Diversity in the physician workforce lags behind the rapidly changing US
population. Since the gateway to becoming a physician is medical school, diversity must be
addressed in the admissions process. The Association of American Medical Colleges has
implemented a Holistic Review Initiative aimed at assisting medical schools with broadening
admission criteria to include relevant, mission-driven attributes and experiences in
addition to academic preparation to identify applicants poised to meet the needs of a
diverse patient population. More evidence is needed to determine whether holistic review
results in a more diverse selection process. One of the keys to holistic review is to apply
holistic principles in all stages of the selection process to ensure qualified applicants are not
overlooked. This study examines whether the use of holistic review during application
screening at a new medical school increased the diversity of applicants selected for
interview. Using retrospective data from the first five application cycles at the Oakland
University William Beaumont School of Medicine (OUWB), the author compared
demographic and experiential differences between the applicants selected using holistic
review, including experiences, attributes and academic metrics, to a test sample selected
solely using academic metrics. The dataset consisted of the total group of applicants
selected for interview in 2011 through 2015 using holistic review (n = 2773) and the same
number of applicants who would have been selected for an interview using an academiconly
selection model (n = 2773), which included 1204 applicants who were selected using
both methods (final n = 4342). The author used a combination of cross-tabulation and
analysis of variance to identify differences between applicants selected using holistic
review and applicants in the test sample selected using only academics. The holistic review
process yielded a significantly higher than expected percent of female (adj. resid. = 13.2,
p\.01), traditionally underrepresented in medicine (adj. resid. = 15.8, p\.01), first
generation (adj. resid. = 5.8, p\.01), and self-identified disadvantaged(adj
& Christina J. Grabowski
christinajgrabowski@gmail.com
1 University of Alabama School of Medicine, VH 107 K, 1720 2nd Avenue South, Birmingham,
AL 35294-0019, USA
123
Adv in Health Sci Educ
https://doi.org/10.1007/s10459-017-9807-9
resid. = 11.5, p\.01) applicants in the interview pool than selected using academic
metrics alone. In addition, holistically selected applicants averaged significantly more
hours than academically selected students in the areas of pre-medical school paid
employment (F = 10.99, mean difference = 657.99, p\.01) and community service
(F = 15.36, mean difference = 475.58, p\.01). Using mission-driven, holistic admissions
criteria comprised of applicant attributes and experiences in addition to academic
metrics resulted in a more diverse interview pool than using academic metrics alone. These
findings add support for the use of holistic review in the application screening process as a
means for increasing diversity in medical school interview pools.

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• Impact of holistic review on student interview pool diversity