ABSTRACT
BACKGROUND: Grading standards vary widely across undergraduate institutions. If, during the medical school admissions process, GPA is considered without reference to the institution attended, it will disadvantage applicants from undergraduate institutions employing rigorous grading standards. METHOD: A regression-based GPA institutional equating method using historical MCAT and GPA information is described. Classes selected from eight applicant pools demonstrate the impact of the GPA adjustment. The validity of the adjustment is examined by comparing adjusted and unadjusted GPAs' correlation with USMLE and medical college grades. RESULTS: The adjusted GPA demonstrated significantly improved congruence with MCAT estimates of applicant preparedness. The adjustment changed selection decisions for 21% of those admitted. The adjusted GPA enhanced prediction of USMLE and medical school grades only for students from institutions which required large adjustments. CONCLUSION: Unlike other indices, the adjustment described uses the same metric as GPA and is based only on an institution's history of preparing medical school applicants. The institutional adjustment is consequential in selection, significantly enhances congruence with a standardized measure of academic preparedness and may enhance the validity of the GPA.