In an external review of the admissions process for the Faculty of Medicine, University of Manitoba, Canada, it was suggested that admissions policies be modified to increase the enrolment of students more likely to practise in rural locations, by selecting a cohort of students with attributes reflecting potential for rural practice. A broad-based Working Group devised a framework for scoring personal attributes reflecting a potential for living and working in rural areas. This framework, based on established characteristics reported in the literature, valued applicants who had rural connections, a history of rural employment, a history of rural community service, or a combination of these attributes. Relative weights for the attributes were determined using a priority matrix approach. Historic admissions data, comprising applicants' rural origin (defined only by location of high school graduation), composite scores, and ranking, were reanalyzed to identify the magnitude of numerical constants that, when applied to composite scores, enhanced the relative ranking of eligible rural-origin applicants. This resulted in a hypothetical 29%-33% increase in the number of rural-origin students in incoming classes in those years. In the inaugural year of implementation of the policy and methodology, 60 admission offers (44.1%) were made to applicants with one or more rural attributes. Without adjustments, only 49 applicants with rural attributes (36%) would have been offered admission. This methodology resulted in a 22.4% increase in admission offers to applicants with rural attributes, and ushered in an incoming class that was more representative of the province's rural-urban demographics than in previous years. This methodology, although focused on rurality, could be equally applicable to any attribute, and to achieve greater diversity and equity among medical school applicants.

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