Holistic Admissions in the Health Professions: Strategies for Leaders.

In the wake of national health care reform, development of the future health care workforce has become more important than ever. Millions of newly insured patients, many from underserved urban communities, are seeking health care services. In order to provide high-quality care to rapidly diversifying patient populations, health care professionals must be educated in environments that value diversity, and they must possess the background, qualities, and skills needed to address complex health needs.As the primary educators of the health care workforce, colleges and universities are seeking strategies that will help them increase the diversity of their student populations and, by extension, that of future professionals. The admissions process is one component of an overall strategy to achieve these aims, as it allows universities to build a class of students with many of the attributes needed for success. One emergent strategy is "holistic review," a flexible, individualized way of assessing an applicant's experiences, attributes, and academic metrics and how the individual might contribute value as a student and future health professional. When applied consistently across an entire applicant pool, holistic review contributes to a "holistic admissions" process, best understood as a collection of practices and policies that can help an institution achieve its mission over time. The mission may include diversity goals or other mission-based priorities such as improving the educational environment and meeting local health workforce needs.Although holistic admissions practices have been adopted by many medical and dental schools, evidence of their use in other professions has been limited. To address the need for evidence, Urban Universities for HEALTH,2 with support from the Health Resources and Services Administration (HRSA) and the National Institutes of Health, conducted a large-scale, national study on admissions in the health professions that included not only medical and dental schools but also schools of pharmacy, nursing, and public health. The study examined how universities are admitting students into health professions programs and focused particularly on holistic admissions as a strategy for increasing diversity and cultural competence in the workforce, with the larger aim of improving access to care and achieving health equity. The results of the study indicate that diversity has increased at schools that have adopted more elements of a holistic admissions process, while variables related to student success (e.g., average incoming GPA, graduation rates) remained the same or increased (Urban Universities for HEALTH 2014).In response to this study, the Coalition of Urban Serving Universities (USU) convened a small working group of university leaders to review the evidence and identify a set of common strategies that other leaders could employ as they seek to implement holistic admissions processes at their institutions. The group developed the following list of actions, primarily for college and university leaders and national stakeholders, including higher education associations, accreditors, and funding agencies. In publishing these strategies, it is hoped that higher education leaders will look critically at their own institutions' admissions processes and consider adopting additional practices that may help them enroll more diverse student populations within the context of their unique missions and goals.StrategiesTo prepare a diverse health workforce that meets local needs, health professions schools should consider using a holistic admissions process to admit students.A holistic admissions process incorporates a variety of practices (including holistic review). Schools may choose to implement some practices and not others as they work to improve their admissions processes in accordance with their missions, geographic contexts, and local health care workforce needs.Rationale: The study indicates that schools using a holistic admissions process have experienced increases in the diversity of their incoming classes (Urban Universities for HEALTH 2014). …