Measuring What Matters: What a Better Way of Choosing Doctors Could Look Like
By Dr. Rene Roberts, MD, MS, FAAFP | TEDx & Keynote Speaker | Board-Certified Family Medicine Physician
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She was tearing up before she finished her first sentence.
Then the tears started to roll down her cheeks, her voice cracking.
We were on a video call. A student I mentor through the Urban Bridges Medical Mentoring Program — a stellar college athlete, disciplined, the kind of young woman who has spent years being told she is has what it takes — could barely get the words out. Earlier in the week she had a meeting with her pre-medical advisor. The person whose entire job is to help students like her reach medical school had looked at her file and told her she was probably not going to get in.
Not because of her character. Not because of her grades, which were strong. Because of one number. Her first Medical College Admission Test (MCAT) score.
That was the whole verdict. One number, read aloud by the very person she trusted to guide her, and a door quietly closing behind it.
I want you to sit with who delivered that message. Not a stranger. Not an admissions algorithm filtering her out before anyone actually read her application. The machine I wrote about earlier in this series. This was her pre-medical advisor. A human being, positioned as her guide, who looked at a single data point and decided her future for her. Just like that in one breath.
Here’s What I Told Her
I lead with the number could never see, even if it tried.
She was sitting on goldmine of personal qualities. Being a collegiate athlete had already taught her most of what medicine actually demands. The time management of balancing a full academic load against training, practice, and travel to games and tournaments. The discipline of managing oneself during early mornings and late nights studying. The ability to work on a team toward a goal no single person can reach alone. And the one nobody talks about — the capacity to absorb a loss, a bad result, a devastating setback, and show up the next morning to do it all again with poise and composure.
That last one is not a footnote in medicine. It is the job.
She re-studied. She sat for the MCAT a second time. She raised her score. And this month she starts medical school, having earned multiple medical school acceptances.
She made it. Imagine that.
The Voice on the Other End of the Line
But I need to be honest about why she made it. And it is not only because of her tenacity, though she has that in abundance.
She made it because when that advisor's voice told her she was not enough, there was another voice on the other end of the line telling her the truth.
Many students do not have that voice.
Students who hear "you are probably not going to get in" from the person assigned to guide them do not have a physician on the other end of a call to counteract it. They have only the discouragement, delivered to them often times by someone who has never been to medical school themselves, or trudged on the bumpy road that is medical school admission, or has never sat with a frightened patient, who is reading a number off a page and calling it destiny.
And so they stop. Not because they could not have been extraordinary doctors. Because no one told them they could.
That is the part of this system that never shows up in any dataset. The students we lose not to the algorithm, but to a single sentence from a single person on a single afternoon. The damage was already done to my student's spirit long before she ever retook that exam. She carried it through anyway. Many cannot.
We Already Know How to Measure More
Here is what gives me hope. We are not waiting on some invention that does not exist yet. The tools to measure what actually makes a healer already exist. Some schools already use them. We simply have to decide they matter.
Consider the multiple mini-interview. Instead of one high-stakes conversation, applicants move through a series of short, structured scenarios — ethical dilemmas, communication challenges, moments that look a great deal like the ones a doctor faces every day. And the evidence is striking. Students admitted through a multiple mini-interview process went on to outperform their peers on national licensing examinations (Eva et al., JAMA, 2012). In other research, the multiple mini-interview was the strongest predictor of performance on the clinical skills examination — the simulated patient encounter — while grade point average was the most consistent predictor of performance on written, multiple-choice knowledge exams (Medical Education).
Read that again, because it is the entire argument of this series in a single finding. Different instruments measure different things. Your GPA predicts how you will do on a written test. The multiple mini-interview predicts how you will do in a room with a patient.
We have been screening for the wrong one.
There is more. The Association of American Medical Colleges (AAMC), the same organization that administers the MCAT, now offers the PREview exam, a situational judgment test built to measure professional readiness: accountability, resilience, the relational skills that determine whether a patient trusts you. The AAMC's own research found that these scores tracked with faculty ratings of professional behavior and told admissions committees something the MCAT and GPA could not (AAMC; Academic Medicine). And holistic review — weighing an applicant's experiences and attributes alongside their metrics — has been shown to produce a more diverse pool of candidates than academic numbers alone (Advances in Health Sciences Education).
An Honest Word About the Trade-Off
I am not going to pretend this is free.
Students selected for lived experience and resilience sometimes score somewhat lower on the written exams — the very instruments this series has spent four posts questioning. That is real, and I will not hide it from you.
But ask yourself which gap you would rather close. A few points on a multiple-choice test that measures how well someone takes a multiple-choice test? Or the chasm between a doctor who can pass that test and a doctor who can walk into a room where someone is terrified and make them feel, within minutes, that they are not alone?
There is a difference between the floor of competence and the ceiling of connection. The written exams measure the floor, and they measure it reasonably well. What we have never built our system to find is the ceiling. The tools above can find it. We simply have to be willing to look.
The gate can be built to open. It does not have to rust shut.
A Better System Has More Than One Voice
So what can any of us actually do?
If you sit on any committee that decides who gets in — to a school, a program, a job — add one measure that reveals character, resilience, or lived experience. Just one. Then watch who walks through that you would have filtered out.
If you advise young people, understand the weight of your voice. A student will carry your sentence for years. Make it a sentence worth carrying.
And if you are a person who has been counted out by someone who never bothered to see the whole of you — a pre-medical advisor, an admissions officer, anyone who read your number and stopped there — hear me. You may simply need one voice to counteract theirs. Be your own, until you find others. Because the difference between the student who makes it and the student who gives up is very often nothing more than whether someone was there to say: they are measuring the wrong thing.
I was that voice for one student this year. She starts medical school this month.
The question that has run through this entire series has never really been about medical school. It has been about who we allow to heal us — and therefore, who among us gets healed.
We can build a system that finds the healers. We already have the tools. What we need is the will — and enough voices willing to say what my student needed to hear on the other end of that line.
I am not an exception to the rule. I'm evidence the rule is wrong.
And so is she.
This is the fifth and final post in my "Talking About TEDx" series. If you have read all five, thank you for walking through this with me — from the day I stood backstage, to the filter that decides who gets in, to what a better system could look like. The conversation does not end here. It just moves from the page to the rooms where these decisions get made.
My TEDx talk "Who Gets to Heal?" is now live on YouTube. Watch it here.
Dr. Rene Roberts, MD, MS, FAAFP is a board-certified Family Medicine physician, Fellow of the American Academy of Family Physicians, three-time Castle Connolly Top Doctor (2024, 2025, 2026), and TEDx & keynote speaker. Creator of the L.Y.M.I.T.S. Method™, she is a nationally recognized medical media expert and leading voice in healthcare equity, medical education reform, and resilience. She mentors aspiring physicians through the Urban Bridges Medical Mentoring Program.
