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Introduction <p>The Access Pathway at the Schulich School of Medicine and Dentistry, implemented in 2019/20, aims to improve representation in medicine by supporting applicants from a broad range of equity deserving populations. This study evaluates associations between the Access Pathway and applicant demographics by examining deprivation levels before and after its implementation. The Canadian Index of Multiple Deprivation (CIMD), in which higher scores indicate greater deprivation, was used to assess applicants across four domains: Residential Instability, Economic Dependency, Ethno-Cultural Composition, and Situational Vulnerability.</p> Methods <p>A retrospective review of data collected between 2015 and 2023 was conducted. The primary outcome was the change in CIMD scores across the entire applicant pool pre- and post-Access implementation.</p> Results <p>Across all (<i>n</i> = 18,162) applications to the MD program from 2015 to 2023 mean CIMD scores increased post-Access (compared to pre-Access) in residential instability (0.10 vs. 0.03, 95% CI: 0.03 to 0.10, <i>p</i> &lt; 0.01) and ethno-cultural composition (0.72 vs. 0.65, 95% CI: 0.03 to 0.10, <i>p</i> &lt; 0.01). Conversely, economic dependency scores decreased (-0.13 vs. -0.09, 95% CI: -0.07 to -0.01, <i>p</i> &lt; 0.01). Changes in situational vulnerability were not statistically significant (95% CI: -0.02 to 0.01).</p> Discussion <p>The Access Pathway was associated with shifts in applicant demographics with increased representation from certain marginalized communities while having modest to no association with other domains. By complementing self-reported data with objective deprivation indices, this work provides actionable evidence supporting the role of equity pathways in broadening representation along diverse axes while highlighting domains requiring further effort.</p>

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Associations of an Equity-Oriented Medical School Admissions Pathway with Area-Based Measures of Socioeconomic Deprivation

  • 期刊论文

  • 发表日期：

    2026年5月1日

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  • Hassan Kiani,
  • Arpana Wadhwani,
  • Keegan D’Mello,
  • Jedrin Ngungu,
  • Sandrine de Ribaupierre,
  • George Kim,
  • Amrit Kirpalani

摘要

Introduction

The Access Pathway at the Schulich School of Medicine and Dentistry, implemented in 2019/20, aims to improve representation in medicine by supporting applicants from a broad range of equity deserving populations. This study evaluates associations between the Access Pathway and applicant demographics by examining deprivation levels before and after its implementation. The Canadian Index of Multiple Deprivation (CIMD), in which higher scores indicate greater deprivation, was used to assess applicants across four domains: Residential Instability, Economic Dependency, Ethno-Cultural Composition, and Situational Vulnerability.

Methods

A retrospective review of data collected between 2015 and 2023 was conducted. The primary outcome was the change in CIMD scores across the entire applicant pool pre- and post-Access implementation.

Results

Across all (n = 18,162) applications to the MD program from 2015 to 2023 mean CIMD scores increased post-Access (compared to pre-Access) in residential instability (0.10 vs. 0.03, 95% CI: 0.03 to 0.10, p < 0.01) and ethno-cultural composition (0.72 vs. 0.65, 95% CI: 0.03 to 0.10, p < 0.01). Conversely, economic dependency scores decreased (-0.13 vs. -0.09, 95% CI: -0.07 to -0.01, p < 0.01). Changes in situational vulnerability were not statistically significant (95% CI: -0.02 to 0.01).

Discussion

The Access Pathway was associated with shifts in applicant demographics with increased representation from certain marginalized communities while having modest to no association with other domains. By complementing self-reported data with objective deprivation indices, this work provides actionable evidence supporting the role of equity pathways in broadening representation along diverse axes while highlighting domains requiring further effort.