Medical school admissions competencies: what problems need to be solved?

Premedical or admissions competencies define a standard set of expectations for medical school candidates to guide their preparation for and application to medical school. These competencies also support medical school admissions committees in advancing fair and efficient application review. In their article updating the 2011 premedical competencies with a revised model consisting of 17 competencies that span professional, science, and thinking and reasoning domains, Wasserman and colleagues have attempted to characterize a qualified medical school applicant poised for success. While these competencies constitute a laudable effort, additional refinement may be needed over time to address emerging areas in medical education and health care. These include incorporating qualitative reasoning, fostering artificial intelligence literacy, emphasizing feedback literacy, and articulating the skills required to reconcile competing needs, ultimately reframing professionalism as a complex, adaptive challenge of developing professional identity within a demanding environment. To operationalize these competencies, a robust toolkit with resources, assessment tools, and training materials will be needed. To understand how well the updated competencies capture the enduring and evolving expectations for incoming medical students, medical educators must ask what problems these competencies are trying to solve. In this commentary, the authors propose 3 problems that admissions competencies could solve: (1) linking education to health outcomes, (2) promoting fairness in admissions, and (3) cultivating physicians skilled in relationship building and team functioning. For the competencies to address these problems, medical schools must continue to commit to holistic review processes that evaluate applicants within their unique contexts and opportunities. Focusing the admissions competency framework on behavior-based guidance, rather than on prescriptive experiences, creates a more accessible pathway to medical education that honors applicants' backgrounds, while identifying qualified candidates with the potential to become compassionate, adaptable physicians prepared for the ever-evolving health care landscape.