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White Coat Notes

Holistic criteria aid medical schools

Excerpts from the Globe’s health care blog.

Medical schools traditionally have accepted students with the highest test scores and best science grades. But in an article published online Wednesday by the New England Journal of Medicine, Dr. Robert Witzburg of Boston University School of Medicine writes about what he considers a better approach to choosing future physicians: holistic review.

Medical schools that use this method give potential students points for overcoming adversity, showing resilience, and being empathetic — as well as for academic achievement. Admissions officers consider letters of reference, interviews, and community service experience to evaluate these qualities.

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Since BU medical school adopted this approach in 2003, the profile of its entering class has changed dramatically, Witzburg writes. Students from groups under-represented in medicine — blacks, Native Americans, Pacific Islanders, and Hispanics — make up 20 percent of the class now, up from 11 to 12 percent. Faculty also believe students are more supportive of one another, he said.

The school has not sacrificed academics. Students’ grade point averages and Medical College Admission Test scores have increased slightly over the past five years, which could in part reflect the college’s ability to recruit stronger students.

“No one thinks we should be looking for medical students who aren’t good in science,’’ Witzburg said in an interview in February. But he said that is not the only indicator of future success.

First, do no online harm

Use secure e-mail systems. “Pause before posting” items to a personal or professional blog, to consider the implications for patient protection. And above all, a new policy paper issued Thursday by the American College of Physicians and the Federation of State Medical Boards suggests, doctors should remember that the boundaries of the physician-patient relationship apply online as much as they do in an exam room.

A large majority of state medical and osteopathic licensing boards have disciplined doctors for communicating inappropriately with patients through blogs or social media platforms or for other unethical behavior online, a study published last year in the Journal of the American Medical Association found.

Certainly, Facebook, Twitter, e-mail, and other online forums can be useful tools, said Dr. Humayun J. Chaudhry, president of the medical board group, during a media call introducing the policy. “There are, at the same time, some real challenges and cautions that physicians need to be aware of.”

The policy also touches on how doctors should handle information that may be posted online about them, recommending periodic “self-auditing” of rating sites and other forums.

View the full blog at ­boston.com/whitecoatnotes. Chelsea Conaboy can be reached at cconaboy@boston.com. Follow her on ­Twitter @cconaboy.
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