A study by McMaster University residents has found that most applicants to the medical school continue to come from wealthier neighbourhoods whose median income is above the average Canadian’s by almost $30,000.
The researchers compiled admission data from the university and the Ontario Medical School Application Service — where each applicant has a unique identification number — to analyze 26,120 applicants from 2013 to 2018. Among the data collected was the person’s application year, whether they were offered admission, their acceptance status, and also their postal code during high school.
The postal codes were then matched to a dissemination area from the 2016 Canadian census, which captured the prior year’s median total neighbourhood income.
The study found that the median total neighbourhood income for McMaster’s medical school applicants was $98,816 — around $28,480 more than Canada’s median income of the general population.
Those not admitted came from a neighbourhood whose income clocked in around $7,680 less than those offered admission — the median income of people who got in was around $105,989.
Pitre said it shows that within this already-affluent group, even wealthier people get admitted to the school.
This means patients miss out on having doctors that share their perspective for a deeper understanding of their situations or the health problems that disproportionately affect lower income communities.
“It’s important in general to have a diverse population of doctors to serve a diverse group of Canadians,” Pitre said. “If all the doctors come from incomes greater than $100,000, it’s going to be more difficult for them to have the perspective of somebody who’s maybe from a lower economic situation.”
Having different viewpoints, he added, also increases patients’ trust.
Diversity lacks in applicants, let alone admissions
Studies proving a lack of diversity among medical school applicants date back almost 20 years — The findings are consistent with a 2002 study led by Irfan Dhalla, now vice president of St. Michael’s hospital in Toronto and professor at University of Toronto.
It found first year students at Canadian medical schools were more likely to have a higher socioeconomic status, and some minority groups were also underrepresented.
And while the current study uses a neighbourhood income, which means people might have clocked in much lower or higher than the amount reported, the pattern still persists.
The point, Pitre said, is that people continue to come from wealthier neighbourhoods even after faculties acknowledged a need for change.
“This is a two prong issue. It’s not just fixing the application process — it’s also thinking about systemic barriers,” he said and pointed to the need for mentors to help people get to their medical school journey and resources for poor income families.
Back in its 2010 recommendations for medical education, The Association of Faculties of Medicine of Canada wrote that faculties of medicine “must recruit, select, and support a representative mix of medical students” to achieve diversity in the physician workforce.
There have been some efforts across the country — University of Saskatchewan sets aside some spots for people from lower incomes — but Pitre pointed out the problem begins even before the admissions.
“There’s a big problem before they get to the medical school process,” Pitre said. “People who are from low socioeconomic backgrounds are not really applying to medical schools in large numbers, which is more of a systemic problem than it is by a faculty admission problem in general.”
Pattern seen across Canada
Since 75 per cent of applicants to McMaster come from Ontario, the authors also broke up the applicants by province and territory to make sure that GTA-ers weren’t skewing the results.
The trend persisted across each area, with applicants coming from the wealthier sections relative to each province’s average income.
Pitre said the study was reflective of a nationwide problem.
“McMaster is the most applied medical school in Canada. It has a very open application process; there’s not as many requirements as other medical schools,” he said. “So I think from our point of view, our study end up being quite generalizable to medical school applicants in general.”
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