Substance use medical school applications seen as admissions risk in study

A new study finds that disclosing substance use in medical school applications, or in dental school applications, is widely viewed by doctors and dentists as a potential admissions liability. Researchers at Columbia University Mailman School of Public Health and the University of Miami Miller School of Medicine said the findings point to persistent stigma in health care training and admissions culture.

The study, published in the Journal of General Internal Medicine, surveyed 1,240 physicians and dentists across the United States. Columbia Mailman said the sample was drawn from the American Medical Association and American Dental Association and included emergency medicine physicians, primary care physicians and dentists.

Can substance use disclosure hurt medical school applications?

The study did not measure how admissions committees actually respond to applicants. It measured what health care professionals believe would happen if an applicant disclosed a history of substance use or recovery.

More than four in five respondents said such a disclosure would create a moderate or significant risk for admission, according to the researchers. Even when an applicant presented recovery as part of the reason for wanting to enter medicine or dentistry, half of respondents still saw moderate or significant admissions risk.

• 82.5% of surveyed physicians and dentists said disclosing a substance use history would carry moderate or significant admissions risk.
• 50% said risk would remain even if recovery was described as motivation for a health care career.
• The survey included 349 emergency medicine physicians, 506 primary care physicians and 385 dentists.

Medical and dental school applications do not ask applicants to report a history of substance use, Columbia Mailman said. Applicants are often invited, however, to write about personal hardship, growth or experiences that shaped their decision to pursue a health profession.

That creates a difficult choice for applicants in recovery, the researchers said. Substance use disorders affect an estimated 10% to 12% of physicians during their careers, according to the study team, but the admissions effect of discussing recovery has not previously been examined in a published empirical study.

What did the researchers say the findings mean?

Rae Chang, the lead author, said the research focused on how doctors and dentists think admissions readers would receive disclosures about substance use or recovery. Chang conducted the work at Columbia Mailman while an undergraduate student at Columbia, according to the university.

Lisa R. Metsch, dean of the School of General Studies at Columbia University and a co-author, said the perception of professional risk may be enough to keep some applicants from discussing experiences that shaped their lives and commitment to care.

James Colgrove, a Columbia Mailman professor and co-author, said the findings point beyond admissions to broader stigma in health care education and practice. The researchers said reducing stigma matters both for future clinicians in recovery and for patients with substance use disorders who need respectful, evidence-based care.

The study also found that respondents who had a friend or patient with a substance use history were more likely than others to view disclosure as risky. The researchers did not present that finding as proof of admissions discrimination, but as evidence that many clinicians believe stigma remains a real professional concern.

This story draws on original reporting from Phys.org.