Gauging interest in community service: a retrospective review of admission files.

Medical schools hold a social contract to improve the public health. In meeting this commitment, they have made notable strides in the provision of patient care, development of technology, generation of new knowledge, and training of professionals. Unfortunately, far less progress has been made in devising community outreach activities and meeting basic health needs. To remedy this, physicians should be selected and trained with the appropriate mix of skills, attitudes, and values necessary to improve the public’s health, particularly of the poor and underserved. As a result of the personal orientation and premedical preparation of applicants, as well as the selection criteria of admission committees, many students enter medical school with altruistic inclinations. Educational programs that facilitate community service within the medical curricula are thought to reinforce and integrate altruistic values into the profession and promote social responsibility. If medical schools want to address public health concerns, some have advocated that community service be a part of medical training. Previous studies have documented that students who choose to participate in service–learning experiences differ in their attitudes, skills, values, and understanding about social issues compared with students who do not. By considering applicants’ humanitarian interests, medical school admission committees play a crucial role in helping medical schools fulfill their social contract with the public—the selection of competent and caring future physicians. Validly assessing such diverse qualities, however, remains problematic. Admission committees use undergraduate grade-point average and Medical College Admission Test scores as markers of intelligence and aptitude. Applicants’ humanitarianism or altruism is less amenable to valid measurement. Usually, such characteristics are expressed through the applicant’s self-reported participation in community service activities. Because details regarding these experiences are often sketchy, the scope and depth of an applicant’s community service experience remain difficult to ascertain and quantify. Admission committees rely on community service experience information in selecting applicants who may have altruistic inclinations. Little is known about the predictive capacity of this non-academic performance variable as it relates to behavior in medical school, or future medical practice. This study addresses three questions related to the use of applicants’ community service experience for selection and prediction purposes by an admission committee. First, using key medical school admission file materials, can reviewers reliably assess applicants’ experiences with, and orientation toward, community service? Second, do reviewers use specific aspects of community service to determine their overall assessments of community service involvement? Third, can these assessments predict students’ voluntary participation in a new first-year service–learning elective?