• Lawrence Grierson, Mark Lee, Meera Mahmud, Jason Profetto, Matthew Sibbald, Robert Whyte, and Meredith Vanstone.
• Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
• J Eval Clin Pract. 2024 Jun 1; 30 (4): 678686678-686.

IntroductionDue to the COVID-19 pandemic, the Undergraduate Medical Doctor (MD) Programme at McMaster University (Hamilton, Canada) was unable to run in-person medical school interviews in March 2020, prompting an alternate solution that maximised admission opportunities for Indigenous applicants, prioritised admission for those rated most highly in the interview determination process, and allocated subsequent offers via lottery.MethodsA short survey was administered to applicants who had been offered an admissions interview and were subsequently impacted by the admissions adaptations. The survey elicited perceptions of the adaptation through Likert scale ratings and free-text responses. Survey data were analysed via a sequential (quantitative to qualitative) mixed-methods design.Results196 of 552 potential participants completed the survey. Across quantitative and qualitative analyses, respondents reported that the adaptation had a negative impact on their professional development and personal life. Ratings of negative perception were greater for those who did not receive an offer than for those who accepted or declined an offer. Free text responses emphasised considerable criticism for the lottery portion of the adaptation and displeasure that efforts made in constructing applications were less relevant than anticipated.DiscussionThe negative responses to this unexpected change highlight the profound upstream impact admission policies have on the preapplication behaviours of aspiring medical students. The outcomes support a refined understanding of the value candidates place on the interview in appraising their own suitability for a career as a physician.© 2024 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.

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