1.0 Introduction

The Liaison Committee on Medical Education (L.C.M.E.) stipulates that the school must develop standards for both objective and subjective criteria used for screening, selection, and admission of applications to the medical education program.

L.C.M.E. Standard 10.3 Policies Regarding Student Selection/Progress and Their Dissemination
The faculty of a medical school establish criteria for student selection and develop and implement effective policies and procedures regarding, and make decisions about, medical student application, selection, admission, assessment, promotion, graduation, and any disciplinary action. The medical school makes available to all interested parties its criteria, standards, policies, and procedures regarding these matters.

L.C.M.E. Standard 10.4 Characteristics of Accepted Applicants
A medical school selects applicants for admission who possess the intelligence, integrity, and personal and emotional characteristics necessary for them to become competent physicians.

L.C.M.E. Standard 10.5 Technical Standards
A medical school develops and publishes technical standards for the admission, retention, and graduation of applicants or medical students in accordance with legal requirements.

2.0 Purpose

The goal of the admissions, retention, and graduation policy is to establish admissions requirements for the selection of students to the Saint Louis University School of Medicine.

3.0 Scope

The Saint Louis University School of Medicine (SLUSOM) utilizes a variety of strategies to consider and evaluate potential applicants to medical school for admissions, academic and professional progress, and graduation.

4.0 Definitions

Technical standards for the admission, retention, and graduation of applicants or medical students: This policy represents a statement by the medical school of the: 1) essential academic and non-academic abilities, attributes, and characteristics in the areas of intellectual-conceptual, integrative, and quantitative abilities; 2) observational skills; 3) physical abilities; 4) motor functioning; 5) emotional stability; 6) behavioral and social skills; and 7) ethics and professionalism that a medical school applicant or enrolled medical student must possess or be able to acquire, with or without reasonable accommodation, in order to be admitted to, be retained in, and graduate from that school’s medical educational program. (Element 10.5)

5.0 Protocol and Procedure

Academically successful students considered for matriculation are expected to possess:

1. Intellectual, Conceptual, Integrative and Quantitative Abilities

These abilities include measurement, calculation, reasoning, analysis and synthesis. Problem-solving, the critical skill demanded of physicians, requires all of these intellectual abilities and often must be performed quickly, especially in emergency situations. A student must be able to identify significant findings from history, physical examination and laboratory data, provide a reasoned explanation for likely diagnoses, prescribe appropriate medications and therapy and retain and recall information in an efficient and timely manner. The ability to incorporate new information from peers, teachers, and the medical literature in formulating diagnoses and plans is essential. Good judgment in patient assessment and in diagnostic and therapeutic planning is essential; a student must be able to identify and communicate their knowledge to others when appropriate.

2. Observational Skills

The student must be able to observe demonstrations and participate in those experiments in the basic and clinical sciences determined essential by the respective faculties. A student must be able to observe a patient accurately at a distance and at close hand, noting non-verbal as well as verbal signals. Observation necessitates the functional use of the sense of vision and other sensory modalities.

3. Communication Abilities

A student must be able to speak intelligibly, to hear adequately, and to observe closely patients to elicit and transmit information, describe changes in mood, activity and posture, and perceive non-verbal communications. A student must be able to communicate effectively and sensitively with patients, and all members of the health care team. Communication includes not only speech, but also practicing and writing. In addition, the student must be able to communicate effectively and efficiently in oral and written English with all members of the health care team. A student must possess practicing skills at a level sufficient to accomplish curricular requirements and provide clinical care for patients. The student must be capable of completing appropriate medical records and documents and plans according to protocol and in a complete and timely manner.

4. Motor Functioning Skills

Medical students are required to possess motor skills sufficient to elicit independently information from patients by palpation, auscultation, percussion, and other manually-based diagnostic procedures. Students should be able to conduct laboratory tests (urinalysis, CBC, etc.), carry out diagnostic procedures (paracentesis, etc.), and provide basic medical care (clearing the airway, placing catheters, controlling bleeding, simple obstetrical maneuvers, etc.) in the general care environment, and coordinate fine and gross muscular movements to treat patients in emergency situations. Emergency situations include any circumstance in which a patient requires immediate medical attention Medical students must be able to meet applicable safety standards for the environment, and to follow universal precaution procedures. 

5. Behavioral and Social Attributes

The student must possess the emotional health required for full use of their intellectual abilities, the exercise of good judgment and the prompt completion of all responsibilities for the diagnosis and care of patients. The student must exhibit the development of mature, sensitive and effective relationships with patients, colleagues, clinical and administrative staff, and all others with whom the student interacts in the professional or academic setting, regardless of their race, ethnicity, gender, religion, age or other attributes or affiliations that may differ from those of the student. The student must be able to tolerate physically taxing workloads and to function effectively when stressed. The student must be able to adapt to changing environments, to display flexibility and to learn to function in the face of uncertainties inherent in the clinical problems of many patients. A student is expected to accept appropriate suggestions and criticism and, if necessary, respond by modification of behavior. A student is expected to self-regulate emotions and behaviors and to seek assistance when the ability to do so is compromised. Empathy, integrity, concern for others, interpersonal skills, interest and motivation are all personal qualities that will be assessed during the admission and educational processes.

6. Ethics and Professionalism

Students must interact with all individuals in a respectful and effective manner regardless of gender, age, race, sexual orientation, religion, or any other protected status. They must maintain ethical and moral behavior consistent with professional standards for interactions with students, faculty, staff, patients, and the public. They must understand the legal and ethical aspects of the practice of medicine and function within both the law and ethical standards of the medical profession. Professionalism, compassion, integrity, concern for others, interpersonal skills, interest, and motivation are all qualities that are expected throughout the educational processes.

6.0 Responsibilities 

The Office of Admissions will confirm that the members of the Admissions Committee are apprised of the policy, and ensure that the criteria will be applied equitably during the screening, interview, and selection processes.

7.0 References

L.C.M.E. Standard 10.3: Policies Regarding Student Selection/Progress and Their Dissemination Applicants
L.C.M.E. Standard 10.4: Characteristics of Accepted Applicants
L.C.M.E. Standard 10.5: Technical Standards

Read About L.C.M.E. Functions and Structure of a Medical School

Learn About the Americans with Disabilities Act

Approval

The policy will be reviewed by the Admissions Executive Committee and approved by the Curriculum Committee. The Admission Executive Committee approved it on June 30, 2021, and the Curriculum Committee on July 28, 2021.

Download Technical Standards for Admissions, Retention and Graduation (PDF)

Medical mistakes are all too common in hospitals, but you might not hear much about them from patients themselves. For one thing, many victims and their families, understandably, don't want to talk publicly about painful memories. And even if they do, they're often prevented from speaking out by gag orders or sealed legal settlements.

That's unfortunate, says Lisa McGiffert, director of Consumers Union's Safe Patient Project. "The best cure for medical harm is full disclosure," she says.

Before you tell your story, follow these steps to protect yourself:

Get prompt medical attention. A trusted primary care doctor, for example, can help you decide how to proceed. Or see an independent doctor for another look. If you suspect a friend or family member is in danger, call a meeting with all of her or his doctors.

Get a copy of your medical records. They belong to you and can help you and your other doctors understand what happened, and what needs to happen. Your physician, or the hospital's records department, can help you obtain a complete copy, including medical summaries, doctor and nursing notes, test results, and diagnostic images. Note that you might have to pay for copies. If you believe that someone died from hospital harm, ask for an autopsy, to determine the most likely cause of death. Hospitals don't always do them automatically, but the person's next of kin or the legally responsible party can request one. Because autopsies help doctors learn more about illness and ways to Excellerate medical care, autopsies are usually performed without charge. Although you have the right to pay for an independent one on your own.

Report the problem. Only about 14 percent of medical harm events are reported by hospital staff, according to federal estimates. Make sure you tell your version of events to the hospital. Then contact:

• Your local or state health department.

• The Joint Commission, an organization that accredits and certifies more than 19,000 health care organizations.

• Your state's Medicare Quality Improvement Organization, if you are a Medicare patient.

Don't pay. "You shouldn't have to pay for a mistake or its consequences," says John Santa, M.D. director of the Consumer Reports Health Ratings Center. For example, patients shouldn't be billed for treatment related to hospital error, such as treating a broken hip after a preventable fall in the hospital.

Consider hiring a lawyer. Medical malpractice has a high standard of proof, and attorneys might reject your case. But a lawyer can also help you negotiate with hospitals over medical bills or compensation agreements, even if you aren't considering legal action.

Tell others about your experience. If you have been harmed in the hospital, we encourage you to consider sharing your story with our Safe Patient Project. Consumers Union's advocates use those patient experiences to help push for legislative and regulatory changes. ProPublica, an independent newsroom that has also written extensively about patient safety, also maintains a database of patient stories. In addition, it recently started a Patient Harm Community on Facebook.

Two-Step Admissions Process

1. Students interested in the Medical Laboratory Science option must first be accepted to the Applied Biomedical Sciences B.S. degree, Clinical Science option by application to Undergraduate Admissions.
2. Students currently enrolled in the Applied Biomedical Sciences major, Clinical Science option are eligible to apply to the Medical Laboratory Science option after at least one successful semester in the major.

Admission will be based primarily on:

• Scholarship (both cumulative and science with an emphasis on the GPA of the required prerequisite science courses)
• Personal Statement
• Meeting with the Medical Laboratory Science Program Director

At the current time, applications are reviewed at the end of each semester by the Medical Laboratory Science Program Director and a Department Faculty Committee. Qualified students will be accepted on a space available basis.

For additional information, contact the Medical Laboratory Science Program Director.

Colleges and universities wanting to commit to health and education equity without using affirmative action can turn to the UC Davis School of Medicine for best practices, according to a new article published this week in JAMA online.

The "Viewpoint" article posted Monday recaps how and why the school, over nearly two decades, has significantly boosted enrollment of students historically underrepresented in medical education. The article was authored by School of Medicine faculty members Mark Henderson, associate dean for admissions; Tonya Fancher, associate dean for workforce innovation and education quality improvement; and Susan Murin, the interim dean.

The article, "Holistic Admissions at UC Davis—Journey Toward Equity," was written after the U.S. Supreme Court barred higher education institutions from admitting students based on race. Although California voters narrowly passed Proposition 209, banning race-conscious admissions in 1996, the UC Davis School of Medicine has stood out as one of few institutions that has steadily increased enrollment of Black, Latino and Native American students.

Over the past 15 years, the article states, UC Davis School of Medicine "has tripled enrollment of these students by developing an admissions model that prioritizes state workforce needs and attention to the mission fit, lived experience, and socioeconomic background of each applicant."

In 2006, the proportion of entering Black, Hispanic and Native American students was less than 10%, despite the same groups being a majority of the state's high school graduates. It was also known that students from these groups experience greater income equality, less access to care and poorer health outcomes.

"To fulfill the school's public mission," the article states, "radical change was needed—but without preference for race, sex, color, or ethnic or national origin in the admissions process."

That's when the school's leadership team committed to developing a process to admit students who would be best equipped to meet the workforce needs of California. This represented a new, radical model for medical education.

It meant relying less on metrics—such as the Medical College Admission Test scores, or undergraduate grade-point averages—and adding a number of other criteria to provide a more holistic view of each applicant's life experience. The admissions committee also added new student and faculty members and implemented new methods of evaluating applicants, such as multiple mini-interviews that are less subject to individual bias and are better at predicting who will make a great doctor.

"Asking the question, 'How will this applicant add to or strengthen the future physician workforce in California?' broadened the perspective of committee members, prompting them to consider attributes including maturity, work experience, military service, and personal illness, disability, or other adversity," the authors state.

Even after employing the new criteria, committee members needed ways to put traditional academic metrics into the context of the diverse educational experiences and opportunities of students from different backgrounds. Eventually, researchers from the UC Davis Health's Department of Family and Community Medicine developed the Davis Scale. It is a continuous measure of socioeconomic disadvantage, incorporating factors from the medical school application such as parental income and education, growing up in a medically underserved area, and other socioeconomic variables.

"This scale is placed alongside other academic performance measures to provide context to these metrics, serving as a proxy for resilience or distance traveled, key physician attributes," the article states.

Meanwhile, the school developed innovative pathways or Community Health Scholar (CHS) tracks that helped students align their medical education with workforce needs. They did this with the help of the UC Office of the President, state funding and financial support from organizations such as Kaiser Permanente Northern California.

For example, ACE-PC (Accelerated Competency-based Education in Primary Care) is a three-year program that offers a medical degree to select students in just three years instead of four, helping alleviate the shortage of primary care physicians. Likewise, REACH PRIME (Reimagining Education to Advance central California Health) provides students with extensive patient-care experience the Central Valley, which has a severe shortage of physicians.

Students who pursue CHS pathways often mirror the target patient population or specific workforce need the program intends to address. And because students from historically underrepresented groups often come from low-resource families, including many who are the first in their families to attend college, the school offers a strong support system that includes financial aid, academic coaches and mentors.

"UC Davis' mission-aligned holistic admissions journey shows that institutions committed to education and health equity can make progress in a race-neutral environment," the authors conclude. "Leveling the playing field for low-income students can reduce segregation of medical schools, enhance the impact of scientific teams, grow the primary care workforce, Excellerate access to care for underserved communities, and increase provision of culturally humble care. All medical schools must recommit to their social mission if the U.S. is to achieve health equity."