PLEASE SIGN - An Open Letter to All Canadian Medical School Deans: Commit to Reducing Economic Barriers to Medical School Applications
The COVID-19 pandemic has created new challenges for the medical profession. There have been several innovations, from the implementation of videoconferencing technology for telemedicine and medical education to developing novel strategies to help communities disproportionately impacted by COVID-19.

Similar innovative solutions have been made to the current medical school admissions cycle. This year medical schools widely adopted interviews via videoconference or had applicants submit their recorded responses to interview questions in response to physical distancing requirements. Additionally the AAMC has expanded the criteria for their fee assistance program.  Overall medical schools have also been discussing comprehensive academic accommodations for prospective applicants in the coming admissions cycle – in relation to course load, grades, degree progress, and MCAT, all of which have been impacted by the COVID-19 pandemic.

Notably, the pandemic has worsened job insecurity for those who earn the least: a recent analysis by the Canadian Centre for Policy Alternatives found:

“Two out of every five workers making $14/hour or less and one out of every three workers making $14 to $16/hour are at risk of “immediate” job loss. By comparison, just one per cent of workers making $40/hour are at risk of losing their job. Youth unemployment is likely to at least double from 10.4 per cent to 25.5 per cent, but could reach as high as 33 per cent” (From Toronto Star).

The COVID-19 pandemic has been a “stress test”, bringing to light longstanding inequities that stem from structural determinants of health and impact a qualified applicant’s ability to meaningfully participate in the medical school admissions. Therefore, when discussing COVID-19 related accommodations, we strongly support the utilization of an equitable approach when making accommodations for prospective students. Additionally, special considerations should be made for those hit hardest by COVID-19, specifically, those who are racialized, Black, Indigenous, and of low socioeconomic status (SES) backgrounds.

The CMA Foundation’s generous donation of $5 million dollars to financially support medical learners validates the concerns of financial resource constraints on learners by the COVID-19 pandemic. In acknowledging the economic hardship of medical learners, it is also important to recognize and address the exacerbated financial inequities that persist in the medical school application process. We are therefore asking medical school offices of admission to collaborate with undergraduate medical education leadership, existing offices of diversity and inclusion, and other key stakeholders to:

i)  Urgently collaborate and create a national strategy to address these financial barriers with a focus on underrepresented populations.

- Collaborate with AFMC to develop a program to waive the application fees for low SES applicants, similar to the AAMC Fee waiver program.
- Expand collaboration between medical schools on free MCAT prep courses, free application support, practice interviews and strategies to reduce interview expenses.
ii) Enhance transparency regarding the admissions criteria used to admit applicants.

- This information can empower prospective applicants from low SES backgrounds to make informed decisions regarding where to spend their already limited financial resources.
- UGMEs across the country can help prospective students maximize their financial resources by publicly reporting: (1) the summary statistics of different components of the application (e.g. average GPAs, MCAT scores, and score cutoffs) and (2) how these components are weighted to make an applicants final score.
iii)  Collect and share data from incoming students on the cost of applying and interviewing for medical school, and student demographics.

- Review existing student demographic data collection methods (e.g. surveys, application) to ensure it is collected in an equity-oriented, intersectional, and disaggregated manner, as it relates to the application process and admissions.
- Data should include direct and indirect costs incurred applying, and how applicants paid for these expenses (scholarship, family support, employment, credit cards, etc.)
- Data should be shared and publicly accessible for prospective medical students (e.g. on the AFMC website, in the AFMC Admissions Guide).

Medical schools have recognized that achieving a diverse student body, representative of the communities they serve is essential in reducing population health disparities. Now more than ever, it is essential that all changes to admissions processes align with equity principles. It is time to make our aspirations for socioeconomic diversity within the future medical profession a reality by implementing these proposed changes and carrying them forward after the pandemic. If the COVID-19 pandemic does not alert us to the necessity of these changes, then what will?


Price of a Dream (POD) Task Force,
the Black Medical Students Association of Canada,
and the Canadian Federation of Medical Students
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