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Rowsdower88, I disagree with your response. You and I have discussed this issue in depth on the other thread noted below, and we agreed to disagree respectfully.


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When evaluating med student applicants, what criteria do you believe is most predictive of who make excellent residents?\
That's a tough question, mostly because I think anesthesiology is an extremely hard specialty to apply for / interview for / "try out" for as a medical student. I remember being on a SICU rotation as a 4th yr back in the day and I was pretty much functioning as a junior intern. My seniors and attendings got a pretty damn good idea how I'd function in that regard.

But with anesthesia, it's just so different from anything else that I think the typical criteria such as steps, grades/honors/pass on rotations, MSPE, LORs, research etc, while obviously containing important information, tell a pretty incomplete picture. And I think med studs doing a rotation and seeing how they act IRL similarly is incomplete. But I honestly value the latter much more assuming a student meets cutoffs for the "objective" data (cause like I said before, having a step of 230 + no red flags like failing a rotation is sufficient for me to know a student can pass their tests). Whether our PD admits it or not, the main thing that keeps him up at night is CA-1s failing the BASIC. You can see from the graph I posted earlier that that essentially becomes a non-issue when there's a cutoff. So once you've established that someone is capable of studying to pass a test, what do I look for?

Essentially someone who I think I would actually want to work with and teach for four years. I couldn't care less how well you can intubate or place an IV on your rotation, but I want to be able to see in person during your rotation or infer from your interview / application / LORs (especially *non-anesthesia* LORs) that you / you're :

1. Punctual
2. Have enough social IQ to introduce yourself to the people who need an introduction
3. Able to get along with everyone, including subordinates and superiors
4. Do more than the bare minimum
5. Care about things / give a sht even when it's not absolutely required
6. Receptive to constructive criticism and show evidence that you actually integrated that criticism into future actions
7. Apt to read about topics (both medical and non-medical) for the joy of learning, not just cause you're cramming for an exam
8. Have some passions (like actual passions, not just BS filler "hobbies") for things outside of medicine
9. Have some valuable life and/or work experiences outside of medicine (I mentioned earlier that I've had great experiences with former athletes and former/active military folks)


I will tell you that in the 5 years that I've been academic staff, the chief residents have rarely, rarely been the residents who have had the top step or ITE scores. Because - and I know I've said this ad nauseum - being a good resident and anesthesiologist is more than just having the highest scores.
 
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Rowsdower88, I disagree with your response. You and I have discussed this issue in depth on the other thread noted below, and we agreed to disagree respectfully.


That was the closest we got to an actual discussion of the research, and I'll give you that.

As I recall, you set an arbitrary standard for one aspect of the evidence that I agreed was a reasonable thing someone could do. It wasn't a defense of rejecting affirmative action as it exists currently, nor was it a defense of abolishing affirmative action entirely.

If you're going to make posts now appealing to SCOTUS authority of course I'm going to disagree with them.
 
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The problem is your side hasn't even argued the morality. You just assert that any racial discrimination is bad, full stop, regardless of the positive outcomes that occur
The view is consistent with what a lot popular belief and literature shows wrt the psychological profile of liberals vs conservatives and how they approach moral reasoning. It's relatively well established that conservatives are more likely to engage in black-and-white, either-or, dichotomous thinking, especially when it comes to morality/ethics. Indeed, historically, conservatives were one of the biggest opponents of moral relativism. This is consistent with some positions many conservatives hold like "abortion is always wrong," "illegal drug use is always wrong,"........and "any degree of affirmative action is racist and always wrong."
 
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The view is consistent with what a lot popular belief and literature shows wrt the psychological profile of liberals vs conservatives and how they approach moral reasoning. It's relatively well established that conservatives are more likely to engage in black-and-white, either-or, dichotomous thinking, especially when it comes to morality/ethics. Indeed, historically, conservatives were one of the biggest opponents of moral relativism. This is consistent with some positions many conservatives hold like "abortion is always wrong," "illegal drug use is always wrong,"........and "any degree of affirmative action is racist and always wrong."
That’s an interesting point you are making about the philosophical concepts of Moral absolutism vs Moral relativism, and the psychological profile of conservative vs liberals based on the above principles.

Absolutism holds that the standards are always true regardless of the context. Obviously, its advantages include the critical evaluation of ethics and equality, since the same rules apply to everyone. But the disadvantage is ignoring the gray areas of life.

Relativism considers the contexts of situations and has an advantage of acknowledging diversity and equity. Its disadvantage is inequality and the unanswered question of who can become the arbitrator of these rules.

I would love to read literature/evidence on this. And wonder where the independents/ moderates would figure in this!
 
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That’s an interesting point you are making about the philosophical concepts of Moral absolutism vs Moral relativism, and the psychological profile of conservative vs liberals based on the above principles.

Absolutism holds that the standards are always true regardless of the context. Obviously, its advantages include the critical evaluation of ethics and equality, since the same rules apply to everyone. But the disadvantage is ignoring the gray areas of life.

Relativism considers the contexts of situations and has an advantage of acknowledging diversity and equity. Its disadvantage is inequality and the unanswered question of who can become the arbitrator of these rules.

I would love to read literature/evidence on this. And wonder where the independents/ moderates would figure in this!
In general, conservatives exhibit stronger preferences for order, structure, and closure, and greater intolerance of ambiguity in comparison with liberals:



And from "Political Ideology and Black and White Thinking"


Abstract​

The political ideology of the American people has become increasingly polarized over the last decade; this trend corresponds with increasingly negative views of people with different values. Black-and-white thinking is a propensity to think of things in extremes—thinking something as fully positive or negative and not recognizing almost everything has elements of both. This study explored the history and current state of political ideology in the United States and black-and-white thinking. The aim of the study was to see if political views were related to thinking styles, specifically if an individual’s level of black-and-white thinking could predict their political ideology. Online surveys were completed by 183 adults from the United States. Political ideology was conceptualized as a scale with very liberal on one side and very conservative on the other, along with concepts of social conservatism and economic conservatism. Black-and-white was measured using a scale measuring overall dichotomous thinking with subscales of dichotomous belief, preference for dichotomy, and profit-and-loss thinking. Findings suggest the more conservative someone is, the more likely they were to have higher levels of black-and-white thinking. More liberal individuals had lower levels of black-and-white thinking. Black-and-white thinking could predict conservatism, with it being a stronger predictor of social conservatism than it was for economic conservatism. The implications of this study are that thinking styles and political ideologies are interconnected, and understanding these connections can ideally improve productive conversations in and outside of the therapy office.

 
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@rowsdower88

I truly want to thank you for your heroic advocacy efforts! For your contributions to this insightful thread, I want to give you a gift. Let me know if you are interested!


Mermaid_Man_vs._SpongeBob_074.jpeg
 
Essentially someone who I think I would actually want to work with and teach for four years. I couldn't care less how well you can intubate or place an IV on your rotation, but I want to be able to see in person during your rotation or infer from your interview / application / LORs (especially *non-anesthesia* LORs) that you / you're :

1. Punctual
2. Have enough social IQ to introduce yourself to the people who need an introduction
3. Able to get along with everyone, including subordinates and superiors
4. Do more than the bare minimum
5. Care about things / give a sht even when it's not absolutely required
6. Receptive to constructive criticism and show evidence that you actually integrated that criticism into future actions
7. Apt to read about topics (both medical and non-medical) for the joy of learning, not just cause you're cramming for an exam
8. Have some passions (like actual passions, not just BS filler "hobbies") for things outside of medicine
9. Have some valuable life and/or work experiences outside of medicine (I mentioned earlier that I've had great experiences with former athletes and former/active military folks)
Great list for considering a prospective resident by admissions committee / PD.
However, I noticed that the “Race” consideration was not mentioned even once in your “criteria list”.

Is it presumptuous to conclude that the merit of the candidate based on the above criteria is then the most important factor, and race doesn’t matter at all if you are truly seeking the best candidate?

So why does it matter so much to you that Affirmative Action needs to stay- after all Race was not mentioned even once in your above list.

And that exactly is my point against Affirmative Action- candidates regardless of race, gender, sexual orientation or religion need to be considered based on their metrics, experiences and attributes.

May the odds be ever in favor of the best candidate for every position and every job, regardless of the uncontrollable elements which happens to be race and biological sex.

Let us get rid of “Race conscious admissions” which only serves to divide us all further.

Your above desired candidate traits list just proved my point!
 
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Great list for considering a prospective resident by admissions committee / PD.
However, I noticed that the “Race” consideration was not mentioned even once in your “criteria list”.


So why does it matter so much to you that Affirmative Action needs to stay- after all Race was not mentioned even once in your above list.

And that exactly is my point against Affirmative Action- candidates regardless of race, gender, sexual orientation or religion need to be considered based on their metrics, experiences and attributes.

May the odds be ever in favor of the best candidate for every position and every job, regardless of the uncontrollable elements which happens to be race and biological sex.

Your above desired candidate traits list just proved my point!

Race isn't mentioned in the list because 1. Just like Harvard undergrad, we don't have any explicit quotas or racial balancing, and 2. As I've mentioned previously, we have a general score cutoff which still results in a very diverse applicant pool.

Is it presumptuous to conclude that the merit of the candidate based on the above criteria is then the most important factor, and race doesn’t matter at all if you are truly seeking the best candidate? ,

Yes, it is presumptuous. Because, again, what does "best" mean? See again what I wrote for my #9. I know there's a large swath of folks out there who would refuse to admit it, but being an URM trying to make it in medicine frequently presents as a valuable life experience. And having a diverse group of residents with vehemently different perspectives and opinions is a net positive for our department, our practice, and our patients.

In the age of zoom, we have hundreds of applicants for fewer than a dozen spots, and a very high percentage of them all had steps over 225. I think the lowest step of all our matches this year was close to 240 (and for what it's worth, a slight majority of our match were women, and a quarter of those women were URM). Ultimately, I dont know how many times I can make the point that once some baseline degree of "objective" competency is met, candidates can be selected using criteria which we subjectively find "best." A more "qualified" candidate didn't get discriminated against, because having a 260 instead of a 240 doesn't in isolation make them significantly more "qualified" to be an anesthesia resident, in our opinion.

As an analogy, think about SCOTUS. More specifically, think about the selection of Justice Brown-Jackson. The number of lower court judges with top 10-25 law school pedigree is innumerable. And the number if them who could be relied upon to be a good justice is probably innumerable as well. At that point, when tasked with selecting a justice, what does "best" even mean? If Biden picks her, in part because of race, because that's the best thing for SCOTUS as an institution and for our country inasfar as ensuring all people are represented equally by our most consequential laws, then that is a justifiable decision and arguably a net positive imo (as it was for Thurgood Marshall).
 
I actually worked with one of the recent Stanford surgery grads today. The residency didn’t realize they were doing the racial and sexual demographics. It just happens. Taking their word for it.
 
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Race isn't mentioned in the list because 1. Just like Harvard undergrad, we don't have any explicit quotas or racial balancing, and 2. As I've mentioned previously, we have a general score cutoff which still results in a very diverse applicant pool.



Yes, it is presumptuous. Because, again, what does "best" mean? See again what I wrote for my #9. I know there's a large swath of folks out there who would refuse to admit it, but being an URM trying to make it in medicine frequently presents as a valuable life experience. And having a diverse group of residents with vehemently different perspectives and opinions is a net positive for our department, our practice, and our patients.

In the age of zoom, we have hundreds of applicants for fewer than a dozen spots, and a very high percentage of them all had steps over 225. I think the lowest step of all our matches this year was close to 240 (and for what it's worth, a slight majority of our match were women, and a quarter of those women were URM). Ultimately, I dont know how many times I can make the point that once some baseline degree of "objective" competency is met, candidates can be selected using criteria which we subjectively find "best." A more "qualified" candidate didn't get discriminated against, because having a 260 instead of a 240 doesn't in isolation make them significantly more "qualified" to be an anesthesia resident, in our opinion.

As an analogy, think about SCOTUS. More specifically, think about the selection of Justice Brown-Jackson. The number of lower court judges with top 10-25 law school pedigree is innumerable. And the number if them who could be relied upon to be a good justice is probably innumerable as well. At that point, when tasked with selecting a justice, what does "best" even mean? If Biden picks her, in part because of race, because that's the best thing for SCOTUS as an institution and for our country inasfar as ensuring all people are represented equally by our most consequential laws, then that is a justifiable decision and arguably a net positive imo (as it was for Thurgood Marshall).
@vector2 I'm trying to follow your argument, but it just doesn't contain a magnitude or direction.

Also, "inasfar" isn't even a word, it's "insofar".
 
Race isn't mentioned in the list because 1. Just like Harvard undergrad, we don't have any explicit quotas or racial balancing, …
Thank you for giving me a glimpse into this “holistic” admissions process. I have to admit that I am aghast that no one in the committee wants to admit the word “Race”, and everyone is dancing around the game of saying there is “no explicit quotas”-yet we all know there is only a finite number of seats available and this admissions process is a “Zero Sum” game.
See again what I wrote for my #9. I know there's a large swath of folks out there who would refuse to admit it, but being an URM trying to make it in medicine frequently presents as a valuable life experience.
So basically criterion #9 is Race, and the “secret code word” for Race is Life experiences for the Adcoms. So literally every single ORM candidate- be it Asian or White, has had the exact same life experiences and they are all a monolith, and seem to lack the “pesky diversity of thoughts”.
As an analogy, think about SCOTUS. More specifically, think about the selection of Justice Brown-Jackson. The number of lower court judges with top 10-25 law school pedigree is innumerable. And the number if them who could be relied upon to be a good justice is probably innumerable as well. At that point, when tasked with selecting a justice, what does "best" even mean? If Biden picks her, in part because of race,..
This is one of Biden’s egregious mistakes. Biden should have considered all possible nominees to replace retiring Justice Stephen Breyer, rather than pledging to consider only nominees who are Black and Women. Even 54 percent of Democrats disagreed with his approach.
Of course, he played “identity politics” and ended up tokenizing Justice Ketanji Jackson. Instead, Biden should have said he would just pick the “best qualified nominee” for scotus-and if that happens to be a black woman, so be it.
 
@vector2 I'm trying to follow your argument, but it just doesn't contain a magnitude or direction.

Also, "inasfar" isn't even a word, it's "insofar".
That was your take away from the thread so far and the post you replied to?


And a new account for just this thread?

2/10 . . . I’ve seen better trolling but you threw in a math joke and I’m a sucker for a math or Dad joke
 
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Thank you for giving me a glimpse into this “holistic” admissions process. I have to admit that I am aghast that no one in the committee wants to admit the word “Race”, and everyone is dancing around the game of saying there is “no explicit quotas”-yet we all know there is only a finite number of seats available and this admissions process is a “Zero Sum” game.

I'm not the program director nor have I read in detail all the guidance the ACGME gives about diversity for both the resident and faculty selection to the PDs and chairs, but it's not an accurate characterization that anybody is dancing around the issue. I suspect if you asked the actual PD and chairman who sign off on the match list and liaise directly with ACGME, they'll tell you that your program gets specific, explicit guidance about the need for a diverse match, and you'll probably get flagged at some point if your match (and faculty) are consistently monolithic.

So basically criterion #9 is Race, and the “secret code word” for Race is Life experiences for the Adcoms. So literally every single ORM candidate- be it Asian or White, has had the exact same life experiences and they are all a monolith, and seem to lack the “pesky diversity of thoughts”.

No, criterion number 9 isn't race. Criterion #9 is life experience. It seems overall you're anxious to distort what I wrote, i.e. a process that genuinely has some nuance, into a narrative that fits your preconceived notion that any consideration of race within a holistic selection process automatically means a more "qualified" person is getting excluded. Which is simply not true. And then you continue with hyperbole (or at least what I hope is hyperbole) that "literally every single ORM" is getting treated as a monolith. Which is another statement that is plainly false.

This is one of Biden’s egregious mistakes. Biden should have considered all possible nominees to replace retiring Justice Stephen Breyer, rather than pledging to consider only nominees who are Black and Women. Even 54 percent of Democrats disagreed with his approach.
Of course, he played “identity politics” and ended up tokenizing Justice Ketanji Jackson. Instead, Biden should have said he would just pick the “best qualified nominee” for scotus-and if that happens to be a black woman, so be it.

Disagree fully. And I also suspect the word "token" never once exited your mouth wrt Coney Barrett when trump said It will be a woman [who replaces RBG]..

Also, didn't you just make a criticism about 30 seconds ago implying that you thought programs and the ACGME weren't being transparent about race? But then when Biden says explicitly that a black woman will be nominated to SCOTUS, you're saying he should've just said "best qualified nominee" even if he knew all along it was going to be a black woman? You can't have it both ways, so which is it?
 
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With regard to transparency, dug through my email to see what exactly the ACGME looks at during the evaluation, and this is the language that the program executive committee has to work with when doing their residency review before site visits

Screenshot_20230327_084126_Docs.jpg


@Dr. Rude had asked me my personal opinion and I answered. There is no big conspiracy that programs or PDs/chairs are saying "life experience" but implicitly are being race conscious. It is explicit from an ACGME standpoint.
 
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I'm not the program director nor have I read in detail all the guidance the ACGME gives about diversity for both the resident and faculty selection to the PDs and chairs, but it's not an accurate characterization that anybody is dancing around the issue. I suspect if you asked the actual PD and chairman who sign off on the match list and liaise directly with ACGME, they'll tell you that your program gets specific, explicit guidance about the need for a diverse match, and you'll probably get flagged at some point if your match (and faculty) are consistently monolithic.



No, criterion number 9 isn't race. Criterion #9 is life experience. It seems overall you're anxious to distort what I wrote, i.e. a process that genuinely has some nuance, into a narrative that fits your preconceived notion that any consideration of race within a holistic selection process automatically means a more "qualified" person is getting excluded. Which is simply not true. And then you continue with hyperbole (or at least what I hope is hyperbole) that "literally every single ORM" is getting treated as a monolith. Which is another statement that is plainly false.



Disagree fully. And I also suspect the word "token" never once exited your mouth wrt Coney Barrett when trump said It will be a woman [who replaces RBG]..

Also, didn't you just make a criticism about 30 seconds ago implying that you thought programs and the ACGME weren't being transparent about race? But then when Biden says explicitly that a black woman will be nominated to SCOTUS, you're saying he should've just said "best qualified nominee" even if he knew all along it was going to be a black woman? You can't have it both ways, so which is it?
Replying to #2: Adcoms are using Race or “Life experience” as a tipping point/ plus factor in these holistic admission process, regardless of any nuance into that race box. And that exactly remains a problem with using the race-conscious admissions. US census is outdated and does not even have a MENA classification. The generic race checking allows claiming URM race based on distant ties 4 generations before and get the candidate an advantage for no other reason.

Replying to #3:
Trump is just as wrong to tokenize Justice Coney Barrett based on “religion ( catholic) and woman” just as Biden is on Justice Ketanji Brown on “black and woman”.
However, the difference is that Biden admin is claiming that affirmative action is “not discriminatory” towards any race, and states it is holistic and is much needed, and then Biden just goes ahead and selects the nominee using discrimination based on race. Basically, he wants to have his cake and eat it too!
 
With regard to transparency, dug through my email to see what exactly the ACGME looks at during the evaluation, and this is the language that the program executive committee has to work with when doing their residency review before site visits

View attachment 368462

@Dr. Rude had asked me my personal opinion and I answered. There is no big conspiracy that programs or PDs/chairs are saying "life experience" but implicitly are being race conscious. It is explicit from an ACGME standpoint.
Thank you for sharing that info. Yes, the LCME and ACGME have required US schools and residency programs to bolster students, residents and faculty diversity and teach cultural competence- since 2009 they have aggressively pushed forward on this measure to the extent of ignoring other purposes and goals of academic medical institutions.

When the ACGME/ LCME treat DEI socio-political issues such as health disparities and social inequalities as “settled medical questions” and aggressively infiltrates medical education and training, using these kind of implicit/explicit bias in the form of Affirmative Action, it only serves to politicize medicine.

When Affirmative Action/DEI metrics overwhelm the fundamental purpose of medical education and academic freedom for the institutions, which are under threat to lose accreditation if they don’t satisfy the assigned metrics, it is very concerning. These measures are counter productive- instead of helping the individual medical schools, residency programs and its academic community find unique, independent and relevant solutions for the programs/ communities they serve.
 
And that exactly remains a problem with using the race-conscious admissions

The problem is that there is no set of race conscious admissions that would satisfy you even if it demonstrably resulted in reducing racial disparities in healthcare to your arbitrary standard. The reason ACGME and universities in general moved away from quota based systems (apart from legal reasons) was because racist people in the world viewed the people who got those positions as inferior regardless of what other metrics they might have satisfied (the Clarence Thomas argument). So now, in efforts to still serve the public interest and reduce racial disparities, we have more amorphous and ambiguous criteria - which has its pros and cons.

I don't think you have evidence that a significant number of people are selecting their race inappropriately (based on 4 generations prior in your example), but it would be interesting to see if you did.

Edit: Maybe I'm being too harsh. I'll just say I think your criteria for helping address racial disparities is too high.

When Affirmative Action/DEI metrics overwhelm the fundamental purpose of medical education and academic freedom for the institutions

Lol, when did you get to decide what the "fundamental purpose of medical education and academic freedom" is? I think the fundamental purpose of medical education includes addressing racial disparities in healthcare. Healthcare is ALWAYS going to be politicized man.

It should be considered a national embarrassment that we have massive racial disparities in healthcare. Affirmative action is just one step towards addressing that.

Edit: per the ACGME website: The mission of the ACGME is to improve health care and population health by assessing and enhancing the quality of resident and fellow physicians' education through advancements in accreditation and education.
 
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Edit: per the ACGME website: The mission of the ACGME is to improve health care and population health by assessing and enhancing the quality of resident and fellow physicians' education through advancements in accreditation and education.


I love that statement because it reminds us that residency programs ultimately exist to serve patients, not med school grads.
 
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I love that statement because it reminds us that residency programs ultimately exist to serve patients, not med school grads.

Who do we speak to about changing their priorities?

Sarcasm aside, there are multiple reasonable interpretations about what is in the best interest of patients.
 
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Who do we speak to about changing their priorities?

Sarcasm aside, there are multiple reasonable interpretations about what is in the best interest of patients.


Yeah but it’s a stretch to say a USMLE 260 plastic surgeon or cosmetic dermatologist improves healthcare and population health more than a USMLE 240 primary care doc or hospitalist.
 
Who do we speak to about changing their priorities?

Sarcasm aside, there are multiple reasonable interpretations about what is in the best interest of patients.

Do you want them to take the "population health" part out because it's too woke?

Sarcasm aside, I think a reasonable interpretation of "population health" includes addressing issues like racial disparities in healthcare.
 
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Replying to #2: Adcoms are using Race or “Life experience” as a tipping point/ plus factor in these holistic admission process, regardless of any nuance into that race box. And that exactly remains a problem with using the race-conscious admissions. US census is outdated and does not even have a MENA classification. The generic race checking allows claiming URM race based on distant ties 4 generations before and get the candidate an advantage for no other reason.
I mean, I guess theoretically you're right that "gaming the system" presents a kind of problem, and I know many conservatives think there's an epidemic of Elizabeth Warrens wannabes out there getting into an ivy on their 1/64th Navajo heritage or whatever. But I don't think there any data to show this is a substantively present issue with URM applicants. More a very, very rarely appearing windmill at which some folks like to tilt.

Replying to #3:
Trump is just as wrong to tokenize Justice Coney Barrett based on “religion ( catholic) and woman” just as Biden is on Justice Ketanji Brown on “black and woman”.
I don't know you personally or know your prior views, but I find it very convenient that time after time when I engage on this issue with other conservatives (who were posting on other SDN subforums or other sites' forums at the time of ACB's nomination), there is not a single contemporaneous word to be found by them about how trump was wrong to state explicitly that he was going to nominate a woman. Similarly, if you google news media to find articles from the time about GOP politicians' views on the ACB vs KBJ nominations, good luck trying to find a single person who had consistent negative views about both trump and Biden's pre-announced nominating decisions (Republicans did not raise objections to then-Republican President Donald Trump’s comments in 2020 that he would nominated a woman to the Supreme Court to fill the seat of the late Ruth Bader Ginsburg.). If you were and are indeed consistent on your views, bravo, but I have almost uniformly not found that to be the case with people on the other side of the aisle from me.

Also, I'm curious, do you think Thurgood Marshall was a token justice? How bout Sandra Day O'Connor?

However, the difference is that Biden admin is claiming that affirmative action is “not discriminatory” towards any race, and states it is holistic and is much needed, and then Biden just goes ahead and selects the nominee using discrimination based on race. Basically, he wants to have his cake and eat it too!

I think you meant to use asterisks or some other emphasizing punctuation for the "not discriminatory" part, right? Because I'm relatively certain Biden admin has never used those exact words to describe affirmative action. And even if they did, trying to use that phrase as you're using almost certainly would be out of context from a larger statement.

And as @rowsdower88 has stated, affirmative action is a moral calculus that appeals to utilitarianism. Obviously by the strictest sense of the word, if trump says it's only going to be a woman or Biden says it's only going to be a black woman, then clearly there is a group that's going to be "discriminated" against. However, from a utilitarian point of view, that's weighed against the fact that since our country's founding, despite hundreds of years of the population being 50/50 men/women and plenty of POC living here, literally 108 out of 115 of the most powerful arbiters of law have been white men. I simply just don't find it an injustice or immoral if someone says that an exceptionally qualified woman is going to get a shot now.
 
Vector2 & Rowsdower88, I have observed that Utilitarianism is the main argument used by both of you for moral decision-making- as you have in the case of the Affirmative Action debate. However, I consider utilitarianism approach very dubious and very unfair to everyone.

By using the utilitarian calculation, you are assigning points to the benefits and harms resulting from certain actions ( i.e affirmative action) and comparing them with the benefits and harms that might result from other actions (i.e banning affirmative action).

However, as opposed to your utilitarian argument, can you look at this from my (deontological) perspective?
I feel that it is impossible to measure/ compare and ascribe cost:benefit ratio of certain abstract but meaningful things in life…How do we go about assigning a value to human life, time, work, joy, hardships or human dignity? Then why do you try to give value or compare such abstract and incomparable things in life?

How is it fair for a black applicant born to wealthy black parents who are ivy league alumni/ celebrities be given preference under your “holistic criteria” for admissions because they check the “URM” race box and get a boost on his application, while the rural white applicant who is the son of hard working farmers, or the asian applicant, who is the child of immigrant parents who own a convenience store and barely make ends meet, have to mark the “ORM” race box and be penalized?

Why do you think the admissions committee or the ACGME/ any other body reserves the right to give a value to each of the above applicants lives, and see who benefits society more?

Finally, wouldn’t utilitarian arguments skew organ donor issues? An extreme example of your utilitarianism would be basically a physician allowing a patient to die so that their organs can be used to save the lives of six other patients. Do you see how unjust this argument can be?

Humans do not have the right to be the moral authority of being the arbitrators of justice. ( Definitely NOT ACGME/ LCME/ DOE.
Affirmative Action is a weak utilitarian argument and Race-blind admissions is the best answer for our country.
 
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When evaluating med student applicants, what criteria do you believe is most predictive of who make excellent residents?
Isn't the answer obvious? Passing scores on exams (grades don't matter) and Passing Step Scores like Step 1 then we move on to Race, Gender and Sexual Orientation. Since the goal is to social engineer the residency class to reflect the moral values of the progressives who run the department.
 
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Isn't the answer obvious? Passing scores on exams (grades don't matter) and Passing Step Scores like Step 1 then we move on to Race, Gender and Sexual Orientation. Since the goal is to social engineer the residency class to reflect the moral values of the progressives who run the department.

That begs an question.

Are academic anesthesia departments exclusively run by progressives? If so, why? How did conservatives lose control? Or did previously conservative chairs and program directors increasingly become more progressive after seeing and educating a long line of trainees?
 
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However, as opposed to your utilitarian argument, can you look at this from my (deontological) perspective?
I feel that it is impossible to measure/ compare and ascribe cost:benefit ratio of certain abstract but meaningful things in life…How do we go about assigning a value to human life, time, work, joy, hardships or human dignity? Then why do you try to give value or compare such abstract and incomparable things in life?
Why do you think the admissions committee or the ACGME/ any other body reserves the right to give a value to each of the above applicants lives, and see who benefits society more?

Finally, wouldn’t utilitarian arguments skew organ donor issues? An extreme example of your utilitarianism would be basically a physician allowing a patient to die so that their organs can be used to save the lives of six other patients. Do you see how unjust this argument can be?
Individual human beings, families, institutions, corporations, and governments assign [difficult-to-quantify] value to abstract and/or intangible things such as human life, time, work, joy, hardships, or dignity all the time. Literally all the time. Hell, in the microcosm that is healthcare we make these nebulous valuations every minute.

It's funny you brought up an example using transplants to argue against utilitarianism.....considering utilitarianism is precisely the system UNOS and transplant committees use for organ allocation. Consider for a moment someone who primarily has a deontological, absolutist perspective toward human life, i.e. something common about human life. Deontological ethics is great for trite, emotionally manipulative one-liners like "all human life is equally precious," but it falls apart when the rubber meets the road and you get asked whether the 80 year old with the MELD of 34 who can't stop drinking is just as deserving of a liver as the 50 yo with a lower MELD who follows all the rules, doesn't it?

How is it fair for a black applicant born to wealthy black parents who are ivy league alumni/ celebrities be given preference under your “holistic criteria” for admissions because they check the “URM” race box and get a boost on his application, while the rural white applicant who is the son of hard working farmers, or the asian applicant, who is the child of immigrant parents who own a convenience store and barely make ends meet, have to mark the “ORM” race box and be penalized?

I find it bizarre that at times you appear to want to have a serious, fair discussion, but then in the blink of an eye you devolve into clownish, silly hyperbole like the above paragraph (or that other wildly ridiculous line from your earlier post about how my program treats "literally every single ORM candidate- be it Asian or White, ...like they are all a monolith").

It's reminiscent of other discussions I've seen when talking about an unrelated subject like tax policy. A liberal offers a generality like the corporate tax cut last decade was counterproductive in many respects and should be reversed. And then the conservative replies, "Why in the world would you want to raise taxes on John Q. Everydude's bait and tackle shop in Biloxi? Are you a heartless monster???"

That's kinda what you're doing here with your example implying that Bronny James is definitely getting that ortho spot over the hardworkin', bootstrappin', salt of the earth white kid from Appalachia.

Humans do not have the right to be the moral authority of being the arbitrators of justice.

I beg to differ that human beings [collectively] aren't the ones dictating what's moral or just.
 
That begs an question.

Are academic anesthesia departments exclusively run by progressives? If so, why? How did conservatives lose control? Or did previously conservative chairs and program directors increasingly become more progressive after seeing and educating a long line of trainees?
At least at our institution the opinions of the department chairs do not matter - these priorities are set at the university level and are influenced by the ACGME. So the anesthesia chair may well be a reactionary (as certainly one I have worked for was) but keeping their job depends on maintaining a commitment to DEI.

The next logical question then is whether medical schools or the ACGME have been taken over by progressives and I don't have an answer. It certainly is interesting considering medicine and the AMA in particular were historically some of the most conservative professional organizations in the country.
 
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Political motivation often comes down to personal assessment of other races’ deservingness​


“The term “racial resentment” has been around for decades and originally referred to a less blatant kind of racism in which Black people are seen as violating traditional norms and values like individualism. However, Davis and Wilson disagree with the way the term is defined and measured and, instead, looked to factors like deservingness and defense of the status quo across many years of data.

“The underlying theory is that people who are high in racial resentment are more likely to possess attitudes that reject special racial treatment and amelioration because they benefit African Americans and other minorities unjustly and unfairly,” they wrote.

“The book is predicated on this idea that whites perceive that the American way of life is changing; they perceive that they are being cut in line and that their status is being threatened — and being threatened by undeserving African Americans and other minorities — and that this costs them, thus legitimizing racial myths. It’s a little bit more sophisticated than just holding racial stereotypes,” Davis said.

Wilson added that racial attitudes can have many causes and can be motivated by a host of needs, including the need for security, the need for safety or the need to not feel like the world you see as fair is disrupted.

“Whenever someone receives something, they go through the automatic judgment of whether or not it’s deserved. When people perceive that someone is getting something they don’t deserve and they think that something is very important — a cherished outcome like a scholarship to a university or the ability to buy a house, or even being the first person in line because you got there early — whenever that system of fairness is disrupted, it produces resentment,” Wilson said. “What we’re saying is that that resentment becomes racialized because of the ways in which people think about systems of merit and beliefs that capitalism is fair.”

Wilson pointed out that some of these issues about deservingness are motivated by what might be called racism or prejudiced ideas, but it could be the inverse. “It may be the actual opposite — that racial attitudes like prejudice are motivated by holding certain values that undeserving people should be in a certain place, for example, or that they haven’t paid their dues.”

He stressed that people are not naturally born as racists or with prejudice, but that these are evolutionary traits that manifest because people are part of self-enhancing groups that they want to protect. These groups make people feel good and lead them to the conclusion that they are good people.

“So, if we’re good people and we have negative attitudes about African Americans, we can do two things: We can realize that we’re not good people, or we can blame African Americans,” Wilson said. “It’s easier to say that ‘it’s your fault and you should work harder’; that’s the deservingness mechanism that’s at play. The myth is that African Americans are not working hard and playing by the rules so, even when they do work hard and play by the rules, those [negative] values persevere and get applied more broadly.”

The authors note that it is fair for whites (and any other dominant group) to realize that society is changing, but they say that doesn’t mean it must be resisted and should not be misconstrued as reverse racism.

“I think that there are things taking place in society today that can actually give the perception that the status quo for whites is actually changing. For instance, trigger warnings; we have this renewed emphasis on diversity and inclusion; we have this reaction, this backlash toward political correctness; Barack Obama was elected for two terms; and we also have job outsourcing and immigration issues,” Davis said. “However, another argument that we make is that it is not unreasonable for whites to perceive that; these things are actually occurring. However, the extent to which African Americans and other minorities are benefiting from these things is misperceived.”

Davis and Wilson also tested how racial resentment relates to campaign appeals as well as schadenfreude as retribution. They found that campaign slogans that “convey a threat to the status quo and privilege have a special resonance.” In their related experiment, participants overwhelmingly interpreted President Donald Trump’s “Make America Great Again” rallying cry as African Americans forgetting their place.

“Many whites believe they are being left behind and disadvantaged by racial groups and policies, and reacting to this threat, they will gravitate toward candidates and campaign appeals that seek to protect and defend the status quo or their privilege,” Davis said. “‘Make America Great Again’ becomes a code for returning an era in which whites were more well off.”

The authors also found that high levels of racial resentment correlated with delight in the failure of those not in the majority who — as perceived by the white majority — have received unearned or undeserved perks at the expense of whites. They asked if people would be happy or sad when responding to things related to Obama, such as whether or not he would be identified as the best or worst president in history or his economic successes or failures. They found that “individuals with higher levels of racial resentment are more likely to express sadness in the face of African Americans’ accomplishments and happiness in the face of African Americans’ failures because they perceive African Americans as undeserving of success, and such success thus challenges their notion of justice and fairness.”

African Americans’ racial resentment toward whites is infrequently studied and, when done, Davis and Wilson noted, has been flawed and not equivalent to measurements applied to white racial resentment. The authors applied their same framework of deservingness and justice to African Americans and found that higher levels of racial resentment in African Americans translated into greater support for Obama and for increased spending on welfare and health care. It also manifested as lower support for Trump and decreased spending on law enforcement.”
 
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However, as opposed to your utilitarian argument, can you look at this from my (deontological) perspective?
I feel that it is impossible to measure/ compare and ascribe cost:benefit ratio of certain abstract but meaningful things in life…How do we go about assigning a value to human life, time, work, joy, hardships or human dignity? Then why do you try to give value or compare such abstract and incomparable things in life?

This is very dumb and it isn't related to deontology at all.

You don't really mean this, you can't, because no person could function if they believed this. When you ask your significant other to go pick up milk from the store are you wracked with guilt over the time burden you're imposing upon him/her? No. You understand that we can make assumptions about the value of other people's time and work. When you're voting for a politician who wants to gut social security are you saying there's no conceivable way to measure the damage that would cause? No. You understand that we can quantify how much it costs to keep elderly people alive and we know how many old people would be f***ked if we did that.

What you really mean to say is that these measurements are hard and reasonable people can disagree on edge cases, which no one denies.
 
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Isn't the answer obvious? Passing scores on exams (grades don't matter) and Passing Step Scores like Step 1 then we move on to Race, Gender and Sexual Orientation. Since the goal is to social engineer the residency class to reflect the moral values of the progressives who run the department.
Cry me a river. “Legacy” admissions have always been a big part of admissions to elite colleges not to mention prep schools. I was a kid and remember forced busing, desegregation, whites only. Give the admissions department credit for using their brains to do the best job possible given the flawed society we live in. And you lost me at “woke” which is just a dog whistle at this point.
 
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I find it bizarre that at times you appear to want to have a serious, fair discussion, but then in the blink of an eye you devolve into clownish, silly hyperbole…
I hope you understand that the examples of discrimination against the ORM students that I have cited are not outlandish or hyperbole, but widely reported by NYT and WSJ as part of cases from the SFFA case files on Affirmative Action.

More than 25,000 aggrieved ORM students affected by Affirmative Action (Asians>Whites) bravely signed on as plaintiffs represented by SFFA vs Harvard/UNC, risking their education, career and their future, by going up against an entire establishment before SCOTUS.
Would you in good faith tell these affected students that their cases are all “ bizarre” and “hyperbole”?

All those involved in Academia/ admissions decisions for med schools and residencies- please ask yourself: Is it fair to trample on absolute merit of an applicant by using ambiguous moral sensibilities - all in the name of race?

And thus, the dialogue between the benevolent and bleeding-heart liberals Vs cruel and cold-hearted conservatives continues… 👍
 
More than 25,000 aggrieved ORM students affected by Affirmative Action (Asians>Whites) bravely signed on as plaintiffs represented by SFFA vs Harvard/UNC

"Aggrieved", "affected" and "bravely" are doing HEAVY work there for the supposed cold-hearted conservative. I'm sure they had safety schools and again the appreciable harm done to society was minimal relative to the benefits because those spots ended up going to other qualified students.
 
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"Aggrieved", "affected" and "bravely" are doing HEAVY work there for the supposed cold-hearted conservative. I'm sure they had safety schools and again the appreciable harm done to society was minimal relative to the benefits because those spots ended up going to other qualified students.

Let’s be honest, this isn’t about societal good it’s about how to divide up the plum population positions among the various ethnic groups in a society where opportunities are rapidly diminishing. The moralizing here is impressive.
 
I hope you understand that the examples of discrimination against the ORM students that I have cited are not outlandish or hyperbole, but widely reported by NYT and WSJ as part of cases from the SFFA case files on Affirmative Action.

More than 25,000 aggrieved ORM students affected by Affirmative Action (Asians>Whites) bravely signed on as plaintiffs represented by SFFA vs Harvard/UNC, risking their education, career and their future, by going up against an entire establishment before SCOTUS.
Would you in good faith tell these affected students that their cases are all “ bizarre” and “hyperbole”?

And thus, the dialogue between the benevolent and bleeding-heart liberals Vs cruel and cold-hearted conservatives continues… 👍

No. Just no.

First of all, let's look at the background context behind your claims.

I would bet the majority of people think Students for Fair Admission is some grassroots, organic startup by actual Asian college students who decided to sue Harvard. It's not. It was started by a conservative activist lawyer at the American Enterprise Institute whose specialty is going around the country trying to drum up test cases.

OK, so some rando activist started the org, but surely the majority of Asians support the case, right? Nope. As I pointed out earlier, it's pretty well-established that 70% of Asian Americans support affirmative action.

OK, OK, it wasn't started by Asians and they're generally not against AA anyway, but surely all these highly talented kids must be getting their admissions chances affected so much to the point it's life-changing, right?

1680014776257.png


No.

Asian Americans make up 6% of the US population and yet, as of the most recent class, comprise 28% of the matriculants at Harvard, an over 4x population representation. Not to mention, that 28% is a figure which has increased in the past years. Try to understand the other side for a second and imagine how they could believe that a 4-5x population representation is fair.

And the hyperbole line didn't refer to the notion that I thought literally no extremely wealthy black student had ever "taken" a spot from a poorer white student in the history of all of US college education, but rather to the fact that you think pointing out extreme edge cases makes for a good argument for your side. It doesn't, any more than my tax example or when a pro-life person says all abortion must be banned because an epidemic of 38 wk'ers choosing to electively terminate would result.

All those involved in Academia/ admissions decisions for med schools and residencies- please ask yourself: Is it fair to trample on absolute merit of an applicant by using ambiguous moral sensibilities - all in the name of race?

I'm still waiting for anyone to provide a substantive counterargument to my claim that beyond some arbitrary grade (mix of pass/honors) and step cutoff (like 228-230), there's no objective criteria that necessarily make one anesthesia resident applicant more "meritorious" than another.
 
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No. Just no.

First of all, let's look at the background context behind your claims.

I would bet the majority of people think Students for Fair Admission is some grassroots, organic startup by actual Asian college students who decided to sue Harvard. It's not. It was started by a conservative activist lawyer at the American Enterprise Institute whose specialty is going around the country trying to drum up test cases.

OK, so some rando activist started the org, but surely the majority of Asians support the case, right? Nope. As I pointed out earlier, it's pretty well-established that 70% of Asian Americans support affirmative action.

OK, OK, it wasn't started by Asians and they're generally not against AA anyway, but surely all these highly talented kids must be getting their admissions chances affected so much to the point it's life-changing, right?

View attachment 368527

No.

Asian Americans make up 6% of the US population and yet, as of the most recent class, comprise 28% of the matriculants at Harvard, an over 4x population representation. Not to mention, that 28% is a figure which has increased in the past years. Try to understand the other side for a second and imagine how they could believe that a 4-5x population representation is fair.

And the hyperbole line didn't refer to the notion that I thought literally no extremely wealthy black student had ever "taken" a spot from a poorer white student in the history of all of US college education, but rather to the fact that you think pointing out extreme edge cases makes for a good argument for your side. It doesn't, any more than my tax example or when a pro-life person says all abortion must be banned because an epidemic of 38 wk'ers choosing to electively terminate would result.



I'm still waiting for anyone to provide a substantive counterargument to my claim that beyond some arbitrary grade (mix of pass/honors) and step cutoff (like 228-230), there's no objective criteria that necessarily make one anesthesia resident applicant more "meritorious" than another.
This is factually false. “Asian Americans make up same proportion of applicant pool as admit pool”.

If you look at the NYT article I posted earlier, there are MORE Asian applicants and the SAME number admitted. I’m not surprised The Crimson (Harvards own publication which is cited in the graphic you posted) is presenting incorrect information to back its racist policies.
 
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Let’s be honest, this isn’t about societal good it’s about how to divide up the plum population positions among the various ethnic groups in a society where opportunities are rapidly diminishing. The moralizing here is impressive.
I think this also demonstrates the level of protectionism in medicine since there obviously are many more qualified individuals than there are spots to give. You’re right, these are coveted, selective positions that guarantee a decent income and level of prestige and the number of them per capita has been decreasing for some time.

If one truly believes that ORMs are now disadvantaged in medicine, a logical choice would then be to avoid medicine and go into a field where you feel merit is better acknowledged and there is less protectionism since there would be less opportunity for those in power to manipulate selection. I would imagine that engineering or entrepreneurship would be better fits, but then you’re competing against the whole world instead of just Americans.
 
This is factually false. “Asian Americans make up same proportion of applicant pool as admit pool”.

If you look at the NYT article I posted earlier, there are MORE Asian applicants and the SAME number admitted. I’m not surprised The Crimson (Harvards own publication which is cited in the graphic you posted) is presenting incorrect information to back its racist policies.

Did you even read the infographic you posted?

To spell it out for you, it says: "If Harvard admitted students only from the top 10% of its applicants"

Which of course means the stat I posted isn't factually false, because neither Harvard nor any other school on earth only admit students from the top 10% of its applicants.

And again, unless you can contest the fact that eliminating all black and Hispanic applicants would only increase white and Asian chances by ~1%, then the point still stands that race-conscious admissions are not significantly or substantively affecting their chances of admissions.
 
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Did you even read the infographic you posted?

To spell it out for you, it says: "If Harvard admitted students only from the top 10% of its applicants"

Which of course means the stat I posted isn't factually false, because neither Harvard nor any other school on earth only admit students from the top 10% of its applicants.

And again, unless you can contest the fact that eliminating all black and Hispanic applicants would only increase white and Asian chances by ~1%, then the point still stands that race-conscious admissions are not significantly or substantively affecting their chances of admissions.

Did you even read the infographic you posted?

To spell it out for you, it says: "If Harvard admitted students only from the top 10% of its applicants"

Which of course means the stat I posted isn't factually false, because neither Harvard nor any other school on earth only admit students from the top 10% of its applicants.

And again, unless you can contest the fact that eliminating all black and Hispanic applicants would only increase white and Asian chances by ~1%, then the point still stands that race-conscious admissions are not significantly or substantively affecting their chances of admissions.

All true. But I still remember the sting of seeing less academically successful kids admitted to Med schools that rejected me. Also seeing my own kids have the same experience when applying to name brand colleges. These experiences often evoke a deeply personal and emotional reaction.
 
Right...so if Asian share of acceptance went for 25% to 50% at Harvard where class size is 7,000, that would be significant. Maybe I'm missing your point?

I'll chose data from The Economist and discovery from an active lawsuit over The Crimson.
 
Did you even read the infographic you posted?

To spell it out for you, it says: "If Harvard admitted students only from the top 10% of its applicants"

Which of course means the stat I posted isn't factually false, because neither Harvard nor any other school on earth only admit students from the top 10% of its applicants.

And again, unless you can contest the fact that eliminating all black and Hispanic applicants would only increase white and Asian chances by ~1%, then the point still stands that race-conscious admissions are not significantly or substantively affecting their chances of admissions.

I was about to say the same. His presumption is that the only thing that SHOULD decide admission are test scores.

sting of seeing less academically successful kids admitted to Med schools that rejected me

The sting will fade. It seems like you still made it!

share of acceptance went for 25% to 50% at harvard, that is somehow only a 1% difference

You're focusing on only the top test score decile again. The crimson is looking at all deciles.

I'm starting to see this resentment as a good argument for going back to explicit racial quotas to address specific harms in society. Would it make you feel better if you had known that there were some seats automatically set aside for black students that were set apart from the regular applicant pool, the purpose of which was to address issues like racial disparities in healthcare? Like, would it upset you as much if you had just known there was no possible way you could have gotten one of THOSE seats, but the rest of the pool was more test-score meritocratic?
 

Americans see grades, standardized test scores as top factors to be considered in college admissions​


Countering the previous infographic on how nearly 70% of Asian Americans want Affirmative Action, how about the above infographic which shows that 74% of All Americans want an admissions process that is blinded to race and ethnicity?

 
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I was about to say the same. His presumption is that the only thing that SHOULD decide admission are test scores.



The sting will fade. It seems like you still made it!



You're focusing on only the top test score decile again. The crimson is looking at all deciles.

I'm starting to see this resentment as a good argument for going back to explicit racial quotas to address specific harms in society. Would it make you feel better if you had known that there were some seats automatically set aside for black students that were set apart from the regular applicant pool, the purpose of which was to address issues like racial disparities in healthcare? Like, would it upset you as much if you had just known there was no possible way you could have gotten one of THOSE seats, but the rest of the pool was more test-score meritocratic?

Crazy idea - let's simply admit people into academic positions based on *gasp* academic achievement.
 
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Americans see grades, standardized test scores as top factors to be considered in college admissions​


Countering the previous infographic on how nearly 70% of Asian Americans want Affirmative Action, how about the above infographic which shows that 74% of All Americans want an admissions process that is blinded to race and ethnicity?


Maybe The Crimson, Harvards own publication, has a bias? Hard to imagine.
 
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