Med school admissions biased?

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Again, not necessarily. Being any kind of doctor can make you successful. Contrary to what sdn says, being a CT surgeon or a dermatologist or a neurosurgeon appeals to a minority of medical students. A lot of people want to do things like IM and peds and psych, and things of that natur

I think people easily forget that even among MD students the three highest matched fields are IM, FM, and Peds. Yeah a good chunk will go into a fellowship but still. SDN skews people's view because so many people on here are the super competitive type, it's just simple sample bias.

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@Lucca too, why tho? If someone is the dermie at my local hospital because he was smart, put the work in and wanted a cushy lifestyle, why should I care? Can he not be great as his job because of that? Is the world better off with that person in finance or business or law instead?

Let me preface by saying that I'm perhaps naive, though I prefer idealist, and what a lot I will say is rhetoric, but I think we can still strive to meet these ideals.

I don't think the current healthcare system needs more derms with a cushy lifestyle when the people most in need and have the greatest health disparities are living the exact antithesis. The derm can be great at his job, but I think the world would have benefited more from a doctor who entered medicine with genuine interest in the unique role a physician can have for his/her community. Money and prestige should be secondary to your passion in serving those in need, advancing health science, medical education, public outreach, or any other idealized aspect of the profession. When people hoop jump, the emphasis is placed on getting into medical school and becoming a doctor in a very superficial way. Shouldn't your motivation be something less superficial?

Perhaps it has only been my experience, but many pre-meds I know are not passionate about the work that they do. Surely, if someone is really passionate about working in an underserved clinic which ultimately drives them to pursue medicine, they would talk about it. When people are passionate about something, don't they talk about it to their friends? I dislike the idea of hoop jumping because even if these applicants can flip on the switch during an interview and talk about how amazing their volunteer experience has been, ultimately the reason they sought that experience is no longer there after getting into medical school.

And we don't need the best and brightest from these elite schools. Isn't the day-to-day of an average physician merely following guidelines?
 
Let me preface by saying that I'm perhaps naive, though I prefer idealist, and what a lot I will say is rhetoric, but I think we can still strive to meet these ideals.

I don't think the current healthcare system needs more derms with a cushy lifestyle when the people most in need and have the greatest health disparities are living the exact antithesis. The derm can be great at his job, but I think the world would have benefited more from a doctor who entered medicine with genuine interest in the unique role a physician can have for his/her community. Money and prestige should be secondary to your passion in serving those in need, advancing health science, medical education, public outreach, or any other idealized aspect of the profession. When people hoop jump, the emphasis is placed on getting into medical school and becoming a doctor in a very superficial way. Shouldn't your motivation be something less superficial?

Perhaps it has only been my experience, but many pre-meds I know are not passionate about the work that they do. Surely, if someone is really passionate about working in an underserved clinic which ultimately drives them to pursue medicine, they would talk about it. When people are passionate about something, don't they talk about it to their friends? I dislike the idea of hoop jumping because even if these applicants can flip on the switch during an interview and talk about how amazing their volunteer experience has been, ultimately the reason they sought that experience is no longer there after getting into medical school.
Thing is, that hospital does need a derm guy. If he had been someone passionate about helping the undeserved rural patient populations or something and gone out to the boonies to practice, someone else would fill his role, rather than it going unfilled and the net balance sheet of total derm peeps changing. So my question has always been why it's a bad thing for the smarter and more lifestyle oriented person to win the derm spot. Someone has to fill it, and I don't see why that guy taking it is bad.

And we don't need the best and brightest from these elite schools. Isn't the day-to-day of an average physician merely following guidelines?
Counterpoint here is that the schools favoring extremely high MCATs and prestigious pedigrees are not interested in churning out day-to-day PCPs, they overwhelmingly want the "leaders" that will end up super-specialized at an academic center. The schools that are all about missions/producing what their state needs generally are much more accepting of things like MCATs in the high 20s, or weaker GPAs, and don't care about pedigrees
 
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Thing is, that hospital does need a derm guy. If he had been someone passionate about helping the undeserved rural patient populations or something and gone out to the boonies to practice, someone else would fill his role, rather than it going unfilled and the net balance sheet of total derm peeps changing. So my question has always been why it's a bad thing for the smarter and more lifestyle oriented person to win the derm spot. Someone has to fill it, and I don't see why that guy taking it is bad.


Counterpoint here is that the schools favoring extremely high MCATs and prestigious pedigrees are not interested in churning out day-to-day PCPs, they overwhelmingly want the "leaders" that will end up super-specialized at an academic center. The schools that are all about missions/producing what their state needs generally are much more accepting of things like MCATs in the high 20s, or weaker GPAs, and don't care about pedigrees

Agreed that we need derm, but I don't think we need the absolute smartest, lifestyle-oriented people in the competitive specialties. Can't we get by with the less intelligent but more than capable individual who happens to also want to do public health research on skin conditions in the homeless? I'm thinking more along the lines of changing who enters the pipeline to change the overall work force. There's nothing bad about the scenario you gave me, but I'm saying I'd rather have mine.

I don't know enough about how truly competitive academic medicine is, but with the recent NIH budget cuts, I don't know if we need more academic physicians. As an example, many MD/PhD aspirants who are arguably the ones most likely to become academic physicians don't end up as physician scientists in their career. The 80/20 research/clinical split is very rare if I understand things correctly. It's more common to be 50/50 and mediocre at both, definitely not amazing. Many don't conduct research at all or have paltry publication records after residency.

As a whole, I think we need fewer academic physicians and more day-to-day PCPs, even though I want an academic career myself. I don't have numbers to justify this claim, but of course would be interested in these numbers. But as Goro mentioned, it's what medical schools want, not what I want, even if I disagree with the system at a fundamental level.
 
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Agreed that we need derm, but I don't think we need the absolute smartest, lifestyle-oriented people in the competitive specialties. Can't we get by with the less intelligent but more than capable individual who happens to also want to do public health research on skin conditions in the homeless? I'm thinking more along the lines of changing who enters the pipeline to change the overall work force. There's nothing bad about the scenario you gave me, but I'm saying I'd rather have mine.

I don't know enough about how truly competitive academic medicine is, but with the recent NIH budget cuts, I don't know if we need more academic physicians. As an example, many MD/PhD aspirants who are arguably the ones most likely to become academic physicians don't end up as physician scientists in their career. The 80/20 research/clinical split is very rare if I understand things correctly. It's more common to be 50/50 and mediocre at both, definitely not amazing. Many don't conduct research at all or have paltry publication records after residency.

As a whole, I think we need fewer academic physicians and more day-to-day PCPs, even though I want an academic career myself. I don't have numbers to justify this claim, but of course would be interested in these numbers. But as Goro mentioned, it's what medical schools want, not what I want, even if I disagree with the system at a fundamental level.


I strongly disagree with the idea that we don't need academic physicians. Academics drive medical and scientific progress forward, and are often happy to take a pay cut to do so. We do also need more PCPs, but there's no reason to produce them at the cost of producing academic physicians. In fact, some of the best PCPs I've known have also been academics - individuals who are passionate about improving outcomes for undeserved urban populations. In addition, the 80-20 research to clinical practice (or vis versa) split among MD-PhDs is far more common than the 50-50 split. As you say, dividing time between practice and research is hard, so most choose to predominantly do one or the other. Some of the best research and clinicians I know are MD-PhDs, and gain from their insight into both fields.

Also, what's wrong with having the best and brightest in derm? Who says these individuals won't also be passionate about conducting public health research on skin conditions among the homeless? Just because someone is slightly less bright or driven doesn't mean they're less likely to enter derm for the lifestyle. Smartest =/= most lifestyle-oriented.
 
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I strongly disagree with the idea that we don't need academic physicians. Academics drive medical and scientific progress forward, and are often happy to take a pay cut to do so. We do also need more PCPs, but there's no reason to produce them at the cost of producing academic physicians. In fact, some of the best PCPs I've known have also been academics - individuals who are passionate about improving outcomes for undeserved urban populations. In addition, the 80-20 research to clinical practice (or vis versa) split among MD-PhDs is far more common than the 50-50 split. As you say, dividing time between practice and research is hard, so most choose to predominantly do one or the other. Some of the best research and clinicians I know are MD-PhDs, and gain from their insight into both fields.

Also, what's wrong with having the best and brightest in derm? Who says these individuals won't also be passionate about conducting public health research on skin conditions among the homeless? Just because someone is slightly less bright or driven doesn't mean they're less likely to enter derm for the lifestyle. Smartest =/= most lifestyle-oriented.

I think you're taking my argument to an extreme. I never said we don't need academic physicians; I said we needed fewer academics and more PCPs. I am well aware that most academics put their career ahead of their paycheck. I just think in the current healthcare system that more PCPs and a better distribution of PCPs are more immediately needed than academics are. Regardless of the 80/20 vs 50/50 splits, the physicians I have talked to say most MD/PhDs end up going pure clinical. It doesn't seem like the MD/PhD education system is very efficient given the job market and funding climate. We need to decide if there is something wrong with the education system or if it's an issue with the environment these graduates end up in. I favor the latter and until we can fix it, I don't think it's worth funneling money into when these funds could be used to incentivize PCPs or other measures that could close health disparities.

I am not saying there's anything wrong with the best and brightest in derm on the caveat that they also have interests beyond seeing patients in 15 minute appointments. Because resources are limited, I favor genuine interests, even at the cost of intelligence, over hoop jumping. Do what you need to do to get into medical school, but if it's all just for the sake of prestige and salary, I don't think you should be taking up that spot over somebody who is capable and intelligent (perhaps less so), but has genuine, deeply-rooted interests in public health, serving the less fortunate, etc...

And again, I want a career in academics, but I still think academics aren't as critical as PCPs (at this moment, given our resources and problems). The best and brightest who goes into derm and does great public health work is a win-win, but I feel that they are not as common as it should be.
 
I think you're taking my argument to an extreme. I never said we don't need academic physicians; I said we needed fewer academics and more PCPs.

You're right, the phrasing is my bad, I meant to say that I strongly disagree with the idea that we need fewer academics. If anything, I think we need more academics, and we need to better incentivize our best and brightest to enter into research, as it is currently a very low-paying field that requires extensive training. However, I agree that we are experiencing a similar problem with primary care, which also requires extensive education for relatively little compensation. You make an interesting point about the value of funding MSTPs -- it seems like you're saying those programs should no longer be funded at all, and the funds instead used to subsidize PCPs? I'm not sure I agree with the idea of funneling more money away from research and towards primary care. Science is already experiencing a funding drought, and IMO there are other more wasteful government expenditures that could be redirected towards PCP funding without negatively impacting the scientific and medical community. I'm just not convinced that the MD-PhD system is fundamentally broken -- yes, it's long, expensive, and arduous, but MD-PhDs around the globe are making valuable scientific contributions that arguably are enabled by their dual background in science and medicine.
 
You're right, the phrasing is my bad, I meant to say that I strongly disagree with the idea that we need fewer academics. If anything, I think we need more academics, and we need to better incentivize our best and brightest to enter into research, as it is currently a very low-paying field that requires extensive training. However, I agree that we are experiencing a similar problem with primary care, which also requires extensive education for relatively little compensation. You make an interesting point about the value of funding MSTPs -- it seems like you're saying those programs should no longer be funded at all, and the funds instead used to subsidize PCPs? I'm not sure I agree with the idea of funneling more money away from research and towards primary care. Science is already experiencing a funding drought, and IMO there are other more wasteful government expenditures that could be redirected towards PCP funding without negatively impacting the scientific and medical community. I'm just not convinced that the MD-PhD system is fundamentally broken -- yes, it's long, expensive, and arduous, but MD-PhDs around the globe are making valuable scientific contributions that arguably are enabled by their dual background in science and medicine.

If we had more money, the world would be fixed :p.

I don't think there's anything wrong with the MD/PhD programs. It's just that the education system is failing in the current environment, though it's mostly the environment to blame. I think we just disagree on where we should spend our limited funds right now. As far as MD/PhD funding goes, I would favor MD and PhD collaboration and more of these interdisciplinary co-authored grants rather than MD/PhDs. If that is not an option, yes, I would favor cutting some MSTPs for more PCP incentives.
 
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*waits patiently*

Okay - here are my thoughts. Don't expect anything too enlightening.

1. Defining "success" in medicine based on the competitiveness of the residency (either specialty or program) is a flawed metric. I can see how someone might think this is a good way to measure success because "competitiveness" by definition implies value and demand greater than supply, but 90%+ of spots in the ACGME match are in "non-competitive" specialties (defined here as all specialties except derm, rad onc, and the surgical subspecialties) (source: charting outcomes). Obviously this doesn't say anything about competitive programs within non-competitive specialties, but that's harder for my to quantify quickly so I won't attempt to because math is hard. Also, that's not to say anything about the osteopathic AOA match, which has many more spots, nearly all of which are in the "non-competitive" specialties. So if we're defining "success" as matching into a competitive residency (let's just for the sake of argument say specialty and not program right now), then <10% of medical students find "success". Obviously that isn't true.

2. A better way to operationalize success is to define it as going into the specialty of your choice, at the type of program of your choice, in the location of your choice, and ending up in the practice environment of your choice. The downside to this, of course, is that its essentially impossible to measure. But that's really the point. What defines success is individual to each person - not to the commonly espoused SDN mantra of ortho/derm or bust. Most applicants don't want ortho, or derm, or CT, or neurosurg, or whatever. I personally would flip my s*** if I had to do derm for the rest of my life. Anyway, we need to realize that our definition of success in this thread is not the definition of success that matters to anyone.

3. Most people at schools that would be most conducive to jumping ship to business/consulting/non-medicine/whatever will end up in medicine. Overwhelmingly so. If someone brings up that extremely misleading article about only 60% of students at Stanford going onto residency in 4 years and uses it as evidence I will have a spontaneous subarachnoid hemorrhage so please don't. Yeah, it sucks that some people end up outside the medical field, but ultimately, in my opinion, it's their education, and they can do what they want with it - and some of them end up doing great things with it anyway, even if it isn't practicing medicine.

4. Yes, sometimes the disingenuous but highly driven and intelligent person will be picked over the genuine but slightly less whatever person, but it is my experience (trigger warning: anecdotal evidence) that most people entering medicine do so with good intentions.

Anyway, those are my thoughts. They aren't eloquent, universally applicable, or necessarily even logically sound, but you asked and so I did my best.
 
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Okay - here are my thoughts. Don't expect anything too enlightening.

1. Defining "success" in medicine based on the competitiveness of the residency (either specialty or program) is a flawed metric. I can see how someone might think this is a good way to measure success because "competitiveness" by definition implies value and demand greater than supply, but 90%+ of spots in the ACGME match are in "non-competitive" specialties (defined here as all specialties except derm, rad onc, and the surgical subspecialties) (source: charting outcomes). Obviously this doesn't say anything about competitive programs within non-competitive specialties, but that's harder for my to quantify quickly so I won't attempt to because math is hard. Also, that's not to say anything about the osteopathic AOA match, which has many more spots, nearly all of which are in the "non-competitive" specialties. So if we're defining "success" as matching into a competitive residency (let's just for the sake of argument say specialty and not program right now), then <10% of medical students find "success". Obviously that isn't true.

2. A better way to operationalize success is to define it as going into the specialty of your choice, at the type of program of your choice, in the location of your choice, and ending up in the practice environment of your choice. The downside to this, of course, is that its essentially impossible to measure. But that's really the point. What defines success is individual to each person - not to the commonly espoused SDN mantra of ortho/derm or bust. Most applicants don't want ortho, or derm, or CT, or neurosurg, or whatever. I personally would flip my s*** if I had to do derm for the rest of my life. Anyway, we need to realize that our definition of success in this thread is not the definition of success that matters to anyone.

3. Most people at schools that would be most conducive to jumping ship to business/consulting/non-medicine/whatever will end up in medicine. Overwhelmingly so. If someone brings up that extremely misleading article about only 60% of students at Stanford going onto residency in 4 years and uses it as evidence I will have a spontaneous subarachnoid hemorrhage so please don't. Yeah, it sucks that some people end up outside the medical field, but ultimately, in my opinion, it's their education, and they can do what they want with it - and some of them end up doing great things with it anyway, even if it isn't practicing medicine.

4. Yes, sometimes the disingenuous but highly driven and intelligent person will be picked over the genuine but slightly less whatever person, but it is my experience (trigger warning: anecdotal evidence) that most people entering medicine do so with good intentions.

Anyway, those are my thoughts. They aren't eloquent, universally applicable, or necessarily even logically sound, but you asked and so I did my best.

I'm just 10x more jaded than u cuz im still on the pre-med end of this ordeal. But I believe you.
 
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I'm just 10x more jaded than u cuz im still on the pre-med end of this ordeal. But I believe you.

I think you're the least jaded as a preclinical medical student. On either side of that you get more cynical.
 
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~32% of Harvard undergrad's class comes from 11% of the high schools represented at Harvard. About 6% come from just 10 high schools. (Source: The Crimson 2013)
"In total, one out of every 20 Harvard freshmen attended one of the seven high schools most represented in the class of 2017—Boston Latin, Phillips Academy in Andover, Stuyvesant High School, Noble and Greenough School, Phillips Exeter Academy, Trinity School in New York City, and Lexington High School."

Make no mistake, these are extremely competitive charter, private, and boarding schools. Household names to kids (such as myself) whose classmates self-medicated with adderall more often than marijuana and cigarettes. Some of them have tuitions upwards of 40-60k a year and the boarding schools in particular have entry starting as early as Kindergarten.

I think it's worth mentioning the potential challenges students without this elite pre-K-12 background face in terms of standing out at top tier undergrads. I'm not saying that students are at all disadvantaged by going to elite undergrads, but if you are jumping into an environment where 50% (if not more) of your peers have had access to elite education, advising and extracurricular opportunities, it's more difficult to stand out. Using Harvard (since it's the example above), HMS is only going to take so many HMS, Yale, Stanford, etc. grads because it values diversity and isn't going to pull all of its students from any one school or cluster of schools. For Harvard undergrads, this means that they're not just competing against everyone else, but they're also going to get compared to one another. Yes, Harvard is filled with many average students doing average things, but there is a much higher proportion of stellar students with crazy scores, ECs, national honors (due to many factors, most of which can probably be tied back to socioeconomic factors). It's not just that these students are currently at an elite school with incredible advising and unlimited resources/opportunities. Rather, it's that a majority of these students have also been reaping the benefits of elite education and advising for their entire lives. They have literally been groomed for this type of success.

Of course, even an average Harvard student who is unable to outshine their peers and get a Top 5/10/20 acceptance is probably still in a better position to get a medical school acceptance somewhere. And that is important. But if you are talking about the chances of elite medical school acceptance (relative to undergrad), I think it's worth mentioning the level of competition that exists at elite undergrads and more importantly the types of people who are set up to succeed in these environments. If you come from a humble educational background, have never met a doctor outside of your PCP or seen the inside of a science lab, the pre-med environment at elite institutions (where disparities between students are already so great) is going to slap you across the face. If these students don't get connected quickly to appropriate and supportive pre-med/academic advising (and they often don't) they are going to become overwhelmed by the 4 extra (remedial) math/science classes they need to catch up to their peers or get scared off by hearing about the research at X prestigious lab their 16 year old roommate has already published. The assumption that the pre-med path must not be for people like them (or attainable for people like them) becomes a self-fulfilling prophecy.

Getting into a top tier medical school from any undergrad means being the top of that undergrad. But, if you factor in the potentially less overwhelming and more level playing field at some non-top tier schools, hard to say for some students that elite undergrad is the better way to an elite medical school.
 
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Where you go to HS does not have as much of a pull on where you go to UGrad, or at least not as much as where you go to UGrad influencing where you go to Med school. ( I went to a posh HS and applied to a few colleges where my gpa was a bit below the median- rejected).
This kind of statement gets under my skin a bit. I grew up in a town with only one school (read: no school choice) where no AP or honors credits were offered, and graduated valedictorian of my small, rural HS class with a high ACT score and a perfect 4.0. But my HS didn't have resources; the guidance counselor didn't have a clue how to advise a student interested in taking the SAT (not that there was anywhere to take it nearby since no one ever did), and didn't know how to submit our PSAT scores for national merit consideration. That environment directly--and, I would argue, strongly--affected the undergrad institutions where I and other students from that type of HS could have any shot at all. And maybe the schools I applied to found some fault with my applications I don't remember--I'm certainly not perfect--but it's difficult to believe that my educational background didn't have much of an effect on the situation.

The fact that this bias carries on through med school selection is deeply saddening but not at all surprising.
 
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This kind of statement gets under my skin a bit. I grew up in a town with only one school (read: no school choice) where no AP or honors credits were offered, and graduated valedictorian of my small, rural HS class with a high ACT score and a perfect 4.0. But my HS didn't have resources; the guidance counselor didn't have a clue how to advise a student interested in taking the SAT (not that there was anywhere to take it nearby since no one ever did), and didn't know how to submit our PSAT scores for national merit consideration. That environment directly--and, I would argue, strongly--affected the undergrad institutions where I and other students from that type of HS could have any shot at all. And maybe the schools I applied to found some fault with my applications I don't remember--I'm certainly not perfect--but it's difficult to believe that my educational background didn't have much of an effect on the situation.

The fact that this bias carries on through med school selection is deeply saddening but not at all surprising

I think we went to the same high school. Guidance counselor told me senior year that there was no way for me to take math (which only went up to precalc) and a science due to scheduling/funding/lack of classes. Said (excitedly) that this would give me the opportunity to take 3 periods of gym. pblxschoooool

I somehow got accepted to an elite undergrad. I have no idea how. I looked exactly like you and tens of thousands of other students on paper. My ECs were considered above average for people at my school, but they were nothing out of the ordinary (Sports, Honor Societies, Church/Blood Bank Volunteering, Student Council etc.). My school didn't have Model UN or a newspaper and I didn't know high schoolers could be in real science labs or do congressional internships. Not a legacy, certainly not rich, but not that poor, not urm, and my high school had never sent anybody to this school. I still can't fully wrap my head around how admission officers go about deciding whether the soccer player from Wisconsin or the tuba player from Minnesota gets admitted.

Unfortunately, even going to an elite undergrad doesn't level the playing field. The first time I ever stepped foot in a science lab was freshman fall (high school doesn't have/offer labs). Because my school didn't offer APs or calculus/physics, science majors and the premed track required substantially more coursework due to all the remedial coursework you have to take first. The academic transition can also be tough since you're coming from high school classes that were not challenging and required limited effort while your peers have been in high-stress, academically demanding environments for years. By the time you figure out how to succeed academically and start thinking about med school, you realize your peers have already been piling on the ECs and have publications/nonprofits in the works. Feeling inadequate and under-resourced takes an emotional toll.

Feel very blessed to have the opportunities that schools like this afford people like me. But, the extent to which the education/socioeconomic disparity persists from ug admissions, through undergrad (elite or not) to medial school makes one cynical, watching qualified people get beat down by the system.
 
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I would claim that the "ivy" status is confounding the fact that these students are simply the top of the applicant pool, which is why they are in the ivy league institutions in the first place. It is not necessarily that there is a preference for ivy leagues, but simply that the curricula, grading methods, and competition between students are more rigorous at the ivy's. As such, the students who are top performers at the ivy leagues truly are at the top, whereas one could feasibly argue a lack of competition at a lower tier school as contributing to a student's success.
 
It's much harder to get into a top med school nowadays. Many Ivies are at ~10% and top med schools are almost an order of magnitude lower. But there are multiple pipelines to the top undergrads, sure. It's well-known that legacies get an advantage and athletes can get decent bumps. If your daddy donates $150 million, they're not going to reject you. But you ignore the fact that most of the kids who do make it through are truly astounding. They got there through an amazing work ethic and a lot of hard work and they kept it through college. There's no reason to disparage someone (not saying that you are) or classify them into a "he went to X so he must have a stick up his ass" category just because they went to X school. Most of the people who go through the top schools are truly amazing people - there aren't that many rich daddies to go around.

And IMHO leaving their childhood in the dust well before it was over, and many burn out or no longer have the helicopter to run mission control. I personally think our undergraduate college admissions process is both illusory and cruel. Time to limit applications to 6-8 per applicant.


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Time to limit applications to 6-8 per applicant.

Agree that the avg number of apps is ridiculous but not sure this would help lessen the bias towards elite pre-K-12 pedigrees in undergrad admissions. Top schools already have difficulty getting students from disadvantaged and less-represented backgrounds to apply to their schools and that's without an app limit. With an app limit, students from schools with less resources and formal advising would likely adopt the most risk-averse strategy and the one taken by the majority of their peers and apply to non-reach schools.

edit: many of these kids can also only attend private schools with scholarship/generous fin aid. more apps = more chances at finding a school to throw money at you
 
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With an app limit, students from schools with less resources and formal advising would likely adopt the most risk-adverse strategy and the one taken by the majority of their peers and apply to non-reach schools.
I agree and would even suggest that this is already happening, especially in situations where there is effectively an app limit based on how much money one can afford to blow on something that may/may not pan out.
It's must easier to justify a few more $30 app fees to schools where a person feels like they have a shot (and a chance at a scholarship) than a single $100 fee to a school that feels far out of reach even before they start to consider cost. If cash is limiting and a person's advisors, etc., keep telling them that apps to top schools are a "waste of their money," why would they take the risk?
 
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And IMHO leaving their childhood in the dust well before it was over, and many burn out or no longer have the helicopter to run mission control. I personally think our undergraduate college admissions process is both illusory and cruel. Time to limit applications to 6-8 per applicant.

This would disproportionately affect disadvantaged students. The legacies, children of big donors, athletes, etc. would still get their boost and know where they have a good chance of getting in. The wealthy can hire private tutors and admissions advisers to help their kid craft a good school list. The poor and students from disadvantaged areas where their school doesn't regularly send kids to top schools would have more difficulty with crafting school lists because they don't know which schools they would have a good chance of getting into. As it is now, it's pretty difficult to tell if you're competitive for a certain tier of schools. As an interviewer now for my alma mater, I've seen it from the other side and it's pretty clear which kids come from affluent families and have had application help versus students from poorer families who are less informed at how to play this game.
 
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^knowing the game is the important bit for the very top, imo. Getting into a top ~20 undergrad can still be done as a clueless public school kid, if you score great on SAT/ACT and had good grades and some common but strong extracurricular involvement like captaining your highschool sports team, school robotics team, getting super into photography with your high school arts club, or volunteering for several years in something you care about. Getting into top ~5 or HYPSM or whatever (aldol's alma mater is in there iirc) on the other hand requires not only the scores and grades but a very carefully crafted narrative and ECs that stand out - you captained a regional club team that won state or competed at the national level, founded a new organization or started your own photo business, worked your summers in your dad's lab. The test score ranges for Vandy and Rice are up there the same as Stanford and MIT these days; it's not so much different student ability for these "tiers" but differences in how unique and well presented your app is.

There's also the whole early decision meta-game that I've learned about in the past few years. Apparently for many of these elite colleges, you can increase your admit odds like 3-4x by applying in the early pool, but you can only do this for one school and must withdraw everywhere else if you get in. This sort of functions like a 1-school-only first round, and it's only if this fails that you have to scramble to apply to two dozen other elite places to try and get lucky at a couple. Not knowing about this game costs you your best shot at getting into a favorite top place!

it's all really kind of fascinating to me
 
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^knowing the game is the important bit for the very top, imo. Getting into a top ~20 undergrad can still be done as a clueless public school kid, if you score great on SAT/ACT and had good grades and some common but strong extracurricular involvement like captaining your highschool sports team, school robotics team, getting super into photography with your high school arts club, or volunteering for several years in something you care about. Getting into top ~5 or HYPSM or whatever (aldol's alma mater is in there iirc) on the other hand requires not only the scores and grades but a very carefully crafted narrative and ECs that stand out - you captained a regional club team that won state or competed at the national level, founded a new organization or started your own photo business, worked your summers in your dad's lab. The test score ranges for Vandy and Rice are up there the same as Stanford and MIT these days; it's not so much different student ability for these "tiers" but differences in how unique and well presented your app is.

There's also the whole early decision meta-game that I've learned about in the past few years. Apparently for many of these elite colleges, you can increase your admit odds like 3-4x by applying in the early pool, but you can only do this for one school and must withdraw everywhere else if you get in. This sort of functions like a 1-school-only first round, and it's only if this fails that you have to scramble to apply to two dozen other elite places to try and get lucky at a couple. Not knowing about this game costs you your best shot at getting into a favorite top place!

it's all really kind of fascinating to me

Yes, the importance of being well informed about how the college admissions game works should not be understated. When I applied to college, being the first in my family to go to school here in the US and all, I didn't know anything, and all of my classmates played everything very close to the chest (kind of school where people dont share their GPAs, class ranks, test scores, etc with one another) until acceptances came out. I applied to ~9 schools I think and looking back at it my list and application were hilariously poorly put together besides having good metrics and a lot of EC involvement. It wasn't until all acceptances were out that I learned that people were applying to 30-40 schools and had paid thousands of dollars for professional consultation on putting together their app / had their parents or college siblings write their admissions essays. One of my classmates who ended up at MIT and is now going into HFT on Wall St. reported an extremely low family income in order to claim disadvantaged status. While it's true that his family's income as reported to the IRS is very low...they also own multimullion dollar corporate assets in his home country and don't have a regular income because all of their income comes from investments and shares held in another country. I also applied early decision to a school where it doesnt pose any advantage whatsoever.

If I'm completely honest, this is probably where my chip-on-the-shoulder comes from and also why I got into SDN from such an early stage in college. Fool me once, and all that.
 
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There's also the whole early decision meta-game that I've learned about in the past few years. Apparently for many of these elite colleges, you can increase your admit odds like 3-4x by applying in the early pool, but you can only do this for one school and must withdraw everywhere else if you get in. This sort of functions like a 1-school-only first round, and it's only if this fails that you have to scramble to apply to two dozen other elite places to try and get lucky at a couple. Not knowing about this game costs you your best shot at getting into a favorite top place!

You don't increase your admit odds - this is where numbers are deceptive. Yes, the percentage of accepted applicants in the early pool is higher but that's because 1) the applicants are generally stronger and would have been admitted in the regular pool anyway and 2) the legacies, athletes, etc. make a big proportion of this round. They do not admit people in the early pool that wouldn't also be strong candidates in the regular pool. If they're unsure, they just defer.

Further, there's a difference between early action and early decision. Early decision works pretty much like you say. Early action is different because it does not commit you to the school if they admit you. You can still apply to all the other schools - you just have the peace of mind of knowing that you were admitted in December and so you have 3-4 months to let the idea of being at that school fester in your mind.

Finally, not knowing this won't cost you a place at your top school because if you were strong anyway, you would have gotten in the regular round. Applying early doesn't give you that much of a boost. It would just cost you the peace of mind of knowing early.
 
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I think knowing the game is a huge advantage that cannot be understated, but I also have to say that many elite undergrads and med schools will make an effort to offer acceptances to students who lack the resources to understand the game. For every student at an ivy league college who 'played the game' in high school and knows exactly how they won their acceptance, there are 2 or 3 kids who really have no idea why they were accepted or what the admissions committee was thinking when they let them in. That doesn't mean they didn't work hard in high school, it just means that they didn't really know how to strategically craft an application. One of the awesome things that ivy league schools can do for these less advantaged students is teach them how to compete at the next level (like med school admissions).
 
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Yes, the importance of being well informed about how the college admissions game works should not be understated. When I applied to college, being the first in my family to go to school here in the US and all, I didn't know anything, and all of my classmates played everything very close to the chest (kind of school where people dont share their GPAs, class ranks, test scores, etc with one another) until acceptances came out. I applied to ~9 schools I think and looking back at it my list and application were hilariously poorly put together besides having good metrics and a lot of EC involvement. It wasn't until all acceptances were out that I learned that people were applying to 30-40 schools and had paid thousands of dollars for professional consultation on putting together their app / had their parents or college siblings write their admissions essays. One of my classmates who ended up at MIT and is now going into HFT on Wall St. reported an extremely low family income in order to claim disadvantaged status. While it's true that his family's income as reported to the IRS is very low...they also own multimullion dollar corporate assets in his home country and don't have a regular income because all of their income comes from investments and shares held in another country. I also applied early decision to a school where it doesnt pose any advantage whatsoever.

I don't think 30-40 schools is common even today... I think I applied to between 10 and 20, ultimately. I didn't like filling out their "secondaries" much. But it sounds like what your classmate did is illegal because I believe you have to report foreign investments on CSS PROFILE. Not that anybody would likely find out if you didn't - it's just really unethical and if anybody found out and he got federal aid, he would be in a lot of trouble.
 
You don't increase your admit odds - this is where numbers are deceptive. Yes, the percentage of accepted applicants in the early pool is higher but that's because 1) the applicants are generally stronger and would have been admitted in the regular pool anyway and 2) the legacies, athletes, etc. make a big proportion of this round. They do not admit people in the early pool that wouldn't also be strong candidates in the regular pool. If they're unsure, they just defer.

That doesn't mean there isn't an additional boost (although it's much smaller than are you would think based purely on acceptance rate). IIRC, Columbia has ~18% ED and 3% RD acceptance rate. It's not 6x easier to get into, but that doesn't mean there's not a boost. This is probably especially true a) for people with hooks (e.g. Penn says the only consider legacy status for ED apps) and b) full-pay students at need-aware colleges (e.g. Tufts, much higher acceptance rate ED), who are a guaranteed $68k.
 
You don't increase your admit odds - this is where numbers are deceptive. Yes, the percentage of accepted applicants in the early pool is higher but that's because 1) the applicants are generally stronger and would have been admitted in the regular pool anyway and 2) the legacies, athletes, etc. make a big proportion of this round. They do not admit people in the early pool that wouldn't also be strong candidates in the regular pool. If they're unsure, they just defer.

Further, there's a difference between early action and early decision. Early decision works pretty much like you say. Early action is different because it does not commit you to the school if they admit you. You can still apply to all the other schools - you just have the peace of mind of knowing that you were admitted in December and so you have 3-4 months to let the idea of being at that school fester in your mind.

Finally, not knowing this won't cost you a place at your top school because if you were strong anyway, you would have gotten in the regular round. Applying early doesn't give you that much of a boost. It would just cost you the peace of mind of knowing early.
I find it hard to believe all the same peeps would get in either round. Harvard's early admit rate as 18.4% compared to 3.8% regular, a 5x increase! It makes sense for them to have a higher rate, too, because the yield is going to be higher - either locked in at 100% or at least a lot higher from being the person's choice of early action (you can still only apply to one early, right?). And seeing as some of these Ivies are filling 30-40%+ of their class from early admits I don't think it's just the athletes and VIPs.

Maybe there is some data out there showing ED score profiles vs normal decision or something, but this is the first I've ever heard anyone claim that it doesn't help your odds!
 
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I just want to throw out there that there are countless examples on SDN, mdapps, and irl of state school applicants absolutely obliterating the med school application process with tons of top 10 interviews and acceptances. I just want to caution against "too undergrad being a prerequisite for top med school" and steer us towards "it's a factor but not the only nor most important one".
 
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I think knowing the game is a huge advantage that cannot be understated, but I also have to say that many elite undergrads and med schools will make an effort to offer acceptances to students who lack the resources to understand the game. For every student at an ivy league college who 'played the game' in high school and knows exactly how they won their acceptance, there are 2 or 3 kids who really have no idea why they were accepted or what the admissions committee was thinking when they let them in. That doesn't mean they didn't work hard in high school, it just means that they didn't really know how to strategically craft an application. One of the awesome things that ivy league schools can do for these less advantaged students is teach them how to compete at the next level (like med school admissions).
40% of Princeton students are full-pay. At Princeton, that probably means >250k family income. I doubt most of those students lacked access to information on "crafting" an application (even if they didn't get a counselor, or have excellent counseling through a top public or private HS, they mostly had at least 1 parent who is a college graduate, and likely a parent who graduated from an elite college, which is more than most students have).
 
I just want to throw out there that there are countless examples on SDN, mdapps, and irl of state school applicants absolutely obliterating the med school application process with tons of top 10 interviews and acceptances. I just want to caution against "too undergrad being a prerequisite for top med school" and steer us towards "it's a factor but not the only nor most important one".
a certain 80+ LizzyM URM rhodes scholar comes to mind, lol
 
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40% of Princeton students are full-pay. At Princeton, that probably means >250k family income. I doubt most of those students lacked access to information on "crafting" an application (even if they didn't get a counselor, or have excellent counseling through a top public or private HS, they mostly had at least 1 parent who is a college graduate, and likely a parent who graduated from an elite college, which is more than most students have).
you might enjoy this if you hadn't seen it

wasn't even surprised to learn my student body had 3.5x as many people from the Top 1% as the Bottom 60% (though we were the worst offender of every college in the database)
 
At Harvard, the percentage of students receiving grant money is (or was, not sure about this year) around 65% with the average grant covering about 80% tuition, room, and board. So while many of the students are wealthy, many are decidedly not.

Edit: This is definitely school-dependent though, and even year-dependent.

40% of Princeton students are full-pay. At Princeton, that probably means >250k family income. I doubt most of those students lacked access to information on "crafting" an application (even if they didn't get a counselor, or have excellent counseling through a top public or private HS, they mostly had at least 1 parent who is a college graduate, and likely a parent who graduated from an elite college, which is more than most students have).
 
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At Harvard, the percentage of students receiving grant money is (or was, not sure about this year) around 65% with the average grant covering about 80% tuition, room, and board. So while many of the students are wealthy, many are decidedly not.

Edit: This is definitely school-dependent though, and even year-dependent.
Only 1 in 5 students at H came from the bottom 60%

So yeah maybe they aren't just stuffing themselves with millionaires, but they are at least stuffing themselves very very heavily from the top quartile or third
 
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you might enjoy this if you hadn't seen it

wasn't even surprised to learn my student body had 3.5x as many people from the Top 1% as the Bottom 60% (though we were the worst offender of every college in the database)

That's fascinating, seems like my school might be somewhat of an outlier among top schools then.
 
That's fascinating, seems like my school might be somewhat of an outlier among top schools then.
Which unfortunately still means a parent making 60k puts you in the poorest 1/5th

That's a pretty absurd factoid and even more absurd to know it's one better than peers on this issue
 
you might enjoy this if you hadn't seen it

wasn't even surprised to learn my student body had 3.5x as many people from the Top 1% as the Bottom 60% (though we were the worst offender of every college in the database)
I have. My current college is pretty high up there as well, outside of Top 10, though. Something like 80% of our students are from the Top 20% - so many, possibly the majority, of the 52% of students on financial aid are definitely upper middle class.
 
I don't think 30-40 schools is common even today... I think I applied to between 10 and 20, ultimately. I didn't like filling out their "secondaries" much. But it sounds like what your classmate did is illegal because I believe you have to report foreign investments on CSS PROFILE. Not that anybody would likely find out if you didn't - it's just really unethical and if anybody found out and he got federal aid, he would be in a lot of trouble.
Oh man 30 to 40! There's no way it is worth doing that many secondaries! Lol
 
Which unfortunately still means a parent making 60k puts you in the poorest 1/5th

That's a pretty absurd factoid and even more absurd to know it's one better than peers on this issue

I agree, it's totally absurd. It's also interesting that it's not something I've noticed as a student, which I'm guessing is because students from different economic backgrounds tend to self-segregate, unfortunately.
 
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I have. My current college is pretty high up there as well, outside of Top 10, though. Something like 80% of our students are from the Top 20% - so many, possibly the majority, of the 52% of students on financial aid are definitely upper middle class.
"% on aid" is just a generally bogus figure to go by, it seems to me. WashU also has some nice sounding numbers like half get aid, avg aid 40k or something...but obviously when 95% of students are from families making $65,000+ there is not nearly as much SES diversity as the finaid numbers would lead you to believe.

I agree, it's totally absurd. It's also interesting that it's not something I've noticed as a student, which I'm guessing is because students from different economic backgrounds tend to self-segregate, unfortunately.
Having friends describe their hobbies of flying planes or travelling internationally alerted me pretty quick, and it seems like everyone's parent was either retired young, a doctor, or running their own business.

I wonder how much schools would have to relax their admissions standards to combat this issue, too. Like this year WashU's ACT IQR was 33-35, so entirely inside of the top percentile of scores, I think same for HYP. What fraction of top percent scorers even come from the bottom half economically? Especially when you add in expectations about AP/IB classes and great grades. Maybe these schools would honestly love to admit more of these missing demographics but aren't even getting apps like that.
 
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Actually it just occurred to me that these schools keep their admissions financial-blinded. I think the idea is to help avoid favoritism of the rich that can pay sticker price. But in reality it might be very much a double-edged policy, since it must also make it impossible to spot the lower SES kids.
 
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I wonder how much schools would have to relax their admissions standards to combat this issue, too. Like this year WashU's ACT IQR was 33-35, so entirely inside of the top percentile of scores, I think same for HYP. What fraction of top percent scorers even come from the bottom half economically? Especially when you add in expectations about AP/IB classes and great grades. Maybe these schools would honestly love to admit more of these missing demographics but aren't even getting apps like that.

They would probably have to relax admissions standards quite a bit. Which would then mean that they'd likely have to relax their grading policies as well, since admitting less prepared students and throwing them in classes where they'll compete with some of the top students in the nation would be setting them up to fail. A student from a rural public high school that lacked AP classes will have an extremely difficult time catching up academically to kids who have been in prep schools their whole lives.

I still think it's an effort absolutely worth pursuing, though. Just logistically difficult.
 
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This kind of statement gets under my skin a bit. I grew up in a town with only one school (read: no school choice) where no AP or honors credits were offered, and graduated valedictorian of my small, rural HS class with a high ACT score and a perfect 4.0. But my HS didn't have resources; the guidance counselor didn't have a clue how to advise a student interested in taking the SAT (not that there was anywhere to take it nearby since no one ever did), and didn't know how to submit our PSAT scores for national merit consideration. That environment directly--and, I would argue, strongly--affected the undergrad institutions where I and other students from that type of HS could have any shot at all. And maybe the schools I applied to found some fault with my applications I don't remember--I'm certainly not perfect--but it's difficult to believe that my educational background didn't have much of an effect on the situation.

The fact that this bias carries on through med school selection is deeply saddening but not at all surprising.
I'm sorry.
I more meant when you talk about neighboring school systems, where some are slightly more vigorous than other ( but they all offer AP's and honors and a full range of classes in STEM and english and humanities and foreign language) that there isn't much of a difference. Also, I beleive top schools do take coming from a disadvantaged academic background into account, or this was what I thought. Also, I'm from MA, so even the rural parts of MA ( western MA) have some of the best schools systems in the US, so I'm a bit unaware on just how bad some school systems are.
But being from a town with an amazing school system/HS , I wouldn't know as much as somebody who has lived through a weaker school system, like you. You're right. I take back that original comment.
 
Which unfortunately still means a parent making 60k puts you in the poorest 1/5th

That's a pretty absurd factoid and even more absurd to know it's one better than peers on this issue

Similarly, the meanings of "rich" or well-off at these schools becomes wildly distorted. People with family incomes $200-400k will not see themselves as all that well off, since the wealth of some of their peers is astronomical. Eye rolls on eye rolls when middle-class becomes an acceptable description for people with doctor/lawyer/professional parents. Maybe they're upper middle class, but that term just seems like an effort to tie these income brackets to the traditional working middle class. I think the ridiculous percentage of the ultra rich walking around these campuses just blinds you to economic realities.

Pre-ug I used to think rich people were the people who had been on a cruise.
 
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"% on aid" is just a generally bogus figure to go by, it seems to me. WashU also has some nice sounding numbers like half get aid, avg aid 40k or something...but obviously when 95% of students are from families making $65,000+ there is not nearly as much SES diversity as the finaid numbers would lead you to believe.


Having friends describe their hobbies of flying planes or travelling internationally alerted me pretty quick, and it seems like everyone's parent was either retired young, a doctor, or running their own business.

I wonder how much schools would have to relax their admissions standards to combat this issue, too. Like this year WashU's ACT IQR was 33-35, so entirely inside of the top percentile of scores, I think same for HYP. What fraction of top percent scorers even come from the bottom half economically? Especially when you add in expectations about AP/IB classes and great grades. Maybe these schools would honestly love to admit more of these missing demographics but aren't even getting apps like that.
Emphasis on scores over GPA is also one way need-blind schools maintain a revenue-producing SES imbalance. "Need blind" is another nearly meaningless indicator since scores, parental education (and general occupation), and zip code paint a fairly vivid picture, and many need blind schools leave students with gaps in financial aid.
 
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I wonder how much schools would have to relax their admissions standards to combat this issue, too. Like this year WashU's ACT IQR was 33-35, so entirely inside of the top percentile of scores, I think same for HYP. What fraction of top percent scorers even come from the bottom half economically? Especially when you add in expectations about AP/IB classes and great grades. Maybe these schools would honestly love to admit more of these missing demographics but aren't even getting apps like that.

I think looking at elements of the app in context is maybe a better way to frame it than needing to relax the standards. Top UGs expect you to be the top of your hs and to do the very best given the resources you had. So, if you're coming from an elite hs with every AP imaginable, it's not so much that the standards are higher for you so much as the schools expect you to utilize all of these immense resources. If your school doesn't have APs or high level classes, the school obviously doesn't expect you to have taken them.

At least at my school, regional admissions officers play a huge role in not just reviewing their regions applications, but reaching out to schools/communities in their region pre-application to get a sense for the environment students in these places encounter. Helps them better contextualize a student's app.

I think the fact that such a large percentage of the class has crazy test scores and AP preparation just speaks to the crazy percentage of advantaged students getting into these types of places. Also, anecdotally, many of the lowest SES students I've encountered have come from ivy prep pipeline programs, so these students have received a disproportionate amount of college/SAT prep, and AP class exposure relative to students in the lowest SES overall. Many also went on scholarship to elite boarding/private schools through these programs.
 
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I think looking at elements of the app in context is maybe a better way to frame it than needing to relax the standards. Top UGs expect you to be the top of your hs and to do the very best you had given the resources you had. So, if you're coming from an elite hs with every AP imaginable, it's not so much that the standards are higher for you so much as the schools expect you to utilize all of these immense resources. If your school doesn't have APs or high level classes, the school obviously doesn't expect you to have taken them.

At least at my schools, regional admissions officers play a huge role in not just reviewing their regions applications, but reaching out to schools/communities in their region pre-application to get a sense for the environment students in these places encounter. Helps them better contextualize a students' app.

I think the fact that such a large percentage of the class has crazy test scores and AP preparation just speaks to the crazy percentage of advantaged students getting into these types of places. Also, anecdotally, many of the lowest SES students I've encountered have come from ivy prep pipeline programs, so these students have received a disproportionate amount of college/SAT prep, and AP class exposure relative to students in the lowest SES overall. Many also went on scholarship to elite boarding/private schools through these programs.
I had no idea schools paid close attention to the highschools or backgrounds applicants were coming from. I figured people's apps were judged by someone from the other side of the country that had never heard of their local public highschool and didn't know or care whether their parents made 40 or 80 or 160k. It's both good to hear schools put some effort into identifying diamonds in the rough, and sad to know that it's so insanely skewed even with these efforts already in place.

It blows my mind that there are freaking high schools awarding merit scholarships to bring diversity. High schools. Smh
 
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I actually don't know if this is the case, but at elite ugs, I think middle-class (like the real middle class) students from mediocre to poor public high schools with limited college prep struggle as much if not at a higher percentage than many from the lowest SES brackets. Since a large % of people in the lowest SES brackets end of up at ivies through programs targeted at getting these students into elite UGs or elite boardin/private schools, many of these students show up with years of pretty intense college prep. They obviously still face huge challenges relative to their well-off peers, but I think elite UGs don't do a very good job recognizing the huge college prep gap for populations outside the lowest SES. Admitting that kid from a rural school district with no AP classes without programs to support their steep academic transition is reckless.
 
Thing I still haven't really gotten used to: regularly seeing different people in Choate sweatshirts.
 
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I had no idea schools paid close attention to the highschools or backgrounds applicants were coming from. I figured people's apps were judged by someone from the other side of the country that had never heard of their local public highschool and didn't know or care whether their parents made 40 or 80 or 160k. It's both good to hear schools put some effort into identifying diamonds in the rough, and sad to know that it's so insanely skewed even with these efforts already in place.

It blows my mind that there are freaking high schools awarding merit scholarships to bring diversity. High schools. Smh

I wish these schools released stats on how many of the "diversity" admits come to them through elite boarding/private schools so we could call them out on it. I think the programs that get kids into these elite high schools are doing great things, but 1) it shows how much elite hs education/advising matters and 2) prevents these UGs from having to take responsibility for getting kids up to an elite academic level since a boarding school has already been doing that for them. Let's them go about saying, "Look how well our super disadvantaged students are doing-anyone can succeed here!" without actually having to acknowledge/work at solving the educational disparities they talk/write papers about.
 
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Thing I still haven't really gotten used to: regularly seeing different people in Choate sweatshirts.

"Where are from?" will be followed by "What HS did you go to?" bc there's a good chance regardless of where you're from, you went to X, Y or Z elite boarding/prep school and might know their tennis buddy James.
 
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"Where are from?" will be followed by "What HS did you go to?" bc there's a good chance regardless of where you're from, you went to X, Y or Z elite boarding/prep school and might know their tennis buddy James.
And if you're not from X, Y, or Z, you're from Wellesley or Lexington High.
 
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