) who gets fired don’t deserve it as much as someone else.
Wow… I wrote such a long reply…
hey rebecca,
that really sucks that u opted out. cuz i told them i’ll decide whether i can still afford to go to shad after i get an internship, but i got a $1000 scholarship + 750 in bursary near the end of april.i think if u ask them they’ll find a way to get u in.
just out of curiosity, which company did u interview for.
chocofusion, you got more stuff at the end of April?? I didn’t know that they’ll let you decide after you hear back from the internship. I thought the deadline was April 16th and that was it.
So you asked for more bursary or what? My parents don’t make a lot (like a lot lower than the average income) and I got quite angry when I only got 500 bursary. I heard other people got a lot more even when their parents made a lot more.
I thought 89 is an A and 80 is an A-.
I thought most university exams are worth at least 30%… It’s still possible to get 65 =P You never know when the prof will curve the marks down or the exam turns out to be a killer.
Personally though, if I knew I didn’t have to try that hard to keep the same letter grade and only letter grades count, then I’d rather spend more time with family, extracurriculars, hobbies, or studying for other stuff. I’m still using that time wisely. It’s not like I’m going to play computer games all day.
I’ve had a course with an exam worth 75% of my mark in my first year hehe.
… And we had a fire alarm during that exam, so only 50/70 questions were marked lol.
How do they pick which 50 questions to mark? It’s not like the exam tells you “Start from the beginning in case the fire alarm goes off”
uhm we had 2 tests and a final exam for that course. There was a fire alarm in both of those tests… so the prof decided if there is a fire alarm during the first hour of the exam, then only 30 questions will be marked, second hour then only 50 questions will be marked and i can’t believe someone still pulled the fire alarm :@
i think the prof should have had security in the building keeping an eye on the fire alarms instead of taking this step… york had to pay quite a lot of money for these false alarms this year and it would have made sense to give that money to the security guards instead of the fire dept :/
Sorry it gets a bit “ranty”.
I think people need to think it’s a lottery because thats the only way to make
sense of it, all your article did was make me think it’s completly a
irrational system. The problem isnt just one of selection process, it’s
of spaces availible and a seeming intent to keep a shortage inplay.
First they need to increase the spaces. Then an automatic entrance for those who
achieved the 4.0 etc and lotto the rest would do a much better job i think.
The admissions process is COMPLELTY inadequate (beyond meetign the req’s) for
figuring out who is “Doctor” material (whatever that means) should be done
in the actual training phase like other professions. A proctologist is a
different person than someone persuing psychiatry (maybe not so different ;p).
Joshua says : “this past year Queen’s interviewed 760 candidates and accepted only 100 in the first round.”
This is an amazing statmement! How many people cant even find a family doctor?
Ya know When health care is gaurenteed by the charter Then we as canadians deserve it.
Medical is the only service idustry thats treated like a controlled substance.
Why is med school so different than say taking the nessecary undergrad to get into
graduate studies? I think it displays an elitist mentality and serves none.
Joshua says : “Committees don’t say “if you get this GPA, volunteer this many hours, get this MCAT score,
and say this in an interview, you will automatically get in”
I think they should. Your right though and it’s VERY unfortunate.
I also think sometimes people invent things to try and justify insanity as a need
to rationmalize the irrational.
Joshua says : “The problem with medical school admissions is that they’re working with limited information. ”
Thats why the admissions should be about reqs versus spots, subjectivity aside.
Joshua says : “All they get are some numerical scores, an essay, some letters, and a relatively short interview ”
Thats WAY more than most professions. Airline pilot for instance (just to speak to having
people lives in your hands).
Joshua says : “not to mention the subjectivity ”
I find it AMAZING that it’s ok that people are allowed to include subjectivity in the admissions toolkit.
Joshua says : “involved with evaluating some of these. All they can do is come up with a process that they think will
select for candidates with potential to be competent physicians, with no guarantee they actually will be.”
There is NO POSSIBLE way to know with the limited time they have with each candidate that this one would be good or not.
Though, stopping daming up the admissions process and limiting the seats is a GREAT and Sane way to maintain a shortage.
Joshua says : “it’s not the best physician candidates who get in, but the individuals who do the best in the admissions process.”
true in all admissions processes the extra hoops and convoluted logic doesnt solve it.
Joshua says : “The hope of the admissions committees strongly believe there is a correlation between the two, ”
Hope without intellegent planning is the hallmark of the damned.
Bad or good physicians should be encouraged or removed as nessecary in the actual training process.
where you can get a sense of them.
Joshua says : “There are so many qualified applicants for fewer spots. However, my hope would be that with enough attempts,
those who would make great physicians will eventually get in.”
I know of two EXCELLENT people that said “screw this” and moved on. One had 3.7 and 4.0 gpa’s with all the
nessecary volenteering etc. There are LOADS of them out there tryign to hang in … the question
is why arent they filling the MASSIVE whole in our helath care system??
haha i wonder when york will open their med school… i just wish they start it by the year after next (which is unlikely) but yea that will mean about 150 extra seats guys… (and more chances for me to get into med school )
Great post! Really puts things into perspective …