Toward Creating Equity in Awards Received During Medical School: Strategic Changes at One Institution

Area of Science:

• Medical Education
• Health Equity
• Medical Honor Societies

Background:

• Membership in Alpha Omega Alpha (AΩA) is prestigious but historically favors students not underrepresented in medicine (not-UIM).
• Previous selection methods at UCSF School of Medicine prioritized academic metrics, potentially creating bias.
• A need existed to address inequities in AΩA selection to ensure broader representation.

Purpose of the Study:

• To describe the implementation of a holistic AΩA selection process at UCSF School of Medicine.
• To evaluate the impact of this holistic process on the selection of underrepresented in medicine (UIM) students.
• To assess changes in AΩA eligibility and selection rates between metric-driven and holistic review periods.

Main Methods:

• Transitioned from a clerkship metric-driven selection to a holistic review process for AΩA, starting with the class of 2017.
• Implemented changes including diverse selection committees, revised criteria, bias mitigation training, and blinded application review.
• Compared AΩA eligibility and selection outcomes for classes from 2014-2016 (metric-driven) versus 2017-2019 (holistic).

Main Results:

• During metric-driven selection, not-UIM students were significantly more likely to be eligible (4x) and selected (3x) for AΩA.
• Following holistic selection, not-UIM students remained more likely to be eligible (2x), but selection rates between UIM and not-UIM students became equitable (OR=.7, P=.12).
• The holistic process successfully created equity in UIM student representation among selected AΩA members.

Conclusions:

• A holistic selection process effectively addressed inequities in AΩA membership, promoting greater representation for UIM students.
• This approach, grounded in equity pedagogy, demonstrates a viable strategy for fair selection in medical honor societies.
• The findings have broader implications for creating equitable award selection processes within medical education.