Medical Colleges Still Frown at Online

Students aspiring to medical school who took key prerequisite courses online are often ineligible to apply to the postgraduate programs they might otherwise choose -- and despite the growth in mainstream acceptance of online programs, the status quo looks unlikely to change soon.

Stanford University School of Medicine’s admissions requirements state that “online course work and degrees will not be considered.” The same goes for the Johns Hopkins University and University of Pittsburgh Schools of Medicine.

Harvard Medical School has “no specific policy” but requires that student applicants secure approval from the admissions office for online courses “on a case-by-case basis”; the same is true at Weill Cornell Medicine. Morehouse School of Medicine accepts students who took online math courses but not online science courses. Numerous other institutions don’t specify their policies around online courses on their admissions webpages.

A few -- Duke University, University of Washington and University of California, Irvine, Schools of Medicine among them -- specifically note in admissions requirements (here, here and here) that online prerequisites in some cases are acceptable.

Higher education professionals are growing more accustomed to and invested in online education as a means to attract different types of students and provide more flexible opportunities for learning. But champions of online learning have many battles left to convince traditionalists that their approach can be valuable and high quality.

Amid the online boom, medical colleges have faced pressure to enroll a more diverse collection of students. Law colleges, meanwhile, have begun to move in the direction of offering larger portions of their programs in hybrid and online formats, though not without resistance from skeptics of new forms of learning.

Approximately one-third of higher education enrollments in the U.S. are online, and 2.2 million undergraduate students are enrolled in exclusively online programs, according to data from the U.S. Department of Education. Online math and science programs are growing more numerous as technology becomes more sophisticated. On the other hand, some experts have questioned whether online courses ultimately produce comparable outcomes to face-to-face courses.

To be fair, medical education on the whole hasn't been entirely hostile to the online modality. Despite skepticism in the admissions office, Harvard Medical School has partnered with the MOOC provider edX on a series of 10-week online certificate-bearing courses geared toward students interested in exploring topics in the field before enrolling in medical school. The tech company OnlineMedEd, meanwhile, offers hundreds of free videos for current medical students looking to supplement overwhelming course work.

Hesitating to Recognize Online

Most of the restrictive admissions policies at medical colleges have been in place for many years. At Johns Hopkins, the possibility of lifting the restrictions last came up in 2014, when the institution decided to begin allowing students who had taken prerequisites in community colleges.

According to Paul White, assistant dean for medical school admissions, restrictions around online courses stayed in place because of concerns about the widely varying quality of online programs.

“Oftentimes we need letters of recommendations from people who are teaching those courses and who can talk about the individual classroom participation, not just how they’re participating online, but questions they might ask,” White said. “It isn’t so simple as ‘we just don’t want any online courses.’”

For face-to-face programs, his team uses criteria including average GPA and SAT or ACT, as well as the acceptance yield and graduation rates of the student's institution or institutions. White, though, is comfortable and familiar with face-to-face education in a way he simply isn't yet with online -- even when it's offered by a brick-and-mortar institution.

"My limited experience makes me question if these are indeed the same faculty teaching, or are they adjuncts hired specifically for the online program," White said. "I realize there are exceptions to this and I am not saying everyone on the admissions committee thinks this way."

Duke University for years has admitted students with online courses as pre-requisites, provided that those courses were approved by the student's undergraduate institution, and that the student didn't complete an entire degree program online. Andrea Liu, assistant dean of admissions, said she believes science courses with lab components only work if they're done in-person.

"They have to be able to interact interpersonally, in person with people," Liu said. "That’s what they would be doing as a physician."

Admissions staffers at Johns Hopkins typically reach out to applicants who took prerequisites online and ask if they’re willing to retake them in person as a condition for admission, according to White. Assuming they’re interested in enrolling, they’re usually able to pick up a summer course to fill in the gaps, he said.

White isn’t concerned that the institution limits the diversity of its student body by rejecting students who have taken courses online. He doesn’t anticipate the policy changing soon.

“We’re always willing to consider looking at it again,” White said. “But there’s nothing on the radar right now.”

New Forms Emerging

Many medical school admissions officers tend to think they have more information about the relative quality of a student’s prerequisite face-to-face courses than they would about online courses, according to Geoffrey Young, senior director of student affairs and programs for the Association of American Medical Colleges. "Medical schools are traditional in that they historically have thought about education as brick and mortar," Young said.

Science courses are a particular area of concern for medical colleges, according to LaZondra Hill, assistant director of admissions at Morehouse School of Medicine. Hence, the institution requires that students take science prerequisite courses with lab components in person.

In certain places, though, taking science courses online is no longer unthinkable. In 2017, Arizona State University launched a (mostly) online bachelor's degree in biochemistry, taught by the institution's full-time instructors from the same curriculum as the comparable on-ground program. Within a year 300 students had enrolled in the program, and now more than 650 students are currently enrolled in the program's courses, according to Ara Austin, a clinical assistant professor of biochemistry who oversees the program.

For critical lab portions in biochemistry and organic chemistry, online students come to campus for a seven-day bootcamp in which they complete all of the lab assignments that students in the on-ground course take over a semester.

While Austin doesn't get much face time with each individual student, especially when they're learning remotely, she thinks the experience is no less interactive than 300-student lecture courses in the face-to-face program.

"If the argument is that I don’t get to know the students online, I don’t really get to know the students on campus either," Austin said. But in fact she does get to develop connections with them through e-mail and Skype, she said.

More than 85 percent of the program's students live out-of-state. Many live in rural areas, and nearly 30 percent of students are black or Latinx. Early graduates of the program have had success enrolling at medical colleges in California, Austin said, particularly when they make the case to admissions officers there that their online program shouldn't disqualify them. But she's been pushing for more medical colleges to look favorably upon online courses as a means of enrolling students who wouldn't otherwise get opportunities.

"Slowly their cold hearts are melting," she said jokingly.

Even so, admissions directors interviewed for this article said they don't anticipate dramatically changing their stance on online education anytime soon. Liu said she has seen increasing interest from students in taking pre-requisites online, though.

"Things change so fast, maybe we’d have to change our mind if that’s the only way people are getting their degrees," she said. "I think we have years to come before that happens.