Investigating the support for equitable admissions policies in health professions education: the Formal Consensus method

Abstract

Higher education institutions increasingly aim to implement equity in admissions. However, there is no one-size-fits-all solution to determine which equitable admissions procedures are suitable in a specific context, nor which groups should be its beneficiaries. Therefore, we applied the Formal Consensus Method (FCM) to investigate the support amongst experts and stakeholders for different equitable admissions policies and target groups within the context of Health Professions Education in The Netherlands. We found majority support (median of ratings ≥ 7 on a scale of 1 to 9) in both groups for the target groups ‘applicants with a low or average socio-economic status’ and ‘applicants with an underrepresented migration background’. The majority of participants was also in favor of Contextualized Admissions, especially when used to increase enrolment of applicants with a low or average socio-economic status, with an underrepresented migration background, and asylum status holders. Lastly, both groups supported lottery with extra tickets for applicants with an underrepresented migration background. However, as the range of ratings fell outside the FCM prescribed range of 5-9, no case in which there was majority support could be defined as a ‘consensus’. The expert group proposed the use of Bonded Medical Places for applicants from the Caribbean parts of the Dutch Kingdom. The policies and target groups for which broad support was found, could contribute to equitable admissions, improved student diversity, and enhanced quality of health education and future care. Our application of the FCM in the area of equitable admissions policies may be useful for researchers in other countries where equity principles are not (widely) used in admissions decisions.