Accepting randomness in medical school admissions: The case for a lottery

McMaster University’s medical school, faced with the need to socially distance during the COVID-19 pandemic, recently replaced their structured admission interview process with a partial lottery. At first, it may seem that leaving medical school admissions partly to chance could erode autonomy and meritocracy. Yet our current system for selecting medical students is strained by a limited predictive ability. In the search for good doctors, we lack meaningful, quantifiable, and comparable criteria. Partial or weighted admissions lotteries can offer us an escape. They have the potential to reduce mental and financial burdens on both applicants and medical schools, avoiding an overemphasis on marginal differences between applicants. Lotteries are also a simple way to address persistent admissions disparities by being truly non-discriminatory. At the very least, lotteries represent a useful benchmark against which we can rigorously compare current and future selection methods.