Exploring Equity in Canadian Undergraduate Medical Education Admissions

The diversity in the Canadian population is not reflected in the intake of medical students or the physician population.Although there is greater gender balance than in the past, other underrepresented groups are not making the same strides.This note reports on the preliminary steps in a five-year plan to provide evidence for modifying undergraduate medical student selection processes that support equitable access to medical programs for underrepresented groups using the principles of inclusive education.Historically, white, middle-class men held the overwhelming majority of seats in Canadian medical schools (Blishen, 1991).Despite the so-called feminization of medicine in Canada, the United States, the United Kingdom, and elsewhere (Notzer & Brown, 1995;Paik, 2000), female students, like their male counterparts, tend to be a socially privileged group (Bellaire, Malhotra, Mrkobrada, & Touw, 2002;Bickel, 2000Bickel, , 2001)).Canadian undergraduate medical students are disproportionately white, urban, middle-class women and men with advanced educational preparation, and with well-educated parents who hold professional or high-status jobs, and live in neighborhoods where the median family income is in the top quintile of the Canadian population (Dhalla et al., 2002).Black and Aboriginal women and men, gays and lesbians, the differently abled, and those from rural and socially or financially disadvantaged backgrounds are among those who continue to be underrepresented in Canadian medical programs.A complex web of reasons explains why some groups are underrepresented in medical schools.Often cited are financial obstacles that are intimately linked to other social, geographic, and educational disadvantages (Bellaire et al., 2002).To support students from recruitment through to successful completion of their program, academic medical centers have responded in a variety of ways.For example, recent attention has focused on establishing preadmission schools (Searle, 2003;Strayhorn, 1999Strayhorn, , 2000)), using innovative recruitment strategies (Curran & Rourke, 2004;Frankl, 2003), hiring diverse faculty who model values and attitudes of equity and social justice (Frankl, 2003;Mclean, 2004), deeply incorporating diversity into the curriculum (Baez, 2004), and warming chilly classroom and clinical climates (Beagan, 2001).Collectively, such examples form the basis of inclusive education.

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