Resolution: F-20-11: CALL TO ACTION OF THE AOA AND AACOM TO ANNUALLY PUBLISH FEE WAIVER DATA WITHIN THE APPLICANT PROFILE REPORT

[Valerie Lile]

1  WHEREAS, increasing the representation of low Socioeconomic Status (SES) and
2  underrepresented minorities is acknowledged as a goal of American Association of Colleges of
3  Osteopathic Medicine (AACOM) and the American Osteopathic Association (AOA); and
4  WHEREAS, there are numerous financial barriers to accessing medical education, persons from
5  low SES backgrounds are often excluded from medical education; and
6  WHEREAS, physician-patient concordance results in higher patient satisfaction and diversity in
7  medicine improves care and outcomes. As such it is the duty of medical educators to make
8  medical education accessible to people of all backgrounds. To do so benefits our future patients,
9  and the future of the profession^1,2,3; and
10  WHEREAS, physicians from low socioeconomic and underrepresented minority groups are
11  more likely to provide public benefit by serving poor, minority, and Medicaid populations4; and
12  WHEREAS, the average DO applicant applied to 8.7 schools in 2018, averaging $596.20 for
13  primary applications alone. Each secondary application received and submitted can cost between
14  $60.00 and $200.00 per program. As of 2020, the initial registration fee for the MCAT is
15  $320.00 with preparation courses ranging from $160-$2,000 or more^5,6,7; and
16  WHEREAS, 30% of American applicants spent over $1500 in travel expenses for one interview
17  cycle, and the lowest quintile of applicants in 2019 had an average household income of $2000
18  per month⁸; and
19  WHEREAS, the current American Association of Colleges of Osteopathic Medicine
20  Application Service (AACOMAS) fee waiver covers the $196 primary application fee which
21  includes one (1) school, but does not include the $46 fee for each additional school. Therefore,
22  students receiving the full fee waiver are expected to pay $354.20 on average for primary
23  applications alone (if applying to the average of 8.7 schools), creating an undue burden on
24  applicants from low SES backgrounds⁹; and
25  WHEREAS, the amount of aid given each year by AACOMAS as well as the number of
26  applicants receiving financial aid is not publicly available information; now, therefore, be it
27  RESOLVED, increasing transparency in financial assistance would help ameliorate the financial
28  barriers that contribute to race and SES disparities in medical school applicants.
29  RESOLVED, that SOMA encourage the AOA and AACOM to require transparency in the fee
30  waiver process for Osteopathic medical school applicants. Including, but not limited to, annual
31  reporting of the number of applicants who applied for fee waiver, the number of applicants who
32  received fee waiver, the total sum of money available for fee waivers during each application
33  cycle, the median income of applicants who applied for the fee waiver, the median income of
34  applicants who received the fee waiver; and be it further
1  RESOLVED, that SOMA lobby to the AOA and AACOM to improve public reporting of the
2  fee waiver process which would benefit applicants from low SES backgrounds, thereby
3  increasing the diversity of osteopathic applicants and matriculants.

SOMA Policy:

Policy of Other Organizations Named in the Resolved Statements (AOA/AMA/etc):

References

1. Verlinde, E., De Laender, N., De Maesschalck, S. et al. The social gradient in doctor-patient communication. Int J Equity Health 11, 12 (2012). https://doi.org/10.1186/1475-9276-11-12 https://link.springer.com/article/10.1186/1475-9276-11-12
2. Hardeman RR, Burgess D, Phelan S, Yeazel M, Nelson D, van Ryn M. Medical student socio-demographic characteristics and attitudes toward patient centered care: do race, socioeconomic status and gender matter? A report from the Medical Student CHANGES study. Patient Education Counsel 98, 3 (2015). doi: 10.1016/j.pec.2014.11.013. Epub 2014 Nov 18. PMID: 25499003; PMCID: PMC4433154. https://pubmed.ncbi.nlm.nih.gov/25499003/
3. Magnus SA, Mick SS. Medical schools, affirmative action, and the neglected role of social class. Am J Public Health 90, 8 (2000). doi:10.2105/ajph.90.8.1197 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1446350/pdf/10936995.pdf
4. Whitla, Dean K. PhD; Orfield, Gary PhD; Silen, William MD; Teperow, Carole; Howard, Carolyn MEd; Reede, Joan MD, MPH Educational Benefits of Diversity in Medical School: A Survey of Students, Academic Medicine. Journal of the Association of American Medical Colleges 78, 5 (2003) https://journals.lww.com/academicmedicine/Fulltext/2003/05000/The_Teaching_of_Cultural_Issues_in_U_Sand.7.aspx

5. American Association of Colleges of Osteopathic Medicine Research Department: AACOMAS Applicant Pool Profile: Entering Class of 2019 (2019) https://www.aaorg/docs/default-source/data-and-trends/2019-aacomas-applicant-pool-profile-summary-report.pdf?sfvrsn=23a83a97_6
6. American Association of Colleges of Osteopathic Medicine Research Department: AACOMAS Application Fees and Fee Waivers (2020) https://help.liaisonedu.com/AACOMAS_Applicant_Help_Center/Starting_Your_AACOMAS_Application/Getting_Started_with_Your_AACOMAS_Application/02_AACOMAS_Application_Fees_and_Fee_Waivers#:~:text=AACOMAS%20charges%20%24196%20for%20the,and%20how%20to%20pay%20it

7. Association of American Medical Colleges: Financial Aid (2020) https://students-residents.aamc.org/financial-aid/article/the-cost-of-applying-to-medical- school/#:~:text=MCAT%20Exam%20Fees,testing%20at%20international%20test%20sites.
8. Lam, Justin; Phillips, Chantal; Okafor, Ike. COVID-19: An Urgent Opportunity to Decrease Barriers to Medical School Admission. Canadian Medical Education Journal (2020), doi: 10.36834/cmej.70219 https://journalhosting.ucalgary.ca/index.php/cmej/article/download/70219/54022
9. American Association of Colleges of Osteopathic Medicine Application Service: AACOMAS Application Fee Waiver (2020) https://aacom.org/become-a-doctor/how-to-apply-to-osteopathic-medical-college/application-fee-waiver

Submitted by:

Amy Elfond, OMS III – NYITCOM
Nicole Hunzeker, OMS II – NYITCOM
Thomas Lampeter, OMS II – NYITCOM
Daniela Lin OMS II – NYITCOM
Melanie Orr OMS II – NYITCOM

Action Taken: [Leave Blank. Will be Approved by the House of Delegates or Not Approved.]
Date: [Leave Blank. Date submitted to National Vice President and the National Office.]
Effective Time Period: Ongoing

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