Medical profs question Ontario’s “merit”-based admissions law

“Ontario’s recently passed Bill 33 threatens holistic admission pathways to medical school and could jeopardize the training of future doctors to serve Indigenous, rural, and low-income urban communities, twoprofessors argue in an editorial published in the Canadian Medical Association Journal (CMAJ). In the editorial, Lisa Richardson, vice-dean of strategy and governance at the University of Toronto’s Temerty Faculty of Medicine, and Marcia Anderson, vice-dean of Indigenous health, social justice and anti-racism at the University of Manitoba, express concern that the law fails to take into account the needs of Indigenous people and racial minorities. The doctors draw on their respective two decades of experience as field researchers and leaders in Indigenous health to “set the record straight,” Dr. Richardson says. Definition of ‘merit’ unclear Bill 33, also known as the Supporting Children and Students Act, became law last November. It requires “publicly-assisted universities to assess applicants based on merit and to publish the criteria and process to be used for assessment into programs of study.” The law fails to define “merit,” while implying that current admission criteria are neither rigorous nor transparent. Drs. Richardson and Anderson argue that a medical workforce made up of physicians of different origins and cultural backgrounds reflects Ontario’s cultural diversity, and thereby serves the interests of public health. Although Ontario faces a severe shortage of doctors, only 1,100 students are admitted to the province’s medical schools each year — and the handful admitted on holistic criteria are already considered “meritorious candidates,” they note. The editorial cites several academic studies that document the positive effects of existing equity-forward admissions policies, and questions the evidentiary basis of the law. “We agree merit should be the central determinant of admissions to medical schools,” the authors write. “However, only by expanding traditional definitions, which focus on biomedical and scientific academic domains, to include comprehensive measures of merit through evidence-based approaches can medical schools create the diversity required to respond to the health needs of Canada’s population.” Medical faculties call for a seat at the table Details of how the government plans to implement Bill 33 have not been made public, and the authors are calling on the province to give them a seat at the table where “merit” is defined. “If we don’t include people from minority communities in how we define merit, we’re making a mistake,” says Connie LeBlanc, president and CEO of the Association of Faculty of Medicines of Canada (AFMC) which represents Canada’s 19 medical schools. In the wake of U.S. Supreme Court rulings striking down race-based equity, diversity and inclusion (EDI) measures, the AFMC has ramped up its support for EDI initiatives. Last year, it stopped using US standards to accredit Canadian medical schools. Each Canadian medical school sets its own admission criteria. The steps in assessing candidates have been developed through years of consultations with experts, and reflect the most up-to-date understanding of the type of excellence required for admission to medical school, Dr. Richardson says. “It’s a very rigorous process in which merit is assessed in a highly relevant and practical manner, in order to train excellent doctors to serve the needs of our society.” According to Statistics Canada , Ontario has about 335 Indigenous physicians, representing about one-third of the 1,175 Indigenous physicians nationwide. Some universities, like Queen’s and the University of Ottawa, reserve a certain number of spots for Indigenous students; while U of T doesn’t, it enables Indigenous applicants to submit additional documents to help them meet the institution’s “extremely robust” selection criteria which, Dr. Richardson notes, are clearly laid out on the department’s website. Support for a holistic admissions process An online survey conducted in 2025 at McMaster University invited the school’s 647 medical students to answer questions on equity-based admissions. Of the 95 medical students who took the survey, a majority supported holistic admissions criteria to counteract the systemic barriers facing Black and Indigenous students. However, less than half of respondents said they were familiar with equitable admissions measures. Above all, the survey indicated medical students were concerned that admissions processes disproportionately favoured applicants from higher socioeconomic backgrounds. Meanwhile, the Ontario Confederation of University Faculty Associations (OCUFA), which was invited to submit its opinion on Bill 33 to the Ministry of Colleges, Universities, Research Excellence and Security, argues that admissions criteria are already merit-based. OCUFA President Rob Kristofferson said he’s concerned that the Conservative government may be seeking to standardize admissions in faculties acrossthe province, and unjustifiably encroaching on an area outside its expertise. In a 2021 study on policies adopted by Premier Doug Ford’s government, the non-partisan NGO Evidence for Democracy found that the government often failed to provide scientific evidence to support its policy decisions. Inclusiveness and rigour in medical admissions “We’re not saying that Indigenous applicants should receive preferential treatment,” says Dr. Anderson. “But, rather, that there should be a more comprehensive assessment of the merits of Indigenous candidates.” The AFMC’s Dr. LeBlanc notes that, from a national perspective, holistic admissions are effective equalizing tools to address widespread systemic discrimination. Medical school is “intense and a long haul,” she says. Given this reality, it would be in no-one’s best interest — neither students, the university nor the health care system — to admit students who lack the potential to succeed. “There is no credible evidence that faculties of medicine which achieve diversity through equitable admissions processes have lower graduation rates,” she concludes. READ MORE: Critics mull challenge to Ontario’s Bill 33 The post Medical profs question Ontario’s “merit”-based admissions law appeared first on University Affairs .

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