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When Mark Henderson became admissions dean at the UC ����ԭ�� School of Medicine in 2007, he was charged with making systematic changes to the way students were being admitted to the school.

California’s physician workforce wasn’t keeping up with the state’s changing demographics — across social, socioeconomic, or racial and ethnic backgrounds. School enrollment, an obvious indicator of the future workforce, showed that only 10% of UC ����ԭ��’ newest medical students were African American, Latino or Native American — in a state that was already majority-minority.

“I knew we had to do a better job of recruiting classes more representative of California’s diverse population and communities,” recalled.

Seventeen years later, UC ����ԭ�� is ranked the medical school in the country, according to U.S. News & World Report. Nearly half of UC ����ԭ�� medical students now belong to groups historically underrepresented in medicine.

UC ����ԭ�� School of Medicine Demographics 2000-2022

While the U.S. Supreme Court banned race-conscious college admissions last summer, the UC ����ԭ�� School of Medicine for years has enrolled a student body that better reflects California's diversity in accordance with the ruling and with the state’s own ban on .

As a school that graduates over — more than 80% of whom remain in California — UC ����ԭ�� plays a key role in addressing the state’s shortage of physicians in rural and lower-income communities. By graduating doctors to meet the needs of the state’s diverse patient population, UC ����ԭ�� is better fulfilling its mission as a public university in and for California. Studies have shown that patients from minority communities experience better outcomes, including  and , when treated by a provider from their own cultural or linguistic background.

“UC ����ԭ�� is a great model for how to create an intentional, mission-oriented, holistic approach to admissions,” said Amy Addams, director of student affairs alignment and holistic review at the , or AAMC. “They have a very clear sense of who they are as an institution, what their mission is and what they’re trying to accomplish.”

The long journey that increased the UC ����ԭ�� School of Medicine’s diversity was multifaceted: recruiting students from underserved areas, bolstering scholarship support and creating a learning environment supportive of each student’s success.

It also includes a novel admissions tool getting attention across the nation: the school’s socio-economic disadvantage metric, which is being trademarked as the UC ����ԭ�� Scale. The metric incorporates elements such as family income and receipt of need-based scholarships during college. These elements provide a fuller picture of each applicant’s educational opportunities along their way to medical school.

UC ����ԭ��’ admissions success also comes from paying greater attention to the lived experience of applicants. The School of Medicine stays focused on its social mission of training doctors to advance health equity, a longstanding priority for the school.

“We’ve figured out how to stay true to the mission of a public institution, the bedrock on which we’ve navigated the past quarter century despite California’s 1996 ban on affirmative action,” Henderson said. “Our school is three times more ethnically and racially diverse than the national average, and that diversity helps us better meet our state’s health care needs.”

The beginning of a transformation

Henderson was practicing primary care internal medicine at an academic medical center in San Antonio and overseeing its internal medicine residency program in 2000, when he and his wife, oncologist Helen Chew, were recruited to UC ����ԭ��. He was tapped to lead the School of Medicine’s own and employ his knack for recruiting talented medical school graduates.

When he was promoted to associate dean for admissions in 2007, he worked with admissions committee faculty and staff to improve the efficiency and integrity of the process to evaluate over 5,000 applicants to UC ����ԭ�� each year, all while focusing on meeting California’s health workforce needs. This included partnering with IT to design a secure web-based admissions portal that was both user-friendly to applicants and easier for admissions committee members to navigate.

“Here we were, UC ����ԭ��, competing against Stanford and UCSF, a David vs. Goliath situation,” Henderson said. “We needed to make substantial investments to update our process and attract the best candidates to fulfill our school’s values and mission.”

Socioeconomic status in admissions

With a new electronic admissions system in place, the admissions team turned their attention to holistic admissions.

Every school relies on an applicant’s , or MCAT, score, and undergraduate grades, to help determine who gets accepted. But UC ����ԭ�� takes a broader view of those metrics by examining each applicant’s life experience including barriers encountered or “distance traveled.” What did it take for the student to get to college? Did they serve in the military? Did they overcome a major illness?

Students who come from low-income families or attend community college have been underrepresented in medical schools for decades. These students also have a strong desire to serve populations lacking access to care and are more likely to go into much-needed specialties like family medicine, often in rural communities where residents face serious health inequities.

The UC ����ԭ�� Scale helps the school select students who seem motivated to spend their medical careers in underserved areas — something an MCAT score or GPA cannot do.

Novel interview practices at UC ����ԭ�� School of Medicine

UC ����ԭ�� was one of the first schools in the country to incorporate the , or Multiple Mini Interview, into its admissions process.

Unlike traditional admissions interviews led by a doctor or medical student and lasting about 45 minutes, the MMI takes place in a mock clinic setting and consists of visits to multiple stations, each lasting eight to 10 minutes. The person evaluating the candidate, known as a rater, could be a professor, staff member, student, even a community member. The rater knows nothing about the applicant, which removes a bias inherent in traditional or open-file interviews, such as knowledge of the undergraduate institution or academic record, which are considered elsewhere in the process.

The rater may also observe how the applicant interacts with a “patient” who is actually a trained actor. The scenario might simulate a thorny ethical issue or volatile situation to assess the applicant’s problem-solving and communication skills.

“The MMI illuminates how an applicant’s life experiences, thought processes and maturity can affect their performance in realistic situations, which written examinations cannot do,” Henderson said.

Pathways to diversity in health care

When students enroll at UC ����ԭ�� School of Medicine, they can apply to join any of five pathways, or tracks. Each pathway meets a pressing workforce need, such as the shortage of primary care physicians. About 30% of each incoming class enrolls in a pathway, some of which have received state or other external funding including from the .

The pathways:

• , which provides medical t