Birnbaum, Matthew

Committee Member

Guido, Florence M.

Committee Member

Weiler, Spencer


Leadership, Policy and Development


University of Northern Colorado

Type of Resources


Place of Publication

Greeley, (Colo.)


University of Northern Colorado

Date Created





363 pages

Digital Origin

Born digital


The option to identify as disadvantaged in the American Medical College Application Service (AMCAS) primary application may lead to unclear expectations for applicants. Despite its inception more than a decade ago, there are no published materials containing either a comprehensive definition, or explanation of the role of the Disadvantaged Status in student selection. Research on the Disadvantaged Status is similarly lacking. The purpose of this interpretivist case study was to explore how current students made meaning of the option to identify as disadvantaged when they were applying to medical schools. Through this research I uncovered meanings applicants ascribed to the disadvantaged term, how they determined whether they were disadvantaged, and how they decided whether or not to apply as such. Through open-ended interviews with 15 students at a medical school in the Northeast, document analysis of their AMCAS files, and with a theoretical framework that included symbolic interactionism, social comparison theory, stigma, and impression management, it became clear that deciding whether or not to apply as a disadvantaged applicant in the AMCAS primary application is both complex and fragile. Simply having experienced hardships during childhood was insufficient for many participants in this study to determine whether or not they were disadvantaged or should apply as such. The process of determining whether or not to apply as a disadvantaged applicant was confounded by a myriad of factors represented by the following nine themes: experience with disadvantage, resources, ambiguity, audience, pride, stigma, ethics, right to identify, and impression management. I concluded this dissertation with what I considered to be the most significant implications, in particular, that not all applicants are using the Disadvantaged Status consistently. I made recommendations for staff at the Association of American Medical Colleges, faculty and staff at medical schools and undergraduate institutions, and future applicants. I closed this dissertation with my final thoughts on this research experience.


Dr. Adam Lowrance has worked at public and private universities across the country. He has read and made admissions decisions on more than 15,000 medical school applicants. Dr. Adam now helps students become competitive medical school applicants. He is also available to work with schools and organizations. Visit to learn more.

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