Dispelling a few myths about AA, URMs, and medical admissions

[DrBowtie]

I guess by effective I mean a physician population that is culturally competent, well educated, empathetic, and competent. In my book, "effective" means as close to ideal as possible.

This will probably anger you but why the push MAKE people culturally competant? Isn't the whole point of the URM programs to make physicians to serve their minority that they are already culturally competent?

For example many colleges are integrating these type courses into the gen ed requirements. Not only are the ridiculously easy but no one WANTS to take them. Waste of tuition money.

I would like to think my definition of culturally competent is knowing that cultural differences exist and accept them as other peoples culture.

If you disagree with this definition then the above applies.

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[TheMightyAngus]

Just because someone with a 25 MCAT is capable of becoming a doctor, doesn't mean that they should be admitted. A similar argument could be said about competitive residencies. Sure the majority of med students are capable of becoming dermatologists, but they all won't get the chance. You have to find someway to reduce the applicant pool. Numerical cutoffs is the easiest way to do this. And even after you make the cut, you still have to exclude many qualified people.

 

[LadyJubilee8_18]

This will probably anger you but why the push MAKE people culturally competant? Isn't the whole point of the URM programs to make physicians to serve their minority that they are already culturally competent?

For example many colleges are integrating these type courses into the gen ed requirements. Not only are the ridiculously easy but no one WANTS to take them. Waste of tuition money.

No, I'm not angered by this

I think it's important to stress cultural competence because it allows people of all backgrounds to be more adept at serving a variety of people. Because you are more in touch with your own ethnic group does not make you culturally competent; URMS could be culturally incompetent with regard to ORMs for example. When you interact with patients who differ in ethnic background (which you invariably will) it is best to have an understanding of their culture or to at least shed yourself of preconceived notions that may effect how you treat that person. I used the diabetic study of an example of this earlier. I'll repost for convenience:

When I was at HCEM we were talking about health disparities and we started discussing the issue of getting minorities on organ donor lists. We watched a video about how in a community of blacks in Chicago, very few diabetics were ever put on the donor list to receive a new kidney at their local hospital. When they did research to figure out why, it turns out that the clinicians thought blacks would just go back and eat the wrong foods and screw up the kidneys again. They felt since there were a limited number of kidneys, they should give them to the more appreciative whites who would make sure they stayed healthy afterwards. These stereotypes do affect access to health care; they could mean the difference between life and death for some patients.

At some point, people are going to come in contact with members of varying ethnic backgrounds. Teaching cultural competence decreases the probability that racially influenced tragedies will occur. (have you ever seen the movie crash?)

 

[DrBowtie]

No, I'm not angered by this

I think it's important to stress cultural competence because it allows people of all backgrounds to be more adept at serving a variety of people. Because you are more in touch with your own ethnic group does not make you culturally competent; URMS could be culturally incompetent with regard to ORMs for example. When you interact with patients who differ in ethnic background (which you invariably will) it is best to have an understanding of their culture or to at least shed yourself of preconceived notions that may effect how you treat that person. I used the diabetic study of an example of this earlier. I'll repost for convenience:

When I was at HCEM we were talking about health disparities and we started discussing the issue of getting minorities on organ donor lists. We watched a video about how in a community of blacks in Chicago, very few diabetics were ever put on the donor list to receive a new kidney at their local hospital. When they did research to figure out why, it turns out that the clinicians thought blacks would just go back and eat the wrong foods and screw up the kidneys again. They felt since there were a limited number of kidneys, they should give them to the more appreciative whites who would make sure they stayed healthy afterwards. These stereotypes do affect access to health care; they could mean the difference between life and death for some patients.

At some point, people are going to come in contact with members of varying ethnic backgrounds. Teaching cultural competence decreases the probability that racially influenced tragedies will occur. (have you ever seen the movie crash?)

I edited above to define what I think is cultural competence. I think as long as you are able to identify differences, accept them as their culture (not as inferior but just a unique aspect to theirs) then you are culturally competent.

I can do that without taking 6 hours of classes trying to give me "white guilt".

 

[TheMightyAngus]

When I was at HCEM we were talking about health disparities and we started discussing the issue of getting minorities on organ donor lists. We watched a video about how in a community of blacks in Chicago, very few diabetics were ever put on the donor list to receive a new kidney at their local hospital. When they did research to figure out why, it turns out that the clinicians thought blacks would just go back and eat the wrong foods and screw up the kidneys again. They felt since there were a limited number of kidneys, they should give them to the more appreciative whites who would make sure they stayed healthy afterwards. These stereotypes do affect access to health care; they could mean the difference between life and death for some patients.

These disparities happen in part because of epidemiological data. For example, if you happen to cut off your fingers and need them re-attached, you won't be able to find a surgeon to do it if you were a smoker. Nicotine would cause clots in the vascular tissue, resulting in improper blood flow. So smokers get the shaft, and the hospital/insurance doesn't spend the thousands of dollars that the surgery requires. Sure, you can promise and plead that you won't smoke a single cigarette, but the answer is in the data.

So the odds that a black diabetic in a certain chicago community would be able to sustain the necessary follow-up regimen for a kidney replacement is too low to make the surgery cost-effective.

 

[LadyJubilee8_18]

I edited above to define what I think is cultural competence. I think as long as you are able to identify differences, accept them as their culture (not as inferior but just a unique aspect to theirs) then you are culturally competent.

I can do that without taking 6 hours of classes trying to give me "white guilt".

No one is trying to spread "white guilt" but you'd be surprised what people think of others because of their ethnic background. Having classes to make people more familiar and comfortable about different groups of people is positive IMO. You hear all kinds of off the wall things from people who have few interactions with members of other backgrounds. Some kid in my history class is convinced that Mexicans carry their 10 kids over the boarder and put them all on medicare (without social security numbers) and then we have to spend our tax money (THAT WE EARNED) on thousands illegal children getting health care every month. I mean, if they are so poor, why do they have so many kids? Like I said before, a professor (with a PHD) at my University told me that the reason I score so well on tests is because I'm part white (barely). If people are ignorant enough to think statements like this are appropriate in an academic setting, I'm sure people are ignorant enough to take these ideas to the bed side. I think cultural competence classes are beneficial.

 

[DrBowtie]

No one is trying to spread "white guilt" but you'd be surprised what people think of others because of their ethnic background. Having classes to make people more familiar and comfortable about different groups of people is positive IMO. You hear all kinds of off the wall things from people who have few interactions with members of other backgrounds. Some kid in my history class is convinced that Mexicans carry their 10 kids over the boarder and put them all on medicare (without social security numbers) and then we have to spend our tax money (THAT WE EARNED) on thousands illegal children getting health care every month. I mean, if they are so poor, why do they have so many kids? Like I said before, a professor (with a PHD) at my University told me that the reason I score so well on tests is because I'm part white (barely). If people are ignorant enough to think statements like this are appropriate in an academic setting, I'm sure people are ignorant enough to take these ideas to the bed side. I think cultural competence classes are beneficial.

If people willingly went into them with an open mind then yes they could learn a lot.

The fact remains that they are required. Thus forcing people to sit through lectures. This leads to even more resentment IMO.

 

[LadyJubilee8_18]

These disparities happen in part because of epidemiological data. For example, if you happen to cut off your fingers and need them re-attached, you won't be able to find a surgeon to do it if you were a smoker. Nicotine would cause clots in the vascular tissue, resulting in improper blood flow. So smokers get the shaft, and the hospital/insurance doesn't spend the thousands of dollars that the surgery requires. Sure, you can promise and plead that you won't smoke a single cigarette, but the answer is in the data.

So the odds that a black diabetic in a certain chicago community would be able to sustain the necessary follow-up regimen for a kidney replacement is too low to make the surgery cost-effective.

I don't think these examples are comparable. Anyone with type two diabetes and needs a kidney transplant has probably had a history of poor diet. Why is the white diabetic more likely to change his habits than the black diabetic? There is no data saying that blacks just can't control themselves around the chicken and kool-aid. Why would one assume whites would be more appreciative? When it's a matter of life and death, people are usually more inclined to change their habits.

 

[LadyJubilee8_18]

If people willingly went into them with an open mind then yes they could learn a lot.

The fact remains that they are required. Thus forcing people to sit through lectures. This leads to even more resentment IMO.

Nah, you're required to do lots of things in school. It is especially important to be culturally competent when you will most likely hold someone's life in your hands at some point. Classes in cultural competence are just as important (if not more) as basic science classes like biochem. People may not want to be forced to learn anatomy, but it is necessary for them to become quality physicians. Cultural competence classes are no different. Someone just rationalized giving a kidney transplant to white patients over black patients even though both have been known to have poor diets. If these blatant disparities can be construed as reasonable, then cultural competence classes are sorely needed.

 

[DrBowtie]

Does your definition of cultural competence agree with mine that I layed out above?

How would you define it?

 

[LadyJubilee8_18]

Does your definition of cultural competence agree with mine that I layed out above?

How would you define it?

I think cultural competence definitely includes your definition but I also think it has to do with how you regard those differences. I could believe that black people are culturally different because they tend to eat traditional foods that are unhealthy, and I could choose to respect that difference. With this understanding and respect, I could still decide that these bad foods make blacks unworthy recipients of organs and refuse to perform transplants for black patients. Though I accept the differences and respect them, I have used this difference to discriminate and I have added to health disparities. I think it is important to understand cultural differences, respect them, learn not to discriminate because of them, and learn how to interact with patients accordingly. For example people who are Sikhs do not believe in cutting their hair or finger nails (etc.). Say for some reason I, as a physician, feel a Sikh would avoid some disease by cutting his or her hair. If that person refuses to follow my order, I could mark them as "noncompliant". Noncompliant patients are not put on donor lists and are less likely to get proper treatments. Because I didn't act properly considering that person's culture, I've limited his or her access to healthcare.

 

[LadyJubilee8_18]

Does your definition of cultural competence agree with mine that I layed out above?

How would you define it?

I'm going to bed. 'til tomorrow, Mr. Batchelor

 

[DrBowtie]

I'm going to bed. 'til tomorrow, Mr. Batchelor

Indeed. It's 3AM EST. Im out as well.

 

[MoosePilot]

Why do you laugh at the notion that people who get 25s can succeed in medical school? Researchers noted the correlation between the passing value for important medical school exams and certain MCAT scores. The data is based on what happens in real-life medical schools. The requirement for extremely high MCAT scores has been artificially inflated by application pressure; you don't need a 40 and a 4.0 to succeed in medical school. You may think this notion is laughable, but considering actually studied data it seems to be true. If you find a better source that proves other wise, I'm all ears.

About the mass voter grab: The minority vote is split anyway. Blacks vote D. because democrats pushed the majority of the important civil rights legislation. Most minorities who actually vote are old enough to remember this. This is why Dems don't work to court the black vote--they know they already have it. Republicans don't try to court the black vote because to most blacks, Rep= racist. Reps would have to spend too much time, energy, and money for very little pay off. As for Hispanics, they tend to vote on morality issues because most Hispanics are Catholic. The abortion issue is what seals their loyalty to the right. Politicians do not need to cling to AA in order to secure votes. This notion is laughable; might I add

You really lost me at the gang member, terrorist, KKK comments. The vast majority Arabs and Iraqis do not deserve to be treated like terrorist despite the actions of a few deranged individuals on 911. Likewise, equating all minorities with violent gang members is just racism--its not a valid observation. Contrary to popular belief, most minorities are not selling crack and hanging out of low-rider windows with various automatic weapons. Its interesting how you use the example of the KKK. People aren't scared for their lives because they think every white person who passes by is a KKK member. Though minority groups are associated with a few irrational and injurious individuals, somehow whites escape this stereotype despite the existence of the KKK. When it comes down to it, noting that some destructive individuals happen to be of certain ethnic backgrounds does not give you the right to assume all members of that background are destructive. This reminds me of justification of hate crimes against gays because, "If they weren't gay, people wouldn't be so hateful." When it comes down to it, the problem is not with different ethnic groups, but with the bigotry/racism.

I don't doubt that someone with a 25 can succeed in medical school, but I think it's around that score that the MCAT basically loses predictive value. Getting a 25 or higher basically means you took a science curriculum and might speak English at home. Nothing else. Why take it if you're going to use such a low threshold? I think using at least a few points higher to get into the average range would be a good start. Don't you want your doctor to be at least an average tester?

As for what I said that confused you, I mean that some groups bring discrimination on themself and the group that they're associated with. I'm not saying this is totally right, but I am definitely saying it's not totally wrong. People have to make pre-judgements. If you see a cherry red metallic spiral on top of a cooktop, do you touch it? If you see a man in dirty clothes walking along the sidewalk, alternating between muttering to himself and screaming obscenities, do you get close? Those are extreme examples, but without even reading the details, I'll make a wager with you today that any terrorist that attacks the U.S. is Islamic, that any Crip or Blood is African American, and that any Klan member is white, as long as you'll take all those bets without researching individual cases prior. Sure, I'll lose on the occasional Tim McVeigh, but I'll end up rich and you'll end up bankrupt before it's all over.

 

[MoosePilot]

Nah, you're required to do lots of things in school. It is especially important to be culturally competent when you will most likely hold someone's life in your hands at some point. Classes in cultural competence are just as important (if not more) as basic science classes like biochem. People may not want to be forced to learn anatomy, but it is necessary for them to become quality physicians. Cultural competence classes are no different. Someone just rationalized giving a kidney transplant to white patients over black patients even though both have been known to have poor diets. If these blatant disparities can be construed as reasonable, then cultural competence classes are sorely needed.

What?

You take the "culturally competent" doctor.

I'll take any relatively humane doctor who knows his science and especially his diagnostic skills.

 

[LadyJubilee8_18]

I don't doubt that someone with a 25 can succeed in medical school, but I think it's around that score that the MCAT basically loses predictive value. Getting a 25 or higher basically means you took a science curriculum and might speak English at home. Nothing else. Why take it if you're going to use such a low threshold? I think using at least a few points higher to get into the average range would be a good start. Don't you want your doctor to be at least an average tester?

I took Princeton review and all the people in my class (including me) took diagnostic tests. We all took the science curriculum and spoke English at home, but everyone (except the girl who was retaking) scored lower than a 25. I got a 21 (though I pulled this number up 12 points. Thanks Prenceton Review ). For the last MCAT the average score was a 24 (8 in every section). 25 is better than average. Furthermore, as Brett pointed out earlier, many DO schools have averages far below 25 but they don't have 50% failure rates. So I guess someone with a 25 can succeed in medical school. The problem is, you don't think someone with a 25 can succeed, but you don't look at the information that tells you these individuals can. Usually when I think something, I try to verify. If I'm wrong, I change what I think. Because of application pressure, schools are able to choose people who have higher MCAT scores than the threshold for success. This inflates the minimum MCAT requirement. Not everyone can get in, so some qualified applicants are passed up.

As for what I said that confused you, I mean that some groups bring discrimination on themself and the group that they're associated with. I'm not saying this is totally right, but I am definitely saying it's not totally wrong. People have to make pre-judgements. If you see a cherry red metallic spiral on top of a cooktop, do you touch it? If you see a man in dirty clothes walking along the sidewalk, alternating between muttering to himself and screaming obscenities, do you get close? Those are extreme examples, but without even reading the details, I'll make a wager with you today that any terrorist that attacks the U.S. is Islamic, that any Crip or Blood is African American, and that any Klan member is white, as long as you'll take all those bets without researching individual cases prior. Sure, I'll lose on the occasional Tim McVeigh, but I'll end up rich and you'll end up bankrupt before it's all over.

I still don't think this is a good example. Sure, if you limit the definition of "gang members" to people who are in traditionally black street gangs (Crips and Bloods), the members will probably be black. This is not because all gang members are black, but because you chose black street gangs. Guess what? There are OTHER street gangs that are made up of different races. If you take a sample of all the street gangs, you'd start losing money really fast. Here's a list of NY street gangs starting with A:

* African Mafia
* American Guards
* Albanian Boys Incorporated
* Atlantic Guards
* American Born Chinese (ABC)
* Asian Boyz Gang (ABZ)
* Assyrian-Arab Soljaz
* Almighty_Gaylords
* Agat Blood Town
* ARMENIAN POWER (A.P)
For a comprehensive list of all street gangs in NY, you can visit
http://en.wikipedia.org/wiki/List_of_street_gangs
Here you can see there are Asian gangs, Armenian, Albanian, Arab, and (yes) Black gangs. And this is just the As of one city! Just think of the diversity you would find if you looked at ALL street gangs all across America--all the colors of the rainbow! But because you subscribe to stereotypes, you think all gang members are black and you treat all black people accordingly.

As for the terrorism, there are many non-Arab terrorist. People are terrorists for all sorts of reasons: here are a few terrorist groups who are not Arab:

Ku Klux Klan A racist organisation of mainly Anglosaxon Protestant Christians with a history of violence against Afro-Americans, Jewish People, and Catholics.

Lord's Resistance Army Christian/Pagan terrorist group

Jewish Defense League - United States

Shiv Sena A Hindu militant group, Shiv Sena or "The Army of Shiva the Destroyer"

Jemaah Islamiyah - Southeast Asia

Anti-Abortion Terrorists - United States

Aryan Nations

Most of the Arab terrorist groups on the list were just fronts for Al-Qaeda. Isn't learning fun? For a more comprehensive list of terrorist groups of all backgrounds go to http://en.wikipedia.org/wiki/Terrorist_groups#Left-wing_terrorists

So you see, it's not that all terrorist are Arabs, it's just that the terrorist groups you think of first are Arabs. Better watch your back around all those Hindus, Sikhs, Extreme left wing Whites, Extreme right wing Whites, Indians, Africans, and Southeast Asians too. Or you could just treat everyone like a human being and understand most people aren't out to blow $hit up. As you can see, stereotypes do not justify negative racially related judgments.

 

[LadyJubilee8_18]

What?

You take the "culturally competent" doctor.

I'll take any relatively humane doctor who knows his science and especially his diagnostic skills.

If I was a diabetic and I walked into the office of a doc who was relatively human and really knew his diagnostic tests but who felt blacks shouldn't get kidney transplants because they'll eat bad things and screw up the new kidney, where would that leave me? Dead. Why is everything such a zero sum game? Why can't there be docs who are culturally competent who also really know their science.

 

[MissMary]

From AMSA's Website:

WHAT DOES IT MEAN TO BE CULTURALLY COMPETENT?
Cultural competency is "a set of academic and personal skills that allow us to increase our understanding and appreciation of cultural differences between groups."25 Becoming culturally competent is a developmental process

Culture is a predominant force in shaping behavior, values and institutions. Not only do cultural differences exist, but they also impact health care delivery. Culturally competent providers appreciate family ties and realize that they are defined differently for each culture.8 Rather than being insulted by another culture's perspective, culturally competent providers welcome collaboration and cooperation. For example, a culturally competent physician who had been taking care of a Native American family for about five years noticed that the wife was depressed. The wife slowly revealed that she had been sexually assaulted by her uncle when she was young. The doctor started her on psychotherapy and antidepressants, which helped but did not resolve the underlying problems. After consulting with a Native American medicine man, who then met with the family, the physician and the patient learned that the woman had acquired a bad spirit from the incest. A traditional purification ceremony was performed that released the woman of the spirit and her depression.10

The website also talked about a Hmong child with epilepsy. The parents wanted to pursue tradiational Hmong methods of care and the physican, who was horrified, called CPS on them. The child ended up in foster care.

These are the types of situations indicate that more culturally sensitive physicans are needed. America will only become more and more diverse. When I was in high school, I was a member of the school's health occupation student association and we did a unit on cultural awareness. I remember hearing about cases where the health care provider unknowingly engaged in activities that were considered disrespectful to the patient and their family. There is no reason why doctor's shouldn't have to take a cultural competency course. It certainly won't hurt them in any way and it would be a shame for them to enter the class with resentment because **gasp** they have to learn about other cultures. Can it really be that bad? This type of training will help them develop skills that will teach them how to build a stronger relationship with their ethnic patients, which may result in better care.

 

[little_late_MD]

I've become a bit confused by the turn this thread has taken with regards to "cultural compentence." I thought the purpose of granting URM status was to bring in more minorities in underserved areas, because intrinsically they know more about a certain culture. However, the direction we seem to be going here is that all you really need is a "culturally competent" doctor to go serve in these areas. Wouldn't that negate the necessity of URM status? As long as you could find competent doctors to practice in these areas (perhaps a signed argeement stating such), couldn't we do away with race-based admissions standards?

 

[MissMary]

I've become a bit confused by the turn this thread has taken with regards to "cultural compentence." I thought the purpose of granting URM status was to bring in more minorities in underserved areas, because intrinsically they know more about a certain culture. However, the direction we seem to be going here is that all you really need is a "culturally competent" doctor to go serve in these areas. Wouldn't that negate the necessity of URM status? As long as you could find competent doctors to practice in these areas (perhaps a signed argeement stating such), couldn't we do away with race-based admissions standards?

Not necessarily. I think the idea is that physicans who develop a sense of cultural sensitivity will be able to provide better care for their "ethnic" patients.

However, this does not guarantee that physicans even would be willing to develop these skills or implement any of the suggested stategies. And it doesn't mean that patients' skepticism for a doctor of a different ethnic background would automatically disappear. Furthermore, cultural comp. classes are a nice supplement to what physicans-in training can learn from their ethnic colleagues.

But it does seem to be a step in the right direction. Many institutions are already using workshops and incentives to encourage this.

 

[little_late_MD]

Not necessarily. I think the idea is that physicans who develop a sense of cultural sensitivity will be able to provide better care for their "ethnic" patients.

However, this does not guarantee that physicans even would be willing to develop these skills or implement any of the suggested stategies. And it doesn't mean that patients' skepticism for a doctor of a different ethnic background would automatically disappear. Furthermore, cultural comp. classes are a nice supplement to what physicans-in training can learn from their ethnic colleagues.

But it does seem to be a step in the right direction. Many institutions are already using workshops and incentives to encourage this.

But what I asked was if we could develop these "culturally competent" doctors (and you have to assume for the purpose of this line of thought that we can), then would we need to continue with URM status?

My thinking is going like this: We need URMs to practice in areas that are underserved for the myriad of cultural reasons stated in numerous posts above. If we could train groups of doctors (or all doctors, I'm an optimist ) to be just as culturally aware/competent, and have them agree to serve in this needy areas, then couldn't we just do away with differing standards for different races.

Unless this isn't really about cultural understanding at all, and we are just using this "competence" arguement as a straw man.

 

[bananaface]

What?

You take the "culturally competent" doctor.

I'll take any relatively humane doctor who knows his science and especially his diagnostic skills.

That may work for you. But it doesn't work for everyone. Some patients have special needs. Those special needs people come from all walks of life, not just URM groups. Cultural competence entails things like understanding addiction, realizing that some patients do not have access to certain resources, understanding what keeps geriatric patients from adhering to their medication regimen, realizing and that some patients from certain groups expect to have family members higly involved in medical decisions and accomodating them, not looking certain people directly in the eye, knowing who may be offended when you point with your index finger, expecting that some people will use traditional remedies in addition to western medicine, and not automatically assuming that because someone falls into a racial/ethnic group that they will require accomodations. It's all about barrier awareness and knowing how to get around them. And, not resenting your patients for not fitting into the mold that you may have expected.

 

[MissMary]

In my response, I listed a few reasons why training cultural comp. doctors could not replace URM recruitment. I will make them more clear for you here:

1. Cultural competency training at universities is already being implemented. I am not sure how wide-spread this is or if this is required or voluntary. The ability to train cul. comp. doctors is there, but what is unknown is how many of these physicans in training actually want to attend these classes and how many intend to implement these skills. Brett suggested above that requiring these types of course may increase resentment. We know we don't need anymore of that.

2. Some patients will still prefer a physican from a similar ethnic background regardless. If all culturally competent physicans were White, where would this leave those patients?

3. What can be learned in a class room is limited. I doubt that the URM physican's ability to understand his/her minority patients' background can be duplicated 100% in a semester course. Nothing can compare to years of first-hand experience. So many URM physicans are still desperately needed. Furthermore, nonURMs can stand to learn a lot from their URM colleagues during medical school and residency with regard to cultural awareness.

This does not discredit the importance of cross-cultural training. The training received in these types of courses will no doubt help in cross-cultural communicatiuon and developing a more understanding relationship between the nonURM physican and the minority patient.

Anyway: URM recruitment increases the number of minorities in medicine.
Cultural Competency courses increases physicans' understanding of other cultures.
I'm still trying to understand a few things:

1. What makes you think there are different standards for URMs? Do URMs not have to work just as hard? What is this assumption that URMs are getting into med school with 20s and 2.5s? Are not all students (Black, White, Red, Blue..) who get into medical school qualified?

2. Why are ppl are so offended by race-based AA and not by gender-based AA? Furthermore, there are other groups that suffered under social discrimination in the past, who benefit from AA. Why does AA = leniency for URMs to you?

hmmmmm.....

 

[MoosePilot]

I took Princeton review and all the people in my class (including me) took diagnostic tests. We all took the science curriculum and spoke English at home, but everyone (except the girl who was retaking) scored lower than a 25. I got a 21 (though I pulled this number up CONSIDERABLY after the prep course). For the last MCAT the average score was a 24 (8 in every section). 25 is better than average. Furthermore, as Brett pointed out earlier, many DO schools have averages far below 25 but they don't have 50% failure rates. So I guess someone with a 25 can succeed in medical school. The problem is, you don't think someone with a 25 can succeed, but you don't look at the information that tells you these individuals can. Usually when I think something, I try to verify. If I'm wrong, I change what I think. Because of application pressure, schools are able to choose people who have higher MCAT scores than the threshold for success. This inflates the minimum MCAT requirement. Not everyone can get in, so some qualified applicants are passed up.



I still don't think this is a good example. Sure, if you limit the definition of "gang members" to people who are in traditionally black street gangs (Crips and Bloods), the members will probably be black. This is not because all gang members are black, but because you chose black street gangs. Guess what? There are OTHER street gangs that are made up of different races. If you take a sample of all the street gangs, you'd start losing money really fast. Here's a list of NY street gangs starting with A:

* African Mafia
* American Guards
* Albanian Boys Incorporated
* Atlantic Guards
* American Born Chinese (ABC)
* Asian Boyz Gang (ABZ)
* Assyrian-Arab Soljaz
* Almighty_Gaylords
* Agat Blood Town
* ARMENIAN POWER (A.P)
For a comprehensive list of all street gangs in NY, you can visit
http://en.wikipedia.org/wiki/List_of_street_gangs
Here you can see there are Asian gangs, Armenian, Albanian, Arab, and (yes) Black gangs. And this is just the As of one city! Just think of the diversity you would find if you looked at ALL street gangs all across America--all the colors of the rainbow! But because you subscribe to stereotypes, you think all gang members are black and you treat all black people accordingly.

As for the terrorism, there are many non-Arab terrorist. People are terrorists for all sorts of reasons: here are a few terrorist groups who are not Arab:

Ku Klux Klan A racist organisation of mainly Anglosaxon Protestant Christians with a history of violence against Afro-Americans, Jewish People, and Catholics.

Lord's Resistance Army Christian/Pagan terrorist group

Jewish Defense League - United States

Shiv Sena A Hindu militant group, Shiv Sena or "The Army of Shiva the Destroyer"

Jemaah Islamiyah - Southeast Asia

Anti-Abortion Terrorists - United States

Aryan Nations

Most of the Arab terrorist groups on the list were just fronts for Al-Qaeda. Isn't learning fun? For a more comprehensive list of terrorist groups of all backgrounds go to http://en.wikipedia.org/wiki/Terrorist_groups#Left-wing_terrorists

So you see, it's not that all terrorist are Arabs, it's just that the terrorist groups you think of first are Arabs. Better watch your back around all those Hindus, Sikhs, Extreme left wing Whites, Extreme right wing Whites, Indians, Africans, and Southeast Asians too. Or you could just treat everyone like a human being and understand most people aren't out to blow $hit up. As you can see, stereotypes do not justify negative racially related judgments.

You're right that the average is 24. That surprises me every time I hear it. Sometimes I wonder why I put out effort on the damn thing. I could have skipped the biology section and gotten the average. I could have skipped the PS section and made your threshold. Why did I bother?

If you haven't caught on by now, the first TPR diag is incredibly hard relative to any valid measure. I got a 27 on it and it was probably the third or fourth MCAT I'd ever taken, so I was very accustomed to the test. I got a 31 on the MCAT cold the first time I took it, prior to studying at all for it, so I'm well aware that, at least for me, the first diagnostic is deceiving.

See, you start to make a point and then you wander off into political correctness. Ok, I picked some traditionally black street gangs. Are the Albanians the most common? As for the terrorists, that one especially cracks me up. Just tell me, is my point valid or not? If I hear that American interests were attacked last night and I guess it was Islamic terrorists, what do you think my percent chance is of being right? 99%? More? So if I keep a completely neutral view of who these terrorists are that are attacking the U.S., am I increasing my chance of being right or decreasing? If I'm decreasing, is that smart? In exchange for what? Not making the good Muslims feel bad? Stereotypes are sometimes there for a reason. You take your cultural competency. I'm going to use reason.

 

[MoosePilot]

That may work for you. But it doesn't work for everyone. Some patients have special needs. Those special needs people come from all walks of life, not just URM groups. Cultural competence entails things like understanding addiction, realizing that some patients do not have access to certain resources, understanding what keeps geriatric patients from adhering to their medication regimen, realizing and that some patients from certain groups expect to have family members higly involved in medical decisions and accomodating them, not looking certain people directly in the eye, knowing who may be offended when you point with your index finger, expecting that some people will use traditional remedies in addition to western medicine, and not automatically assuming that because someone falls into a racial/ethnic group that they will require accomodations. It's all about barrier awareness and knowing how to get around them. And, not resenting your patients for not fitting into the mold that you may have expected.

I've heard the politically correct speil before. I'm sure I'll have to read that damn book "The spirit made me fall down" or whatever it is sometimes in that interest too. You define that as cultural competency. LJ thinks it's as important as biochem. I think it's important, but a lot of it is common sense and thus, not to be idealized. It takes 5 minutes to teach an enlisted airman most of the important customs needed to be able to function around Muslims. Which hand to use, what gestures not to make, what to do with your feet, how to behave towards women and children... it's not rocket science. Would I trade that for biochemistry? Would I rather have a doctor that knows why I'm non-compliant, or one that knows what to prescribe in the first place, should I care to take the medicine? Hmmmm... let me get back to you.

 

[little_late_MD]

In my response, I listed a few reasons why training cultural comp. doctors could not replace URM recruitment. I will make them more clear for you here:


3. What can be learned in a class room is limited. I doubt that the URM physican's ability to understand his/her minority patients' background can be duplicated 100% in a semester course. Nothing can compare to years of first-hand experience. So many URM physicans are still desperately needed. Furthermore, nonURMs can stand to learn a lot from their URM colleagues during medical school and residency with regard to cultural awareness.

My isssue here is that URM status is not based on the "awareness" of their "culture" by the minority candidate. It is based on skin color. While I'm not going to bring my own race into this, I can absolutely guarantee you that there are many black, indian, and latino folks who know as much about their cultural heritage as the white guy down the street does. That's the great thing about America, IMHO. We can quit identifying ourselves by the countries we've never been to, but are somewhere on our family tree, and embrace a collective identity known as American.

Anyway: URM recruitment increases the number of minorities in medicine.

I'm all for that, but I think Affirmative Action of any sort is a poor poor solution. It treats the symptoms, not the disease.

1. What makes you think there are difference standards for URMs? Do URMs not have to work just as hard? What is this assumption that URMs are getting into med school with 20s and 2.5? Are not all students (Black, White, Red, Blue..) who get into medical school qualified? or just the nonURM ones?

I would think that by definition AA programs create different standards. That checkbox isn't there for statistical purposes only. Do I think all students who get into medical school are qualified to be physicians? Absolutely not, but that has to do with the arbitrary nature of admissions, and not URM status. What bugs me is stratifying admissions standards by race. Whether people are willing to admit it or not, it exacerbates racial tensions in this country. It doesn't bring us together as a people, it sets us at each other's throats. It gets the fingers pointing, and the voices raised. True, AA status gets more minorities into medicine, but at what cost to our societal fabric?

2. Why are ppl are so offended by race-based AA and not by gender-based AA? Furthermore, there are other groups that suffered under social discrimination in the past, who benefit from AA. Why does AA = leniency for URMs to you?

It's not that AA=leniency, it's that AA creates different standards for different sets of people. AA action doesn't care a whit for cultural differences. It uses race to make up for decades discrimination. If that's our goal, then fine, so-be-it. But let's not put the guise of "cultural understanding" on it. I find that as distasteful as when people are pro-death penalty for its "deterrant value." Study after study has shown that the death penalty does not act as a significant deterrant. Call a spade, a spade. It's for vengence. Likewise, let's not paint a pretty face on affirmative action programs. They're there to equal out the numbers, and that's it. All this post-hoc ergo propter hoc analysis rationalizing it as anything else just serves to cover up the paternalistic nature of the program. At the end of the day, the rich white guys are still pulling the strings, no matter how many minorities we get in medicine. As a said before, AA is treating the symptoms, not the disease.

 

[MoosePilot]

Anyway: URM recruitment increases the number of minorities in medicine.
Cultural Competency courses increases physicans' understanding of other cultures.
I'm still trying to understand a few things:

1. What makes you think there are different standards for URMs? Do URMs not have to work just as hard? What is this assumption that URMs are getting into med school with 20s and 2.5s? Are not all students (Black, White, Red, Blue..) who get into medical school qualified?

2. Why are ppl are so offended by race-based AA and not by gender-based AA? Furthermore, there are other groups that suffered under social discrimination in the past, who benefit from AA. Why does AA = leniency for URMs to you?

hmmmmm.....

1. Look at the numbers. Here's a place we could refer you to studies out the whazoo. If you don't think there are different standards for URMs, then what is this "AA" that we're talking about? Why are we wasting our time yacking?

http://home.sandiego.edu/~e_cook/vault/medical/losangeles/ucla-med-97.html
http://home.sandiego.edu/~e_cook/vault/medical/sanfrancisco/ucsf-med-97.html

(Edit: SDN tends to snip long links... anyway we can fix that so it doesn't happen so often? It puts ellipses in the middle, which break the links.)

So there are URMs being admitted with sub-24, sub 3.0 in conjunction. Not just one measure of potential academic problems, but pretty much the whole show.

I'll tell you whether all students are qualified, when you define qualified to me.

2. There is no gender based AA in med school admissions.

 

[MissMary]

[/QUOTE]

MoosepilotSee, you start to make a point and then you wander off into political correctness. Ok, I picked some traditionally black street gangs. Are the Albanians the most common? As for the terrorists, that one especially cracks me up. Just tell me, is my point valid or not? If I hear that American interests were attacked last night and I guess it was Islamic terrorists, what do you think my percent chance is of being right? 99%? More? So if I keep a completely neutral view of who these terrorists are that are attacking the U.S., am I increasing my chance of being right or decreasing? If I'm decreasing, is that smart? In exchange for what? Not making the good Muslims feel bad? Stereotypes are sometimes there for a reason. You take your cultural competency. I'm going to use reason.


I think her objection (and mine as well) to your comments is that you seem to be suggesting that it is okay to treat all blacks like gang members or all arabs like terrorists. would it be appropriate to treat all whites as if they are members of the KKK? No, it would be completely inappropriate.


If I hear that American interests were attacked last night and I guess it was Islamic terrorists, what do you think my percent chance is of being right? 99%? More?

There is a difference between being aware of current events and stereotyping. Stereotyping is ugly. I'm shocked that you are still defending those comments. I suppose we are all lucky that not everyone thinks this way. No racial groups would get along at all. We would all take the worst things about each community and use it as a blanket approach to all inidividuals of that community. What an ugly world that would be.

 

[MissMary]

To Little Late: I agree. AA is about increasing the numbers of minorities. But it also helps minorities prevail over racism, creates more diversity in medical school and in Medicine, and offers nonURMs and URMs the opportunity to learn from each other in this setting. It isnt solving the problem, but women have come very far with the help of AA. As for URMs, our time hasnt come yet. There will be a day when AA is no longer needed, that time is not now.


To MoosePilot: 1. Your links don't work. 2. There are nonURMs being admitted with low scores as well. 3. There was a time when women did not have the same educational opportunities as men. AA helped them overcome the sexism that hindered their access to these resources. 4. Are you only concerned about AA in medicine? Or are all forms of AA wrong, according to u?

 

[LadyJubilee8_18]

1. Look at the numbers. Here's a place we could refer you to studies out the whazoo. If you don't think there are different standards for URMs, then what is this "AA" that we're talking about? Why are we wasting our time yacking?

http://home.sandiego.edu/~e_cook/va...csf-med-97.html
http://home.sandiego.edu/~e_cook/va...cla-med-97.html

So there are URMs being admitted with sub-24, sub 3.0 in conjunction. Not just one measure of potential academic problems, but pretty much the whole show.

I'll tell you whether all students are qualified, when you define qualified to me.

2. There is no gender based AA in med school admissions.

I can't open your links. Anyway, I doubt most URMs are being admitted with sub 24 and sub 3.0 in conjunction. The average MCAT scores for URM matriculates ranges from approximately 25-30. http://www.aamc.org/data/facts/2005/mcatgparaceeth.htm. I know there are students above and below the average, but I doubt large numbers of minorities are being admitted with very low scores. The reason why there is no gender bias in admissions NOW is because the number of women in medical school reflects the number of women in the population (50/50 women and men). When this goal is reached for minorities, racial bias will become obsolete also. Is AA a great tool to achieve this goal? No, but it's a start. Ultimately, educational reform will have to actually fix the problem.

AA does work to fix the symptoms and not the disease, but when there needs to be immediate change, sometimes you have to fake it 'till you make it (as Tyra Banks would say. I watch too much ANTM)

 

[LadyJubilee8_18]

See, you start to make a point and then you wander off into political correctness. Ok, I picked some traditionally black street gangs. Are the Albanians the most common? As for the terrorists, that one especially cracks me up. Just tell me, is my point valid or not? If I hear that American interests were attacked last night and I guess it was Islamic terrorists, what do you think my percent chance is of being right? 99%? More? So if I keep a completely neutral view of who these terrorists are that are attacking the U.S., am I increasing my chance of being right or decreasing? If I'm decreasing, is that smart? In exchange for what? Not making the good Muslims feel bad? Stereotypes are sometimes there for a reason. You take your cultural competency. I'm going to use reason.

I am shocked that you are still defending these racist generalizations! NO, MOST GANG MEMBERS AREN'T BLACK. They are not, THEY'RE NOT. I'm sorry, but this is a wrong assumption. Did you look at the list? Haven't you ever seen "Gangs of NY"?

Currently, Arab groups (specifically Al Qaeda) are the ones behind most major terrorist attacks. This is not always the case, nor will it always be the case. If you look at all terrorist attacks in history, you will find that there is much less of a change that Arab people were behind them. Besides, most Arabs are not terrorist. Treating ALL Arab people as though they were terrorist is wrong and racist. I'm not saying this because my view is irrational or because I'm trying to be PC, I'm saying it because it's true.

Besides walking down the street and being frightened because some guy has a disheveled appearance and is yelling obscenities is HARDLY comparable to walking down the street and being frightened because some guy is black. When the kids at school blamed you for setting those fires because you were the white kid in shabby clothes (and there were no black kids around), was that ok? Should they have judged you because you didn't appear to be as rich as the others? Looks like someone needs a course in cultural competence.

 

[MoosePilot]

MoosepilotSee, you start to make a point and then you wander off into political correctness. Ok, I picked some traditionally black street gangs. Are the Albanians the most common? As for the terrorists, that one especially cracks me up. Just tell me, is my point valid or not? If I hear that American interests were attacked last night and I guess it was Islamic terrorists, what do you think my percent chance is of being right? 99%? More? So if I keep a completely neutral view of who these terrorists are that are attacking the U.S., am I increasing my chance of being right or decreasing? If I'm decreasing, is that smart? In exchange for what? Not making the good Muslims feel bad? Stereotypes are sometimes there for a reason. You take your cultural competency. I'm going to use reason.

I think her objection (and mine as well) to your comments is that you seem to be suggesting that it is okay to treat all blacks like gang members or all arabs like terrorists. would it be appropriate to treat all whites as if they are members of the KKK? No, it would be completely inappropriate.


If I hear that American interests were attacked last night and I guess it was Islamic terrorists, what do you think my percent chance is of being right? 99%? More?

There is a difference between being aware of current events and stereotyping. Stereotyping is ugly. I'm shocked that you are still defending those comments. I suppose we are all lucky that not everyone thinks this way. No racial groups would get along at all. We would all take the worst things about each community and use it as a blanket approach to all inidividuals of that community. What an ugly world that would be.

Did you think that perhaps there was a reason I included the KKK in there? That was the hint to you PC thralls that I wasn't suggesting anyone treat every person of a certain race like the worst examples, because I thought all of you knew that white people can't be discriminated against. Right? White's aren't ever all thought to be racist, just like men aren't all ever thought to be potential rapists. Oh, wait, yes we are

The point is that it's not wrong to use your brain. If that's steretyping, then fine, I'm a horrible racist and I hate black people for maybe being in gangs, white people for maybe being the Klan, hispanic people for maybe being illegal immigrants, native indians for maybe being unemployed alcoholics, and asian indians for all being geeky virgins. The truth is that we've gotten to the point where it's against cultural standards to point out the elephant standing in the living room. I hate that kind of crap.

 

[MoosePilot]

I am shocked that you are still defending these racist generalizations! NO, MOST GANG MEMBERS AREN'T BLACK. They are not, THEY'RE NOT. I'm sorry, but this is a wrong assumption. Did you look at the list? Haven't you ever seen "Gangs of NY"?

Currently, Arab groups (specifically Al Qaeda) are the ones behind most major terrorist attacks. This is not always the case, nor will it always be the case. If you look at all terrorist attacks in history, you will find that there is much less of a change that Arab people were behind them. Besides, most Arabs are not terrorist. Treating ALL Arab people as though they were terrorist is wrong and racist. I'm not saying this because my view is irrational or because I'm trying to be PC, I'm saying it because it's true.

Besides walking down the street and being frightened because some guy has a disheveled appearance and is yelling obscenities is HARDLY comparable to walking down the street and being frightened because some guy is black. When the kids at school blamed you for setting those fires because you were the white kid in shabby clothes (and there were no black kids around), was that ok? Should they have judged you because you didn't appear to be as rich as the others? Looks like someone needs a course in cultural competence.

Ok, do you have a study for that? Seriously, maybe my assumption is wrong, but just shouting about it doesn't mean it's so. If it's not African Americans right now, then do you think it's whites? Do you think whites comprise the majority of street gangs in the U.S. right now?

Is there a difference between number of gangs and numbers of members of the gangs?

I take your point about times changing. During the "Gangs of New York" time setting, gang members were mostly European immigrants. Some change like that may again occur. There are some serious terrorist groups that aren't Islamic. S. America has a real problem with kidnapping. Groups like FARC are a problem. Great Britain had a problem with IRA. I think Basque separtists were a problem in Spain. I realize those things and I think that's the difference. I don't think that Muslims are innately terrorists or guaranteed to always be the majority of anti-American terrorists, just that they are now. I'll keep informed and when that changes, I'll stop thinking it. The information is true now and if I was going to bet on the religious identity of an anti-American terrorist, I'm not going to make a stupid guess just because it's more politically correct.

 

[MoosePilot]

LJ is right and I'm wrong, as far as I can tell. Most gang members seem to be Hispanic.

http://ojjdp.ncjrs.org/pubs/96natyouthgangsrvy/surv_6c.html

This is an older study, but I'm still looking for newer studies. Signs point to increased caucasian gang activity, but I haven't found any recent figures that are this clear.

 

[MoosePilot]

Looks like someone needs a course in cultural competence.

Yes, that's exactly what I need.

1. Do you think a class that I think is ******ed to begin with is going to radically reshape 31 years of opinions?

2. If I'm such a racist, why did you just discover it now, in an open conversation about race? Have I ever treated anyone differently on SDN because of their race?

I haven't. This is why I feel higher education sucks today. Bring up a controversial topic and there is only one right answer, only one expressable side of any discussion, and anyone deviating from the approved script will get called names at some point.

My ultimate opinion is that each person is unique and should be judged on themselves. Any other judgement is prejudice. Assuming an African American is culturally competent is prejudice and assuming a white isn't is prejudice. If you want to encourage these things, ask questions in the interview, but just favoring minorities because they're culturally sensitive and more likely to go back to their community is like just admitting white people without requiring them to submit GPA and MCAT, because statistically they're the high scorers anyway.

 

[LadyJubilee8_18]

Yes, that's exactly what I need.

1. Do you think a class that I think is ******ed to begin with is going to radically reshape 31 years of opinions?

2. If I'm such a racist, why did you just discover it now, in an open conversation about race? Have I ever treated anyone differently on SDN because of their race?

I haven't. This is why I feel higher education sucks today. Bring up a controversial topic and there is only one right answer, only one expressable side of any discussion, and anyone deviating from the approved script will get called names at some point.

My ultimate opinion is that each person is unique and should be judged on themselves. Any other judgement is prejudice. Assuming an African American is culturally competent is prejudice and assuming a white isn't is prejudice. If you want to encourage these things, ask questions in the interview, but just favoring minorities because they're culturally sensitive and more likely to go back to their community is like just admitting white people without requiring them to submit GPA and MCAT, because statistically they're the high scorers anyway.

I don't follow your posts closely, but I would think you don't go around posting derogatory things about other SDNer's racial backgrounds because

1) We have screen names so you really can't tell who is what unless they say it

2) You would get banned

The best way to find out how someone feels about race is to talk about race. If someone tends to make racist remarks, chances are they are racist. I don't think you are a flaming racist, but I do think you have some inaccurate ideas about certain groups of people. I believe you when you tell me what your ultimate opinion is.

That being said, this is not about who is racist and who isn't or what group comprises the highest percentage of gang members, it is about what works in medicine. No medical school assumes URMs are culturally competent while every other group is not. Every medical student has to take the classes; URMs don't get a free pass to go get ice cream during that time. The bold print is the exact reason why cultural competence classes can never replace URM recruitment. Many people won't understand the value of these classes and they won't take this knowledge to the bed side. Also, people tend to learn more about different cultures by interacting with members of these groups. Having a diverse class does volumes to promote cultural competence.

Making the assumption that URMs are more culturally sensitive to those who share their cultural background is not the same as admitting whites on the assumption that they will have higher scores anyway. Each ethnic group is probably more sensitive to members of their own ethnicity. Since Whites comprise about the same percentage in medical school as they do in the total population, we can be more confident that there are enough white doctors to take care of white patients. Since Asians are about four times more prevalent in medical school, we can be very confident that there are enough Asians to take care of Asian patients. Ideally, each doc will be culturally competent enough to care for any sort of patient, but if we can't depend on this, it's nice to know each American has the option of seeing a doc with whom they are comfortable. The problem with UNDER REPRESENTED minorities is that there aren't enough physicians of these groups to care for patients of these groups.

 

[Bernito]

Moose, quick question. If you do not believe in the URM system the way it is, why claim URM status on your application? (This is not meant to be offensive, there are definitely legitimate reasons, I would just like to hear yours.)

 

[little_late_MD]

No medical school assumes URMs are culturally competent while every other group is not. Every medical student has to take the classes; URMs don't get a free pass to go get ice cream during that time. The bold print is the exact reason why cultural competence classes can never replace URM recruitment. Many people won't understand the value of these classes and they won't take this knowledge available to them to the bed side. Also, people tend to learn more about different cultures by interacting with members of these groups. Having a diverse class does volumes to promote cultural competence.

Why is race the be-all and end-all of cultural differences? I don't really think that has been addressed in this thread. Let's take a broad definition of the word "culture." Should doctors have to take classes about the finance industry, automobile repair, italian cooking, or acrobatics, because there is a very real chance that they would have to interact with these "cultures," and their patients would feel more comfortable talking with someone who understands where they are coming from. Should medical schools actively recruit investment bankers, mechanics, chefs, and contortionists to increase diversity of all kinds? What kind of cultures wil qualify for this overarching "awareness" program? Who will makes those decisions?

Now that I think about it, I'll be sure to find an accountant who is familiar with my cultural heritage, because Lord knows my bookkeeping depends on it. You may think I'm being silly, but really, why is medicine different than any other profession?

 

[MoosePilot]

I don't follow your posts closely, but I would think you don't go around posting derogatory things about other SDNer's racial backgrounds because

1) We have screen names so you really can't tell who is what unless they say it

2) You would get banned

The best way to find out how someone feels about race is to talk about race. If someone tends to make racist remarks, chances are they are racist. I don't think you are a flaming racist, but I do think you have some inaccurate ideas about certain groups of people. I believe you when you tell me what your ultimate opinion is.

That being said, this is not about who is racist and who isn't or what group comprises the highest percentage of gang members, it is about what works in medicine. No medical school assumes URMs are culturally competent while every other group is not. Every medical student has to take the classes; URMs don't get a free pass to go get ice cream during that time. The bold print is the exact reason why cultural competence classes can never replace URM recruitment. Many people won't understand the value of these classes and they won't take this knowledge to the bed side. Also, people tend to learn more about different cultures by interacting with members of these groups. Having a diverse class does volumes to promote cultural competence.

Making the assumption that URMs are more culturally sensitive to those who share their cultural background is not the same as admitting whites on the assumption that they will have higher scores anyway. Each ethnic group is probably more sensitive to members of their own ethnicity. Since Whites comprise about the same percentage in medical school as they do in the total population, we can be more confident that there are enough white doctors to take care of white patients. Since Asians are about four times more prevalent in medical school, we can be very confident that there are enough Asians to take care of Asian patients. Ideally, each doc will be culturally competent enough to care for any sort of patient, but if we can't depend on this, it's nice to know each American has the option of seeing a doc with whom they are comfortable. The problem with UNDER REPRESENTED minorities is that there aren't enough physicians of these groups to care for patients of these groups.

1. It's pretty easy. Except for unusual instances like Shredder, people usually give their race away. However, by the time I know what race someone is on SDN, I know much more about them than that, so it's too late.

2. I've been on this site long enough and I'm perceptive enough that I think I know what's bannable and what's not. The mods try to do a good job warning people that they're approaching bannable territory and prefer to use a graduated response where they warn people, post hold, then ban. I could be pretty nasty and skate the line. Several posters have made an art of that, which I found despicable, but there you have it.

Name some inaccurate ideas. If you can point to facts, I'll change my opinions. I don't consider the musings of researchers, unsupported by their numbers "facts", but if you pull up a study that says in 2005 most gang members are white, I'll change my view. I've already changed it once today based on research.

Have you taken these courses? I'm constantly taking cultural and sexual awareness classes in the military. They dumb down the information to the point that it's no longer valuable and is just annoying. If it was at the same high standard as most education is held to, I'd be happy to learn more. I'm happy to learn more about people from them (but not enough to favor admitting them to med school just for that, I can learn from my patients as well as I can learn from other med students). So I agree that having a diverse class promotes cultural awareness (I hate the term cultural competence and will not use it for anything I value, so please realize that everytime you use it with me, it's got seriously negative connotations), but don't think that's worth racial discrimination to achieve.

Am I so weird? I learned early that discrimination solely on racial lines was wrong. I internalized that and believe it. I have some exceptions, including being willing to make very superficial judgements when the outcome is vital, I don't have the real in-depth information I need to make a better judgement, and the cost to the judged is minimal, so I do favor increased screening for Middle Easterners by airport security. For the most part, though, I don't think we should advance or hold back people based on their race. AA is a serious exception. It's the pendulum swinging the other way, when we want to stop it all together.

 

[LadyJubilee8_18]

This is why I feel higher education sucks today. Bring up a controversial topic and there is only one right answer, only one expressable side of any discussion, and anyone deviating from the approved script will get called names at some point.

I never called you a racist, I did say you were supporting racist generalizations. The suggestions that most gang members are black and that most terrorists are Arab are racist generalizations. Neither of these assertions are true. As we've seen, most gang members are not blacks. Also, most gang members are not Hispanic (most meaning over 50%), Hispanics just comprise a plurality of the gang members (or at least they did in 1996). Besides, I have been called names and my assertions have been rejected during this discussion also. You're just more aware of the derogatory notions that fly your way.

 

[MoosePilot]

Moose, quick question. If you do not believe in the URM system the way it is, why claim URM status on your application? (This is not meant to be offensive, there are definitely legitimate reasons, I would just like to hear yours.)

Several reasons.

1. I'm a pragmatist. I don't believe in the system. Does that mean I should put myself in the "discriminated against" category rather than the "discriminated for" category? I don't like any category. Would putting "other" be some sort of great protest against the system, worthy of hurting my chances of getting into medical school?

2. One pathway just required honesty. The other required me to twist my background to avoid being part of a system I disagree with. I checked white and I checked Native American. They can decide what to do with that true information. I'm pretty sure my long time top choice did nothing with it. I don't think they favor URMs except in recruiting. I'm equally sure that it helped me at a couple of schools, which bothers me.

3. I question what I did, especially now. I'm bothered by the fact that despite having a 36 MCAT, I'll always wonder whether I just got in because I checked that box.

 

[MoosePilot]

I never called you a racist, I did say you were supporting racist generalizations. The suggestions that most gang members are black and that most terrorists are Arab are racist generalizations. Neither of these assertions are true. As we've seen, most gang members are not blacks. Also, most gang members are not Hispanic (most meaning over 50%), Hispanics just comprise a plurality of the gang members (or at least they did in 1996). Besides, I have been called names and my assertions have been rejected during this discussion also. You're just more aware of the derogatory notions that fly your way.

What names have you been called in this discussion? I'm fairly sure I haven't called you anything, except PC. Do you find that offensive?

Ok, what if I said that URMs (the topic of this thread) made up the majority of gang members in that research? Does that make it less racist? It's wholly factual. Can something be totally factual and still racist? Would you avoid the truth because it's painful?

If I randomly picked 10 gang members in 1996, chances were that over 3 of them would have been black, over 4 of them would have been Hispanic, leaving 2 of them to be something else. Is that racist?

 

[LadyJubilee8_18]

Name some inaccurate ideas. If you can point to facts, I'll change my opinions. I don't consider the musings of researchers, unsupported by their numbers "facts", but if you pull up a study that says in 2005 most gang members are white, I'll change my view. I've already changed it once today based on research.

1. Most gang members are black
2. Most terrorists are Arab
3. You can't succeed in medical school with a 25 MCAT
4. Those with the highest numbers are the best qualified to be clinicians and to serve the US population
5. Cultural competence (yeah I said it ) is not needed.

Have you taken these courses? I'm constantly taking cultural and sexual awareness classes in the military. They dumb down the information to the point that it's no longer valuable and is just annoying. If it was at the same high standard as most education is held to, I'd be happy to learn more. I'm happy to learn more about people from them (but not enough to favor admitting them to med school just for that, I can learn from my patients as well as I can learn from other med students). So I agree that having a diverse class promotes cultural awareness (I hate the term cultural competence and will not use it for anything I value, so please realize that everytime you use it with me, it's got seriously negative connotations), but don't think that's worth racial discrimination to achieve.Am I so weird? I learned early that discrimination solely on racial lines was wrong. I internalized that and believe it. I have some exceptions, including being willing to make very superficial judgements when the outcome is vital, I don't have the real in-depth information I need to make a better judgement, and the cost to the judged is minimal, so I do favor increased screening for Middle Easterners by airport security. For the most part, though, I don't think we should advance or hold back people based on their race. AA is a serious exception. It's the pendulum swinging the other way, when we want to stop it all together.

I have not taken these courses, but then again I'm not in the military. You seem to resent having to take courses about cultural and sexual awareness. Have you ever been raped? Anyone you know been killed because of racism? The point is, it's never a bad idea to teach a large group of men who are trained to be violent (for whatever purpose) to be aware of cultural and sexual boundaries. You talk about the pendulum swinging the other way, so you admit there were literally centuries where these groups (URMs) were actively stifled. Until 1965 most blacks weren't even allowed in the nice hospitals, let alone able to pursue medicine. If you spend 300+ years disrupting the achievement of a certain group, it will take some work to repair the damage done. Is it any wonder that without real programs to actively remedy these past scars, 40 years hasn’t been enough to make the corrections? The problem is that AA is too little too late. Anything that works to correct disparities isn't a bad thing in my book. It's not racism, it's a measure of correcting past ailments. Unfortunately, these ailments were imposed along racial lines.

 

[LadyJubilee8_18]

What names have you been called in this discussion? I'm fairly sure I haven't called you anything, except PC. Do you find that offensive?

Ok, what if I said that URMs (the topic of this thread) made up the majority of gang members in that research? Does that make it less racist? It's wholly factual. Can something be totally factual and still racist? Would you avoid the truth because it's painful?

If I randomly picked 10 gang members in 1996, chances were that over 3 of them would have been black, over 4 of them would have been Hispanic, leaving 2 of them to be something else. Is that racist?

(10-4-3=3 by the way)

I have been called irrational, brainwashed, narrow-minded, and a drone who buys into conspiracies. Someone even doubted that I deserve to be at Baylor BECAUSE I AM A URM. All this in one thread! Look, if you showed the table and said that the majority of gang members were URMs that would be true and not racist, but this is not what you said. I never made the assertion that most gang members were white. Again, I reiterate: this is not about what groups are most likely to be gang members, it is about medicine...a topic in medicine even.

 

[Bernito]

Would putting "other" be some sort of great protest against the system, worthy of hurting my chances of getting into medical school?

I believe it would have been a great protest. Change happens first on the individual level. Now you leave yourself open to question because outwardly it appears that your are saying "well it is ok for me but not everyone else."

3. I question what I did, especially now. I'm bothered by the fact that despite having a 36 MCAT, I'll always wonder whether I just got in because I checked that box.

You are speaking as if you are 1 dimensional. There is much more to each applicant than his/her MCAT score, and that is why there is a push for less reliance on standardized test scores and med schools are responding.

I am glad that you did check URM because obviously your background was a factor in your life making it all the more impressive that you are even in the position to pursue medicine at all. Lets not shut the door on others that may not be able to overcome the same obstacles, ay?

 

[MoosePilot]

1. Most gang members are black
2. Most terrorists are Arab
3. You can't succeed in medical school with a 25 MCAT
4. Those with the highest numbers are the best qualified to be clinicians and to serve the US population
5. Cultural competence (yeah I said it ) is not needed.

I have not taken these courses, but then again I'm not in the military. You seem to resent having to take courses about cultural and sexual awareness. Have you ever been raped? Anyone you know been killed because of racism? The point is, it's never a bad idea to teach a large group of men who are trained to be violent (for whatever purpose) to be aware of cultural and sexual boundaries. You talk about the pendulum swinging the other way, so you admit there were literally centuries where these groups (URMs) were actively stifled. Until 1965 most blacks weren't even allowed in the nice hospitals, let alone able to pursue medicine. If you spend 300+ years disrupting the achievement of a certain group, it will take some work to repair the damage done. Is it any wonder that without real programs to actively remedy these past scars, 40 years hasn’t been enough to make the corrections? The problem is that AA is too little too late. Anything that works to correct disparities isn't a bad thing in my book. It's not racism, it's a measure of correcting past ailments. Unfortunately, these ailments were imposed along racial lines.

1. I've changed my opinion on that. Mea culpa.
2. I've qualified it numerous times with most current anti-American terrorists are Muslims. I doubt there is an accurate census and I don't know the proportion of European separatists, S. American narco-terrorists, and Islamic fundies. You're more than welcome to correct me. How many anti-American terrorists have been non-Muslim in the last 20 years?
3. I never said that you *can't* succeed. As a matter of fact, I've said that you clearly *can* succeed. I just believe that the MCAT loses predictive power at around that point. I could take a random guy out of a class, offer him a million bucks if he passed medical school, and without taking the MCAT he *could* succeed. Without any science pre-reqs you *can* succeed. Over 90% of people that get into med school pass. Just getting in is the best predictor of who's going to finish and it has greater than .9 correlation.
4. Ok, what if I turned it around. Prove that those without the best numbers are more likely to succeed? Even among URMs, the adcoms pick those with the best numbers. Why is that? Why don't they just take a certain number out of the middle? For that matter, since there have been so many appeals to authority in this thread, why aren't there totally representative numbers right now in med school? The Adcoms could do it, couldn't they? Why don't they?
5. Prove that it is. Hell, I'd wager you couldn't define cultural competency in a way that you could pass a test written on it and I couldn't. If you can't prove that you have it and I don't without looking at us, how is that fair?

As for whether I've been raped or someone I know has been killed for their race, no. I've never had a vagina, either, but med school is still going to require me to learn to treat the 50% of the population who does. Empathy doesn't require that you experience something to understand it. Have you ever spent food stamps on groceries? Have you ever stood in a line outside the same church where you went to scouts for free cheese and peanut butter? Have you ever had to present a card in a crowded elementary lunch line to get your free meal? Do you need to do those things before you can empathize with me?

Do I admit that there were centuries that URMs were stifled?

Dude, I disagree with you, I'm not one of those people who denies the holocaust and thinks the lunar landing was done in a Hollywood set. I read a book about a young man who got pulled away from his family and forcibly reconditioned to favor white ways over Native American. He couldn't even stay with his family when he wanted to, let alone go to medical school. Hell, yes, URMs have faced nasty conditions in America in the past. I'm for fixing that and erasing it. You don't eliminate racial discrimination by institutionalizing it in the reverse of the historical precedent.

Define racism and define AA. It's not fair of me to ask something of you that I won't do, so:

Racism: Discrimination or prejudice based on race. (2nd definition found at http://www.answers.com/racism&r=67, picked the 2nd, because it's closer to my personal definition).

AA in med school: Actively admitting URMs over others based solely on their race and specifically when they probably wouldn't have gotten in due to MCAT, GPA, ECs, and LORs.

That's discrimination and racism.

 

[LadyJubilee8_18]

Why is race the be-all and end-all of cultural differences? I don't really think that has been addressed in this thread. Let's take a broad definition of the word "culture." Should doctors have to take classes about the finance industry, automobile repair, italian cooking, or acrobatics, because there is a very real chance that they would have to interact with these "cultures," and their patients would feel more comfortable talking with someone who understands where they are coming from. Should medical schools actively recruit investment bankers, mechanics, chefs, and contortionists to increase diversity of all kinds? What kind of cultures wil qualify for this overarching "awareness" program? Who will makes those decisions?

Now that I think about it, I'll be sure to find an accountant who is familiar with my cultural heritage, because Lord knows my bookkeeping depends on it. You may think I'm being silly, but really, why is medicine different than any other profession?

Racial identities are important because people make them so. It's for the same reason that money is important--because people make it so. We happen to live in a society that has allways and will always be obsessed with race. Race and ethnicity matters to people before all other differences--especially because this difference will never change. I am an artist, I am a student, I am pre-med, I am a young, I am politically aware--but any of these attributes could (and probably will change) in the next ten years. I have always been and I will always be black. I have been raised in a certain culture and I have experienced certain things because I am black. If we had a group meeting today and I walked into the room, the first thing you would notice is that I'm black. It's how people function in this country. Race is important because it's like that and that's the way it is (in the words of RUN DMC). We all know it.

As for other forms of diversity, medical schools do try to recruit students of diverse experiences. They encourage students with different majors to apply. They ask all kinds of questions in interviews and on secondaries about your unique, individual experience. They even include a PERSONAL statement. As mentioned before 26% of admissions is determined by numbers. the other 76% could not possibly be determined ONLY by race.

 

[MoosePilot]

(10-4-3=3 by the way)

I have been called irrational, brainwashed, narrow-minded, and a drone who buys into conspiracies. Someone even doubted that I deserve to be at Baylor BECAUSE I AM A URM. All this in one thread! Look, if you showed the table and said that the majority of gang members were URMs that would be true and not racist, but this is not what you said. I never made the assertion that most gang members were white. Again, I reiterate: this is not about what groups are most likely to be gang members, it is about medicine...a topic in medicine even.

Smart ass. 10 - 4.4 - 3.5 = 2.1, by the way. I'm disappointed that you made that comment when the source of my numbers was posted and I quite clearly said "over 4" and "over 3", giving you the subtle hint to the fractional difference.

 

[MoosePilot]

I believe it would have been a great protest. Change happens first on the individual level. Now you leave yourself open to question because outwardly it appears that your are saying "well it is ok for me but not everyone else."

You are speaking as if you are 1 dimensional. There is much more to each applicant than his/her MCAT score, and that is why there is a push for less reliance on standardized test scores and med schools are responding.

I am glad that you did check URM because obviously your background was a factor in your life making it all the more impressive that you are even in the position to pursue medicine at all. Lets not shut the door on others that may not be able to overcome the same obstacles, ay?

I think it would have been a crappy protest. Akin to not voting in an election. Nobody sees the point, nothing happens.

Ah. I use shorthand. I always expect people to follow me. Also, my MD applicants profile is attached. My GPA was below average at many medical schools. My ECs were probably average. My life experiences were well above average. In my opinion, I would have gotten into allo schools without checking the box, but it doesn't matter anymore. No way to test my theory (although I've heard that a school I'm very likely to go to allows access to your records a few years into your education there, so I can see if any commments were made about my racial background).

My point is that it's the background that makes me unique. I want the kid who is the poor white part of me to have the same chance as the kid who is the poor Indian part of me. It's important to me to note what the applicant has gone through. My children hopefully won't have the same background I do, I don't want them to have the same consideration for it that I did.

 

[LadyJubilee8_18]

1. I've changed my opinion on that. Mea culpa.
2. I've qualified it numerous times with most current anti-American terrorists are Muslims. I doubt there is an accurate census and I don't know the proportion of European separatists, S. American narco-terrorists, and Islamic fundies. You're more than welcome to correct me. How many anti-American terrorists have been non-Muslim in the last 20 years?
3. I never said that you *can't* succeed. As a matter of fact, I've said that you clearly *can* succeed. I just believe that the MCAT loses predictive power at around that point. I could take a random guy out of a class, offer him a million bucks if he passed medical school, and without taking the MCAT he *could* succeed. Without any science pre-reqs you *can* succeed. Over 90% of people that get into med school pass. Just getting in is the best predictor of who's going to finish and it has greater than .9 correlation.
4. Ok, what if I turned it around. Prove that those without the best numbers are more likely to succeed? Even among URMs, the adcoms pick those with the best numbers. Why is that? Why don't they just take a certain number out of the middle? For that matter, since there have been so many appeals to authority in this thread, why aren't there totally representative numbers right now in med school? The Adcoms could do it, couldn't they? Why don't they?
5. Prove that it is. Hell, I'd wager you couldn't define cultural competency in a way that you could pass a test written on it and I couldn't. If you can't prove that you have it and I don't without looking at us, how is that fair?

2. Look how we start to add qualifiers: most terrorists who have attacked the US from foreign nations in very recent history. (yes there are terrorist groups who attack US citizens from US soil).
3. You make it sound like people with 25 could, on an off chance, succeed but they are not likely to do so. The point of the thresholds is to pick people who will almost definitely succeed. What would adcoms have to gain by picking a bunch of people who can't do the work and who will not eventually become docs? All I'm saying is, I trust the judgment of the AMA, AAMC, and all the adcomes who decided this was the proper plan of action over you. I'm sorry if that offends you, but when people with more education, more resources, a vested interest in the subject, and have done more research have a different viewpoint than you do--you probably aren't correct.
4. People who have higher MCAT scores are more likely to have higher USMLE scores and do better on written tests. This is not the same thing as being more likely to have satisfied patients, being more able to inspire trust and loyalty from patients, being more open to the needs of others, having the drive to do whatever it takes to further the needs of health care, or being culturally competent enough to disregard prejudice when treating certain patients.
5. Is there evidence that cultural competence is needed? yes. Have there been instances where culturally incompetent doctors have compromised patient health and have cost people's lives? yes. Do I have some "Cultural Competence" quiz from quizland.com so that I can prove I have it and you don't? No Would it make you happier if I said "culturally competent doctors are 95% more qualified to serve the US population"? Again, very intelligent people subscribe to this idea (but maybe they are just trying to secure the minority vote again).

As for whether I've been raped or someone I know has been killed for their race, no. I've never had a vagina, either, but med school is still going to require me to learn to treat the 50% of the population who does. Empathy doesn't require that you experience something to understand it. Have you ever spent food stamps on groceries? Have you ever stood in a line outside the same church where you went to scouts for free cheese and peanut butter? Have you ever had to present a card in a crowded elementary lunch line to get your free meal? Do you need to do those things before you can empathize with me?

I wasn't suggesting that people have to experience everything in order to be empathetic, I was suggesting that if teaching cultural competence and sexual awareness can potentially prevent individuals from participating in these heinous acts, having to sit through a boring class is a small price to pay. The person who is raped or killed because of discrimination suffers much more than the person who has to sit through an hour long class.

Do I admit that there were centuries that URMs were stifled?

Why is that funny? 200 years of slavery followed by 100 years of segrigation (and rampant lynchings) aren't funny to me. That's one...two...three centuries. That counts as centuries, right? And stifling right? Native Americans can claim similar setbacks. The US just hasn't been kind to certain groups

Dude, I disagree with you, I'm not one of those people who denies the holocaust and thinks the lunar landing was done in a Hollywood set. I read a book about a young man who got pulled away from his family and forcibly reconditioned to favor white ways over Native American. He couldn't even stay with his family when he wanted to, let alone go to medical school. Hell, yes, URMs have faced nasty conditions in America in the past. I'm for fixing that and erasing it. You don't eliminate racial discrimination by institutionalizing it in the reverse of the historical precedent.

You're just one of those people who laughs at the notion that slavery and segregation/inequality ever existed? So how do you eliminate the disparities created by racial injustice if not by trying to rebuild the same specific racial communities? Can you find a better solution that does not have to target race specifically even though the prejudice did? You can't subjugate people based on race but then ignore race in the solution.

Define racism and define AA. It's not fair of me to ask something of you that I won't do, so:

Racism: Discrimination or prejudice based on race. (2nd definition found at http://www.answers.com/racism&r=67, picked the 2nd, because it's closer to my personal definition).

AA in med school: Actively admitting URMs over others based solely on their race and specifically when they probably wouldn't have gotten in due to MCAT, GPA, ECs, and LORs.

That's discrimination and racism.

Nice how you tried to be so accurate with the Racism definition, but not with the definition of AA. I'll help:

Affirmative Action as explained by the AAMC:

The Association of American Medical Colleges is deeply committed to increasing diversity in medical schools. This commitment extends to increasing the number of minority physicians available to serve the nation's ever-growing minority population, expanding areas of research undertaken by medical academics, and raising the general cultural competence of all physicians.

On June 23, 2003, the United States Supreme Court upheld affirmative action in university admissions, permitting the nation's medical schools to continue developing a physician workforce that truly mirrors our society. The AAMC has analyzed the implications for medical schools and offers guidance to help schools enhance diversity.

Let me guess, too PC?