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- Jul 17, 2015
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Med school admissions / diversity self.premed
Submitted 8 months ago * by josocml19
I apologize for the long post and if the content offends any of you. Sorry if some points aren't as cohesive or if there is a disjointed flow but I was typing this at 3 in the morning.
__
I have lurked /r/premed for a long time and have really valued the sense of community in this subreddit. I am writing this post partly due to the response that jamal417’s (even if trolling) post ensued (Congrats btw!).
While my post seeks to contextualize some issues that came up in jamal417’s post and which I hope future medical providers are aware of, I also want to stress the importance of not discrediting anyone’s achievements even if you believe they weren’t justly earned. While in your eyes a med school admit “[doesn’t] deserve a spot” or if you think that “others worked harder”, / that “a typical Asian or Caucasian male with these stats would have his application spat on and shredded by the adcoms;” it is not up to you to downplay their achievements. Medical schools have thousands of applicants and it is only up to them to determine who they think might make a good doctor. Reading some of the posts today made me reflect on the attitudes, and biases deeply ingrained in some of us; for instance, someone said “removing all the blacks would make this country a much better place.” This concerns me as I can only imagine that these prejudices may/will materialize in one way or another in patient care.
Medical schools could easily select those with 4.0s, 35+ MCATs, and impressive research experiences, but they don’t. This is because they have a huge social responsibility in training the individuals who will be treating society’s ailments in the future; hence, applicants who demonstrate compassion on top of scientific curiosity/academic excellence (more about this later) are the ones to most likely successfully gain an acceptance. It is also key to understand that our society is increasingly becoming more diverse, and a more diverse/culturally competent workforce is necessary to adequately treat the needs of everyone. For starters, as often mentioned in /r/premed to justify the lower stats for URM gaining acceptance to medical school, minorities are more likely to practice in underserved areas 1, 2. But there’s more to it.
Given my limited experience working as a community advocate for 2 years prior to medical school and having almost finished MS1, I disagree with comments like “I’m struggling to see how having non-white physicians will greatly impact the quality of care our patients receive.” Yes, you can be white and come from a privileged/disadvantaged background and be culturally competent/intend to work with underserved populations, however, while acquired culturally competence may allow you to better understand and communicate with your patients, barriers may still remain that prevent patients from relating to the provider. As we talk about our cultural competence, we subjectively say we have the ability to optimally care for everyone regardless of race. That, however, doesn’t take into account the most important factor in the equation, the patients, who may report dissatisfaction in the delivery of care due to gaps in cultural competence. This has enormous consequences in longitudinal care as there may be language barriers, miscommunication gaps, decreased patient participation that ultimately hinder quality patient care. While a physician of any background would likely be equipped to treat any patient and may in fact succeed in doing so, optimal longitudinal care is facilitated/improved by providers with whom patients can identify. From personal experience and having worked with the underserved for the last 6 years, I can attest that patients feel more comfortable when they can identify with the provider. I’ve had patients often tell me that even though they thought the physician was congenial, they weren't fully satisfied as they were unable to fully understand their condition or to ask questions/complain about issues. This is unfortunate as I’ve seen it lead to repeat visits to the ED since patients do not care for themselves as they should due to multiple barriers.
The medical field pipeline problem is rooted in inequalities that impact individuals early on, as many students from disadvantaged backgrounds often face challenges that hinder high school/college graduation. I believe that this problem extends beyond race as many ORM applicants also come from disadvantaged backgrounds. Medical schools are very aware of that; for instance, the medical school I’m at takes the “disadvantaged statement” very seriously regardless of the applicant’s race/ethnicity. However, the reality is that more often than not, URM students are more likely to come from a low-income/disadvantaged household.
Regarding comments like “I'm not willing to risk my life for the sake of ‘diversity’. If they can't make the cut, don't make them doctors.”: In my case, I started off college on the wrong foot, having attended a low-performing high school, lack of optimal proficiency in the English language, and financial burdens. As a result, I ended up getting some Cs in my transcript. That, however, changed my last two years of college as I bettered my studying skills and managed to make it to the dean’s list my last 4 quarters. Given the academic rigor inherent to medicine, medical schools deeply value academic excellence; however, they are becoming better at contextualizing the stats in relation to the applicant’s story. I know, for example, that at my school an upward trend is very well regarded if the applicant can adequately contextualize any low-performing quarters/semesters. While some may say that I didn’t “make the cut,” I did show continuous improvement and strived to participate in experiences that would allow me to work with community members from all walks of life. Along the same vein, someone said “I don't want my well-being in the hands of someone who was only accepted into medical school to ‘help their underrepresented community’.” I believe that while various achievements (or lack thereof) may play out in medical school admissions, once admitted, all students are held to the same standards and need to pass the boards in order to become licensed.
This conversation can be extended to include controversial topics like admitting URMs in order to rectify historical social injustices, institutional and internalized racism, etc but I wanna spare /r/premed from spurring heated debates... and I wanna sleep. Instead of being resentful or complaining about the admissions process, you could maybe be thankful for any advantages/privileges you may have had or if you come from a disadvantaged background like me, continue working hard, it will pay off!
About me
I am currently an MS1 at a top 5 medical school. During my application cycle, I applied with a 34 MCAT and a GPA that was below my school’s 10th percentile. I applied to about 30 schools and got interviews to all but 5 schools; I ended up going to only 8 interviews and got into all of the schools I interviewed at.
Due to socioeconomic difficulties, my family immigrated to the US when I was 14. Being undocumented in the US drastically shaped my experience in high school and college. During high school, my family lived in a trailer with other relatives, and I had to stay up late or get up very early to get work done as the living room doubled as my bedroom. My high school experience was very alienating; other students often made fun of my accent and some teachers were discouraging (one English teacher once told me she couldn’t give me an A because “I didn’t speak well” though I had a 94% in the class). In spite of all that, I always thought that doing well in school was “my way out.” My parents were very supportive of my school endeavors but they could only do so much as each of them worked 70+ hours/week. Additionally, the healthcare system remained out of reach as we didn’t qualify for Medicaid due to our undocumented status and couldn’t afford insurance. Several times I witnessed family members endure extreme pain as we were afraid of seeing a doctor or going to the ED. In college I became very passionate about bridging the same disparities that my family had faced so I became involved in lots of activities aimed at improving the quality of life of the underserved. Simultaneously, I struggled in college, getting Cs and Bs in science classes as I had to work in order to finance my education. Thankfully, my study habits improved over time. I did research, but I did not really enjoy it.
Throughout college I was an introvert as I always worried that people would judge me because of how I looked and spoke (given my high school experience). Besides that, I was actually embarrassed of saying I was premed, as advisors and peers made it seem like I needed a stellar GPA and other activities I was precluded from given my undocumented status. In science labs, I always felt that I needed to prove myself so that my labmates wouldn't think I didn't understand the material. I was terrified of taking the MCAT since I thought I would do horribly. I also felt extremely self-conscious of people arguing that I was taking a more qualified applicant’s spot both in college and med school; in the end, however, I was too determined to make a difference in underserved communities to give up on my dream. Applying to med school was my secret, I didn’t wanna tell anyone since I didn’t think I stood a chance. I was, however, determined to apply multiple times before giving up. I bring up all of these points to exemplify that being a URM/disadvantaged may result in overcoming challenges/stigmas that other students may never think about.
Edit: sentence structure changes for clarity.
Submitted 8 months ago * by josocml19
I apologize for the long post and if the content offends any of you. Sorry if some points aren't as cohesive or if there is a disjointed flow but I was typing this at 3 in the morning.
__
I have lurked /r/premed for a long time and have really valued the sense of community in this subreddit. I am writing this post partly due to the response that jamal417’s (even if trolling) post ensued (Congrats btw!).
While my post seeks to contextualize some issues that came up in jamal417’s post and which I hope future medical providers are aware of, I also want to stress the importance of not discrediting anyone’s achievements even if you believe they weren’t justly earned. While in your eyes a med school admit “[doesn’t] deserve a spot” or if you think that “others worked harder”, / that “a typical Asian or Caucasian male with these stats would have his application spat on and shredded by the adcoms;” it is not up to you to downplay their achievements. Medical schools have thousands of applicants and it is only up to them to determine who they think might make a good doctor. Reading some of the posts today made me reflect on the attitudes, and biases deeply ingrained in some of us; for instance, someone said “removing all the blacks would make this country a much better place.” This concerns me as I can only imagine that these prejudices may/will materialize in one way or another in patient care.
Medical schools could easily select those with 4.0s, 35+ MCATs, and impressive research experiences, but they don’t. This is because they have a huge social responsibility in training the individuals who will be treating society’s ailments in the future; hence, applicants who demonstrate compassion on top of scientific curiosity/academic excellence (more about this later) are the ones to most likely successfully gain an acceptance. It is also key to understand that our society is increasingly becoming more diverse, and a more diverse/culturally competent workforce is necessary to adequately treat the needs of everyone. For starters, as often mentioned in /r/premed to justify the lower stats for URM gaining acceptance to medical school, minorities are more likely to practice in underserved areas 1, 2. But there’s more to it.
Given my limited experience working as a community advocate for 2 years prior to medical school and having almost finished MS1, I disagree with comments like “I’m struggling to see how having non-white physicians will greatly impact the quality of care our patients receive.” Yes, you can be white and come from a privileged/disadvantaged background and be culturally competent/intend to work with underserved populations, however, while acquired culturally competence may allow you to better understand and communicate with your patients, barriers may still remain that prevent patients from relating to the provider. As we talk about our cultural competence, we subjectively say we have the ability to optimally care for everyone regardless of race. That, however, doesn’t take into account the most important factor in the equation, the patients, who may report dissatisfaction in the delivery of care due to gaps in cultural competence. This has enormous consequences in longitudinal care as there may be language barriers, miscommunication gaps, decreased patient participation that ultimately hinder quality patient care. While a physician of any background would likely be equipped to treat any patient and may in fact succeed in doing so, optimal longitudinal care is facilitated/improved by providers with whom patients can identify. From personal experience and having worked with the underserved for the last 6 years, I can attest that patients feel more comfortable when they can identify with the provider. I’ve had patients often tell me that even though they thought the physician was congenial, they weren't fully satisfied as they were unable to fully understand their condition or to ask questions/complain about issues. This is unfortunate as I’ve seen it lead to repeat visits to the ED since patients do not care for themselves as they should due to multiple barriers.
The medical field pipeline problem is rooted in inequalities that impact individuals early on, as many students from disadvantaged backgrounds often face challenges that hinder high school/college graduation. I believe that this problem extends beyond race as many ORM applicants also come from disadvantaged backgrounds. Medical schools are very aware of that; for instance, the medical school I’m at takes the “disadvantaged statement” very seriously regardless of the applicant’s race/ethnicity. However, the reality is that more often than not, URM students are more likely to come from a low-income/disadvantaged household.
Regarding comments like “I'm not willing to risk my life for the sake of ‘diversity’. If they can't make the cut, don't make them doctors.”: In my case, I started off college on the wrong foot, having attended a low-performing high school, lack of optimal proficiency in the English language, and financial burdens. As a result, I ended up getting some Cs in my transcript. That, however, changed my last two years of college as I bettered my studying skills and managed to make it to the dean’s list my last 4 quarters. Given the academic rigor inherent to medicine, medical schools deeply value academic excellence; however, they are becoming better at contextualizing the stats in relation to the applicant’s story. I know, for example, that at my school an upward trend is very well regarded if the applicant can adequately contextualize any low-performing quarters/semesters. While some may say that I didn’t “make the cut,” I did show continuous improvement and strived to participate in experiences that would allow me to work with community members from all walks of life. Along the same vein, someone said “I don't want my well-being in the hands of someone who was only accepted into medical school to ‘help their underrepresented community’.” I believe that while various achievements (or lack thereof) may play out in medical school admissions, once admitted, all students are held to the same standards and need to pass the boards in order to become licensed.
This conversation can be extended to include controversial topics like admitting URMs in order to rectify historical social injustices, institutional and internalized racism, etc but I wanna spare /r/premed from spurring heated debates... and I wanna sleep. Instead of being resentful or complaining about the admissions process, you could maybe be thankful for any advantages/privileges you may have had or if you come from a disadvantaged background like me, continue working hard, it will pay off!
About me
I am currently an MS1 at a top 5 medical school. During my application cycle, I applied with a 34 MCAT and a GPA that was below my school’s 10th percentile. I applied to about 30 schools and got interviews to all but 5 schools; I ended up going to only 8 interviews and got into all of the schools I interviewed at.
Due to socioeconomic difficulties, my family immigrated to the US when I was 14. Being undocumented in the US drastically shaped my experience in high school and college. During high school, my family lived in a trailer with other relatives, and I had to stay up late or get up very early to get work done as the living room doubled as my bedroom. My high school experience was very alienating; other students often made fun of my accent and some teachers were discouraging (one English teacher once told me she couldn’t give me an A because “I didn’t speak well” though I had a 94% in the class). In spite of all that, I always thought that doing well in school was “my way out.” My parents were very supportive of my school endeavors but they could only do so much as each of them worked 70+ hours/week. Additionally, the healthcare system remained out of reach as we didn’t qualify for Medicaid due to our undocumented status and couldn’t afford insurance. Several times I witnessed family members endure extreme pain as we were afraid of seeing a doctor or going to the ED. In college I became very passionate about bridging the same disparities that my family had faced so I became involved in lots of activities aimed at improving the quality of life of the underserved. Simultaneously, I struggled in college, getting Cs and Bs in science classes as I had to work in order to finance my education. Thankfully, my study habits improved over time. I did research, but I did not really enjoy it.
Throughout college I was an introvert as I always worried that people would judge me because of how I looked and spoke (given my high school experience). Besides that, I was actually embarrassed of saying I was premed, as advisors and peers made it seem like I needed a stellar GPA and other activities I was precluded from given my undocumented status. In science labs, I always felt that I needed to prove myself so that my labmates wouldn't think I didn't understand the material. I was terrified of taking the MCAT since I thought I would do horribly. I also felt extremely self-conscious of people arguing that I was taking a more qualified applicant’s spot both in college and med school; in the end, however, I was too determined to make a difference in underserved communities to give up on my dream. Applying to med school was my secret, I didn’t wanna tell anyone since I didn’t think I stood a chance. I was, however, determined to apply multiple times before giving up. I bring up all of these points to exemplify that being a URM/disadvantaged may result in overcoming challenges/stigmas that other students may never think about.
Edit: sentence structure changes for clarity.
