KEY CONSIDERATIONS FOR GETTING INTO DENTAL SCHOOL

FOR UNDERREPRESENTED MINORITY (URM) APPLICANTS

Gary L. France, D.D.S.

Dr. Gary L. France is formerly the Advisor and Consultant for Diversity for the UCLA
School of Dentistry. Dr. France is a consultant for the Educational Outreach Department
of the University of California, Office of the President. Direct correspondence to him by
e-mail at gary.france@ucop.edu.

The Surgeon General’s Report on Oral Health in America, published in 2000,

pointed out that while diversity in our society is increasing, the number of
underrepresented minorities (URMs) prepared to provide dental care, is decreasing.1 The
Associated Press recently noted that a third of the nation’s 152,000 active dentists are
over 55. As they begin to retire, the number of dentists in the United States – already too
low to serve much of the rural population – will actually begin to decline. More than 31
million Americans now have no dentist in their immediate area.2 This dilemma is
heightened for minorities.
The analysis of the ratios of dentists to population by race and ethnicity found in
the Surgeon General’s report revealed disparities which are cause for national concern.
In 1996, the ratio for Caucasians was 1:1450; for Hispanics, 1:5400; for Blacks, 1:6150;
and for Native Americans, 1:10,000. For the total population of Americans, the ratio was
one dentist for every 1700 people.3 The data for dental education is also quite alarming
for the future. There has been a decrease in the total production of dentists since the early
1990s. The total number of graduates of dental schools was at a high of 5460 in 1991. In
2000, the number of graduates was 4250. The decline of minority graduates from dental
school is even more dramatic. Enrollment data for URM students in dental schools
indicate that:
ƒ The number of underrepresented minority students (African-Americans, Hispanic,
and American Indian/Alaskan Native) who graduated from dental school peaked at
564 in 1991. That was 14.1% of the class. By 2000, the number of underrepresented
minority graduates had declined by 393, or 9.2% of the class.

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ƒ The total enrollment for all underrepresented minorities reached its all-time high in
1988-1989 at 2323, and the peak of enrollment of Black students was 1037 in 1984-
1985.
ƒ In 2001-2002, there were 854 Black students enrolled in the nation’s schools of
dentistry.
More specifically, data for the period 1995-1996 show that:
ƒ There was a 10% decline in total enrollment of African-Americans during this period,
with the number of Black students dropping from 951 to 854. The 17% decline
among Black males was even more upsetting. The number of Black male students
declined from 407 (42% of Black students) to 339 (39% of Black students). The
decline for African-American females is less dramatic, but still troubling. The
number of Black female students declined from 544 to 515.
ƒ There has been a slight increase in Hispanic students. In 2001-2002, there were 1030
Hispanic students enrolled in the nation’s schools of dentistry, compared with 966 in
1995-1996.
ƒ There was little change in the number of enrolled Native Americans: 73 in 1995-
1996 and 74 in 2001-2002.
ƒ In 2001-2002, thirteen of the nation’s schools had no Black students enrolled in the
entering class, and ten schools had only one Black student enrolled in the entering
class.
ƒ Similarly, for the same year, eight schools reported no Hispanic students in their
entering class, and ten schools reported having only one Hispanic enrolled in the
entering class.3
The development of a pipeline for the recruitment and retention of URMs into
dentistry is crucial. It must be a priority of all involved in perpetuating diversity in the
dental profession. Studies have documented that people generally seek health care
providers who are the same race, cultural background, and ethnicity.4 In 1999, Black
and Hispanic dentists reported that the majority of their practices were made up of
patients of their own ethnicity. It is generally accepted, that addressing the crisis of the
shortage of minority dentists is a function of dental schools and the dental school

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admission processes they use to promote diversity. However, is it their sole
responsibility?
The role of the URM dental school applicant cannot be overlooked and must be
explored. Timely improvement of the dental provider shortage for minorities could be
assisted by them. The considerations that URM applicants use in the dental school
admissions process is a critical component. Especially if the considerations in their
control could make a difference in acceptance to dental school being sooner. This paper
discusses the need for dental school applicants, especially URM, to comprehensively
evaluate the dental schools to which they are applying. By using the resources on the
dental admission process, it is possible that there will be dental schools included that
would not have been prior to such a review, schools that increase the potential for
acceptance in that dental admission cycle. The example of the two similar dental school
applicant’s situation, later discussed, demonstrates this.
The process of admission into dental school can be frustrating for all dental
school applicants. The mystery of how the selection process works is even more
complicated and confusing to understand, because standards for admission, vary from
dental school to dental school. Admission requirements and eligibility for acceptance
may be weighted differently from institution to institution, and from applicant to
applicant. However, the common goal of all dental schools is to select the most qualified
and diverse class from its applicant pool. This is done with an attempt to be fair,
balanced, and sensitive to the needs of dentistry. This includes education, research, and
clinical practice, for which there is a need for diversity. The American Dental Education
Association (ADEA), which the 56 United States dental schools are members, has a
longstanding commitment to promoting diversity in dentistry and dental education. One
of the core values of the ADEA, as stated in its bylaws is “. . . expanding the diversity of
dental education . . .” defined as “The Association values diversity and believes that those
who populate dental education - students, faculty, staff, administrator, and patients -
should reflect the diversity of our society.”5
Besides academics (grades and test scores), overcoming personal adversity,
demonstrating independence and critical thinking skills, are among the different factors
used in admission criteria. Members of admissions committees look for evidence from

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the applicant’s application that might demonstrate the profile of a desire to be a
continuous student as a dentist and to make a contribution to the dental profession in the
future. An important factor that many URM applicants overlook is the importance of
sending applications to dental schools which might look favorable for their admittance
due to its need for diversity. Making an informed decision on which schools might be
favorable means doing research.
There is data available that will help URM and all applicants to determine which
dental schools have accepted students resembling their profile in the past. The ADEA,
for example, is an excellent source for providing such information. As applicants strive
to be chosen by a dental school, they should likewise chose schools that are likely to
accept them, using sources available. This is especially true of URM applicants. This
consideration is part of the dental admissions process, which is in their control. The
following situations prompted the writing of this paper.
In Table 1, at first glance, the two URM applicants appeared to have a similar
profile. Both applied to dental school for admission in the Fall, after Spring graduation
from their respective university and college. They each applied to up to eight dental
schools. Three of those schools were the same. The dental schools applied to were both
public and private. Both applicants had grade point averages (GPAs) and Dental
Admission Test (DAT) scores in the range of admitted dental students over the last five
years. Applicant A had an overall 3.25 GPA and majored in Chemistry at a large, well
known public university, recognized as a research institution. Applicant B had an overall
GPA of 3.34 and a science GPA of 3.23 and majored at a small, out of state private
college, known nationally and well respected. Applicant A’s DAT scores were Academic
Achievement-19; Perceptual Average-19; and Total Science Average-20. Applicant B’s
DAT scores were Academic Average-18; Perceptual Average-18; and Total Science
Average-18. Both had excellent letters of recommendation and participation in
extracurricular activities. They are URMs, but neither was economically or educationally
disadvantaged. However, Applicant B had an uncle who was a dentist, and Applicant A
was the first in his family to graduate from college. Applicant A was accepted.
Applicant B had to reapply for admission. Why?

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 For any applicant who is rejected, questions arise. Why was I not admitted? Why
did someone I know with the same grades and test scores (or maybe even lower ones) get
in over me? How was the decision made? What could I have done differently? What
more do I need to do? These are questions that can lead to frustration and even to anger.
All applicants must determine if they fulfill the objectives of the dental school that they
are applying to, to avoid this situation. This means doing their homework in the
admissions process. One aspect URM applicants should consider is whether the dental
school which they are applying promotes diversity and can demonstrate that commitment
historically, proactively, or both. Although Applicant A was accepted to dental school, it
was not 100% of those applied. Even though Applicant B was denied acceptance, they
did make it to the waiting list of some schools. In many instances admission is granted
from that point. But what was the difference in this case? Could it possibly have been
the applicant’s consideration in the selection of schools they applied? For many students
parents, alumni, and pre-health profession advisors, the process is unknown – a mystery.
To the many faculty, administrators, staff, alumni, and community representatives
involved in making decisions for all of the 55 dental schools, the admissions process
requires close scrutiny of an enormous pool of well-qualified applicants that will produce
a first year class commensurate with that school’s goals. It should be the objective of a
bright, well rounded, motivated, and self-directed dental school applicant to use that same
scrutiny in the selection of which dental schools to apply. The competitive environment
of the admission process among dental schools is not exempt from diversity outreach.
On the contrary, because of the shortage in the applicant pool of URMs who qualify for
admission to dental school, competition is more fierce among schools to attract those
diverse students in their programs. Those URM applicants should consider this when
submitting their dental school applications. Keeping this in mind, they may be more
likely to succeed in gaining admission to school. If not, they may omit applying to a
school which would accept them.
Most dental school admissions committees do a comprehensive review of
evaluating the full achievement record of its applicants. Not only are the quantitative
factors, such as grades and test scores, used in the evaluation, but qualitative factors
which recognize the merit demonstrated in a broad variety of academic and personal

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achievements; Academically, it could be publications and research; personally, it could
be leadership roles, volunteering, and work experience.
The dental school applicant’s achievements, academically and personally, the
trajectory of their paths, their accomplishments, and the challenges they have overcome
in their lives may be summed up differently among dental admission committee
members. Dental school admission committee members attempt to evaluate applicants
considered for admission to their schools in totality. How each admission committee
member evaluates totality is more subjective than objective. The aspects of a dental
application can be interpreted widely in range and in scope among committee members.
For instance, one member might center on the academics as the focal point of totality,
where another might believe that one’s life experience might be a better indicator of what
type of student would be better for the dental profession, as a whole, in addition to dental
school. The diversity of opinions will hopefully bring fairness and balance necessary for
a class that represents the dental school’s ideology and commitment to the dental
profession and the public welfare which it serves.
“In a quantitative and qualitative application review, dental schools can move
away from a formulaic model of admissions. This is traditionally practiced by
institutions which receive large numbers of applications,” says the former Dean of
School 1. “The decision to implement a more comprehensive review process of
admissions will have a profound effect on the quality of dental professionals that is
produced by a dental school. This has a huge impact on a society that is becoming more
culturally diverse and dentally knowledgeable; even more reason to widen the range of
criteria beyond academics, to differentiate more carefully, the decision to offer admission
to a prospective candidate.”
Academic preparation is the most significant factor in dental school admissions.
It is the barometer that can be used, not only for admission, but for potential successful
matriculation while a dental student. There is a direct correlation between academic
success as an undergraduate and success in dental school. In the example of the two well
qualified URM dental school applicants: one successfully gained acceptance into dental
school, the other not. The successful applicant went to a large state university where
competition is fierce in his major, Chemistry. Although not reflected in his overall and

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science GPAs, his last two year’s GPA was .5 and .7 higher, respectively, than his
averages. He participated in two summer research programs. He was president of the
pre-dental club at his school. He worked in his dentist’s office and received outstanding
personal letters of recommendation from a department chairman and the director of a
research program.
The applicant who was not admitted, Applicant B, again had a competitive GPA
and DAT score. The GPA was consistent, with no fluctuations up or down. The
applicant went to a small college known for its preparation of both medical and dental
students. The college has a high success rate for admittance to both medical and dental
schools from their programs. In fact, Dental Schools #16, #17, and #27 had
representative dental students from this college. The applicant was a member of the pre-
dental club. The applicant had no documented research experience, but had worked in an
uncle’s dental office before senior year in college. The applicant’s letters of
recommendation were from the pre-health committee at the college, the uncle, and the
president of the local dental society. There were all excellent, strongly recommending
the applicant. However, there were no recommendations from the professors or pre-
dental advisor, personally.
Both were well qualified, underrepresented, and admissible applicants. From
historical trends of underrepresented dental students entering dental school over the last
five years, one would consider them both admissible. What made the difference between
getting accepted and not getting accepted? They both received interviews, and both
experienced being on a waiting list. Only one gained acceptance. Why?
Applicant A applied to eight schools; Applicant B to seven. Three schools were
the same. This is not unusual for the number of applications submissions to dental
schools by dental school applicants. Table 2 illustrates profiles of schools applied by
both. Applicant A was accepted to six schools. Applicant B was placed on the waiting
list of Dental Schools #5 and #52. Although denied after interviews with Dental Schools
#1 and #54, there was still a chance for Dental Schools #5 and #52.
“In the interview, the applicant has the opportunity to present more information
about himself than is in the dental school application, which will be useful in the decision
making process,” says an admissions committee member of Dental School #1. “The

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applicant can either enhance or diminish his profile from the paper application through
the interview. If they are assertive and show determination, it could be the difference for
acceptance; conversely, an applicant qualified by his credentials could eliminate himself
if he shows a lack of independence, communication skills, or maturity.” Could the
interview have caused the denial for Applicant B?
The Associate Dean of Student Affairs from Dental School #52 says, “Sometimes,
the applicant that is on the current year’s waiting list, under the same circumstances the
previous year, would have been admitted. In the current year they miss, because the
current year’s waiting list of admissibles is shorter. Number 4 on the current waiting list
gets admitted, where last year the cut-off number was number 6.” Could Applicant B be
the victim of poor timing for an admission letter?”
As for extracurricular pursuits, it sometimes is not enough that an applicant be
just a member of a club or group. The applicant admitted was the president of his pre-
dental club. This demonstrates leadership. He did volunteer at the local dental school,
and while in college, he worked at his dentist’s office. The Applicant denied, seemingly
having more opportunity to work at the uncle’s office during the summer months, chose
to work only one – the summer before the application process.
Applicants are reviewed by the context in what areas they have demonstrated
accomplishment. The admitted applicant was the first to complete college in his family,
and he also worked during college. It is not a negative that the denied applicant did not
do these things, however, when an applicant prevails with challenges, like working and
going to school, combined with high academic and personal achievement, it denotes
something special. Could this “something special” have gained him admission?
Today, there is more aggressive outreach for the URM applicants, not only by the
schools doing it for the past 25 years, but by additional schools acknowledging the need
for diversity in their classes. That being the case, it seems as though Applicant B should
have had an excellent chance to be admitted. Why was she denied? “Many dental school
applicants, well represented and underrepresented, focus on the goal of going to a
particular school versus focusing on the particular dental schools that will help them
reach their goal – to be a dentist,” says the Director of Minority Affairs of Dental School
#41. “There are applicants, especially underrepresented minorities, that we would have

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accepted to dental school, had they applied. However, because of the distance from
home or the location, the application to our institution is not sent.” One of Applicant B’s
considerations for application submission was based on location. Had she included
Dental School #41, she might have been admitted.
Applicant A looked at schools that might be favorable toward him. With the
information he received from available sources, he identified these schools. He was able
to “blueprint” his selection of dental schools, and send applications, to those with best
chance of admittance. Choosing a school that is likely to accept them, regardless of its
location, should be included in all applicant’s submission list. That could be the place
that allows them to start a dental career sooner than later. With the grades and test scores
rising and outreach for diversity expanding to more schools, researching which dental
schools to apply by dental school applicants for admission becomes more evident. This
is the applicant’s responsibility in the application process. An opportunity for admission
to dental school could be missed. For the URM applicant, it could not only affect them,
but the minority group to which they represent. If they are dentists sooner, they could
address the dental shortages of that minority group’s population, groups that recent
reports show they are most likely to treat.
Despite the revelation that there is complexity in the process of dental school
admissions, the drive to be fair and equitable in selecting classes that are well qualified
and diverse is the goal of all dental schools. To select from a small pool of URM
applicants that are high achievers, well prepared, and just as admissible to most dental
schools, is difficult. However, the admissions committees of some dental schools will
accomplish this. The disadvantage the URM applicant can cause themselves is to not do
their “job” in considering all possible dental schools that might accept them. The dental
school applicant today must realize the multifaceted process of dental school admissions
and determine which school would be their best chance for admittance, from
informational sources available on all the dental schools.
Regarding dental school admissions, it is no longer feasible for any dental school
to base the critical decision of accepting applicants mostly on grades and test scores. A
broader scope of information is necessary to identify well rounded applicants –
academically strong, demonstrating leadership, persistence, self-reliance, and

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determination. Furthermore, efforts to address increasing the oral health workforce
diversity, capacity and flexibility will be part of the admissions decision. Implementation
strategies to increase diversity, capacity, and flexibility must be applied to all components
of the dental workforce: research, education, and both private and public health
administration and practice.6
Additionally, the URM dental school applicant needs to broaden their scope and
consideration of dental schools. Acquiring information available on dental school
application and enrollment data and the school’s commitment toward diversity. Applying
to a school which would most likely accept them for admission, could affect change in
the oral health workforce capacity among minorities. Efforts are needed by both
admissions committees and URM applicants to fulfill their obligation to the admissions
process. This will make a difference in the dental healthcare shortage disparity among
minorities by increasing the chance of dental training sooner and decreasing the
possibility of a lost opportunity.

REFERENCES

1. Oral Health in America: A report of the Surgeon General. Rockville, MD: U.S.
Department of Health and Human Services, National Institute of Health, National
Institute of Dental and Craniofacial Research, September 2000.
2. The Week Magazine, Volume 3; Issue 125:18, October 3, 2003.
3. Noonan, A., Evans, C. “The Need for Diversity in the Health Professions,” Journal of
Dental Education, 2003; 67(9): pp. 1030-33. (See duplicate Endnote 3.)
4. Brown, L.J., Lazar. “Minority Dentists: Why do we need them? Closing the Gap.”
Washington: Office of Minority Health, United States Department of Health and
Human Services, July Newsletter: 6-7.
5. Sinkford, J. “Introduction. Special Section: Creating a Culture for Diversity – A
Necessary Reality for Survival.” Journal of Dental Education, 2003, 67(9); p. 1029.
6. Office of the Surgeon General of the United States. “A National Call to Action to
Promote Oral Health.” May 2003.

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 TABLE 1
TALE OF TWO UNDERREPRESENTED (URM) DENTAL SCHOOL APPLICANTS

APPLICANT A APPLICANT B
School: Large public university School: Small private college
Major: Chemistry Major: Biology
Overall GPA: 3.25 Overall GPA: 3.34
Science GPA: 3.15 Science GPA: 3.23
DAT Academic average (AA): 19 DAT Academic average (AA): 18
DAT Perceptual average (PA): 19 DAT Perceptual average (PA): 18
DAT Total science average (TS): 20 DAT Total science average (TS): 18
Extracurricular activities: Two years of summer research programs, President Extracurricular activities: Member of Pre-Dental Club, tennis, worked in
of Pre-Dental Club, dental school volunteer, works in dentist’s office part-time. uncle’s dental office before last year of college in the summer, has attended
dental meetings with uncle.
Letters of Recommendation: Chairman, Department of Chemistry, Director of Letters of Recommendation: Pre-Health Committee, uncle who is a dentist,
Summer Research program, employer dentist, department supervisor at the President of local dental society.
dental school. Rating: Excellent.
Personal: 24 year-old male underrepresented group, not disadvantaged. First Personal: 20 year-old underrepresented group female, not disadvantaged. Has
to graduate from college in family. Worked part-time while in college. Last an uncle who is a dentist and influenced her career choice. Did not apply to
two years GPA and Science GPA .5 and .7 higher than average, respectively. uncle’s school #27 because of location. GPA steady throughout undergraduate
Relocation out of state to go to dental school is not a problem. years. Prefers to go to dental school closer to home. Relocation not an option
beyond 500 miles.
Dental Schools Applied: #1, #16, #17, #23, #27, #41, #52, #54 Dental Schools Applied: #1, #5, #8, #25, #43, #52, #54
Dental School Interviews: #1, #17, #27, #41, #52, #54 Dental School Interviews: #15, #52, #54
Dental Schools Accepted: #1, #17, #27, #41, #52, #54 Dental Schools Accepted: None.
Dental Schools Wait Listed: #16 Dental Schools Wait Listed: #5, #52
Dental Schools Denied: #23 Dental Schools Denied: #1, #8, #25, #43, #54

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 TABLE 2

PROFILE OF THE DENTAL SCHOOL’S SELECTED FOR APPLICANT A AND APPLICANT B

FOR ENROLLMENT IN CLASS 2002

SCHOOL AVG. AGE OF AVG. GPA OF AVG. SCIENCE AVG. DAT AVG. DAT % OF URM
ADMITTED ADMITTED GPA OF ACADEMIC PA ENROLLED IN
ADMITTED SCHOOL
1 24 3.6 3.7 22 20 <10%
5 24 3.4 3.3 18 19 <10%
8 25 3.7 3.6 21 20 <10%
16 25 3.0 3.0 16 15 >10%
17 23 3.4 3.3 19 19 >10%
23 24 3.5 3.4 20 18 >10%
25 24 3.6 3.5 19 18 <10%
27 24 3.6 3.4 18 17 >10%
41 23 3.5 3.4 18 17 >10%
43 25 3.4 3.2 19 18 >10%
52 24 3.3 3.2 19 18 <10%
54 25 3.4 3.3 20 19 >10%

Source: ADEA Official Guide to Dental Schools, 41st Edition – School Data

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