Making Medical School Admissions More Equitable

[efle]

Do these physicians sound like they are condescending to everyone and the URM patients just feel like it’s racial bias because of the difference in skin color, or do they only condescend to URMs?

Yeah, I have to wonder if trying to make communication better by adjusting vocabulary can actually make it worse. For example when talking with very old or otherwise less health literate people, switching language from "anti-hypertensive" or "diuretic" to simply "pressure pill" or "fluid pill." Probably appreciated a lot of the time, but probably also very offensive and patronizing to someone who is better educated than the provider realizes. I could see how a patient would also think it was only happening to them because of their skin color or age or occupation etc. Are we supposed to train providers to err on the side of lower literacy if they see in the social Hx that the person works janitorial, to make sure nothing is obscured by jargon? Or does that risk coming off as discriminatory?

And that's assuming the doctor is trying to do better by the patient. If the doctor is just a jerk that gives everybody poor information and hand-wavy incomplete explanations to questions because they're disinterested and in a hurry, they'll definitely come across poorly

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[OchemOficionado]

Yeah, I mean I'm just saying that just because a patient feels like they are being discriminated against doesn't mean they are. I'm wondering how often a white doctor is accused of being discriminatory when they are really just a dick bag to everyone. Not that I think that's okay, lol.

I get what you're saying. I'm sure that both happen. Not sure how we could ever have accurate stats on this though.

 

[Matthew9Thirtyfive]

Yeah, I have to wonder if trying to make communication better by adjusting vocabulary can actually make it worse. For example when talking with very old or otherwise less health literate people, switching language from "anti-hypertensive" or "diuretic" to simply "pressure pill" or "fluid pill." Probably appreciated a lot of the time, but probably also very offensive and patronizing to someone who is better educated than the provider realizes. I could see how a patient would also think it was only happening to them because of their skin color or age or occupation etc. Are we supposed to train providers to err on the side of lower literacy if they see in the social Hx that the person works janitorial, to make sure nothing is obscured by jargon? Or does that risk coming off as discriminatory?

And that's assuming the doctor is trying to do better by the patient. If the doctor is just a jerk that gives everybody poor information and hand-wavy incomplete explanations to questions because they're disinterested and in a hurry, they'll definitely come across poorly

Yeah, I think there are a lot of factors. Patients of color who have higher education likely have been assumed to be uneducated before, and so possibly when a physician uses more simple language, it is perceived as "dumbing it down" for them because the doc assumes they aren't educated enough to understand 2/2 their skin color or another factor.

It's interesting. I've always found that using language that is too scientific actually annoys patients because either they feel like I am talking over them or trying to impress them or put them in their place, or they just get upset because they don't know wtf I'm talking about. I pretty quickly learned when I talk to patients--even those with higher education--that using common, every day language is much better. I have never had someone complain about my demeanor. In fact, quite the opposite.

It helps that I make an effort to be very friendly and welcoming, so maybe that mitigates it a little.

 

[Matthew9Thirtyfive]

I get what you're saying. I'm sure that both happen. Not sure how we could ever have accurate stats on this though.

Yeah, just something I'm curious about. I don't think it's really possible to know.

 

[bearcalbear2019]

Well of course. A white patient isn't going to feel like a white doctor is racially discriminating if he's being a douche. They're the same race.

Yeah, I mean I'm just saying that just because a patient feels like they are being discriminated against doesn't mean they are. I'm wondering how often a white doctor is accused of being discriminatory when they are really just a dick bag to everyone. Not that I think that's okay, lol.

The lines are blurry. The history of oppression is the reason this is so complex and yes sometimes it is simply not race.

Yeah, I have to wonder if trying to make communication better by adjusting vocabulary can actually make it worse. For example when talking with very old or otherwise less health literate people, switching language from "anti-hypertensive" or "diuretic" to simply "pressure pill" or "fluid pill." Probably appreciated a lot of the time, but probably also very offensive and patronizing to someone who is better educated than the provider realizes. I could see how a patient would also think it was only happening to them because of their skin color or age or occupation etc. Are we supposed to train providers to err on the side of lower literacy if they see in the social Hx that the person works janitorial, to make sure nothing is obscured by jargon? Or does that risk coming off as discriminatory?

And that's assuming the doctor is trying to do better by the patient. If the doctor is just a jerk that gives everybody poor information and hand-wavy incomplete explanations to questions because they're disinterested and in a hurry, they'll definitely come across poorly

My approach to this is to match the language of the patient and do whatever feels more comfortable for them. You'll have patients who are total science nerds and want to know the name of drugs and class and mechanism, while most people just want to take the med and feel better.. lol

 

[toedrag]

What an intellectually stimulating thread. There are two other perspective articles in this weekly issue of NEJM that touch upon similar issues: Patient- Experience Data and Bias-What Ratings Don't Tell Us, & A Call for Self Reflection and Action for White Physicians. All good reads

 

[deleted480308]

No, I'm just checking to see if you're being intellectually honest here and recognizing that you also have racial biases. Everyone does.

I’m all about self reflection. We should all do that and if we find something there we need to fix it and make sure we aren’t racially discriminating.

 

[mph876]

I think the article points out a lot of the main issues, but I feel like one of the most important things (that hasn't been mentioned yet) that is always forgotten is if the environment you're entering feels habitable as a URM. If students see a field as hostile and don't feel like they can be happy and succeed in a field, the majority won't enter it. I also like the emphasis on equity because I feel like most people miss out on how we get from equity to equality. I also recently came across this opinion article which I feel like hits on this idea to a degree, not that I necessarily agree with everything in it. Edit: the article went in strangely so for those interested the title is Why aren’t there more Black Doctors? Racism, Classism, or Apathy?

My background is as a black female growing up in the very white suburbs. Graduated top of my class in high school with the highest ACT score (99th percentile) which was fairly well known and became something of a talking point of the class, and still people would ask if the only reason I was getting admissions and scholarships was due to my race. In college I've had issues with stereotypes and preconceptions (among others), and I think this is the problem where persistence within the major/career goal begins. I do work in this topic on campus and the general consensus is students have issues accessing supportive professors (whereas the same profs have been more receptive to non-URM students), work/school balance, and being first-gen is dramatically more common as a URM so you're going in completely blind. Disproportionate lower income also creates a barrier at MCAT and throughout school if you're working and trying to keep your grades up. I know personally on campus I've missed out on a LOR opportunity and potentially a research opportunity (can't tie the research to anything else because I know the other person taken) simply do to race and this is two different instructors. On the academic side of things, I have a strong GPA that puts me in at least the top 7% of my class year. Good EC's and lots of research. And yet, I know next year once I apply others will think the only reason (or main reason) I can get in is being a URM and likely that preconception will later affect how I am treated. And that gets tiring, because at the end of the day I'm reduced to my race once again. I can't be a great applicant and be a URM, I'm only a great applicant because I'm a URM. You could say AA promotes this and blame it, but it's looking completely at the wrong end of the stick. And I think this attitude has been repeatedly represented even in this thread.

I also can't blame minority patients for wanting a doctor that looks like them. I feel like most minorities understand differences of power structures, and when your health and life potentially is on the line, it's one less barrier to overcome. My mom had this issue before, she went to a non-black doctor who diagnosed her with something that is typical for black people. She looked it up, didn't feel like it was the correct diagnosis, treated as recommended by the doctor and it didn't work. Went to another doctor who happened to be black which she didn't plan, re-diagnosed with a totally different issue, treated it, and fixed it. I don't pick my doctors by race and I can't say I know any minority that does, unless there's been a previous issue.

I think to change it and move towards a positive direction involves a lot of public education and working on the pipeline and creating a welcoming environment for URM students and career persons.I feel like most people think Brown v. Board was the end of it and now everyone has an equal footing in education which I think plays into people not understanding AA and stereotypes surrounding race and education which produces a less habitable field to enter as a URM. Increasing funding for more urban schools especially in low income and/or URM focused areas with actual counseling to encourage students to enter 4 year universities vs. vocational schools. Making college more affordable. There's enough case study papers to understand that these approaches work. Also, what I really wish I could find is an article on URM students not in the US to see how the disparity changes. I recently did a research presentation related to this topic and most of the articles from the 70s and 80s echo the sentiment of today with how URM students feel disenfranchised in STEM fields and drop out of the pipeline especially for medicine. So in almost 50 years, nothing has changed. I feel like it will take something revolutionary to really produce results.

 

[bearcalbear2019]

I think the article points out a lot of the main issues, but I feel like one of the most important things (that hasn't been mentioned yet) that is always forgotten is if the environment you're entering feels habitable as a URM. If students see a field as hostile and don't feel like they can be happy and succeed in a field, the majority won't enter it. I also like the emphasis on equity because I feel like most people miss out on how we get from equity to equality. I also recently came across this opinion article which I feel like hits on this idea to a degree, not that I necessarily agree with everything in it. Edit: the article went in strangely so for those interested the title is Why aren’t there more Black Doctors? Racism, Classism, or Apathy?

My background is as a black female growing up in the very white suburbs. Graduated top of my class in high school with the highest ACT score (99th percentile) which was fairly well known and became something of a talking point of the class, and still people would ask if the only reason I was getting admissions and scholarships was due to my race. In college I've had issues with stereotypes and preconceptions (among others), and I think this is the problem where persistence within the major/career goal begins. I do work in this topic on campus and the general consensus is students have issues accessing supportive professors (whereas the same profs have been more receptive to non-URM students), work/school balance, and being first-gen is dramatically more common as a URM so you're going in completely blind. Disproportionate lower income also creates a barrier at MCAT and throughout school if you're working and trying to keep your grades up. I know personally on campus I've missed out on a LOR opportunity and potentially a research opportunity (can't tie the research to anything else because I know the other person taken) simply do to race and this is two different instructors. On the academic side of things, I have a strong GPA that puts me in at least the top 7% of my class year. Good EC's and lots of research. And yet, I know next year once I apply others will think the only reason (or main reason) I can get in is being a URM and likely that preconception will later affect how I am treated. And that gets tiring, because at the end of the day I'm reduced to my race once again. I can't be a great applicant and be a URM, I'm only a great applicant because I'm a URM. You could say AA promotes this and blame it, but it's looking completely at the wrong end of the stick. And I think this attitude has been repeatedly represented even in this thread.

I also can't blame minority patients for wanting a doctor that looks like them. I feel like most minorities understand differences of power structures, and when your health and life potentially is on the line, it's one less barrier to overcome. My mom had this issue before, she went to a non-black doctor who diagnosed her with something that is typical for black people. She looked it up, didn't feel like it was the correct diagnosis, treated as recommended by the doctor and it didn't work. Went to another doctor who happened to be black which she didn't plan, re-diagnosed with a totally different issue, treated it, and fixed it. I don't pick my doctors by race and I can't say I know any minority that does, unless there's been a previous issue.

I think to change it and move towards a positive direction involves a lot of public education and working on the pipeline and creating a welcoming environment for URM students and career persons.I feel like most people think Brown v. Board was the end of it and now everyone has an equal footing in education which I think plays into people not understanding AA and stereotypes surrounding race and education which produces a less habitable field to enter as a URM. Increasing funding for more urban schools especially in low income and/or URM focused areas with actual counseling to encourage students to enter 4 year universities vs. vocational schools. Making college more affordable. There's enough case study papers to understand that these approaches work. Also, what I really wish I could find is an article on URM students not in the US to see how the disparity changes. I recently did a research presentation related to this topic and most of the articles from the 70s and 80s echo the sentiment of today with how URM students feel disenfranchised in STEM fields and drop out of the pipeline especially for medicine. So in almost 50 years, nothing has changed. I feel like it will take something revolutionary to really produce results.

I wish there was really a solution.. it's unfortunate that we live in a society where something like AA has to even exist. I recently participated in a city strike for schools (Oakland) where I've worked with the education system there for the past 3 years and the educational inequity and inequality I've seen is actually disgusting. Most students are URM populations. They just have no money to support their students and public education is an absolute disaster. Meanwhile the residents in the wealthy neighborhood just send their kids to the $50k/yr private school.

 

[Nurse2MD2018]

Yeah, I mean I'm just saying that just because a patient feels like they are being discriminated against doesn't mean they are. I'm wondering how often a white doctor is accused of being discriminatory when they are really just a dick bag to everyone. Not that I think that's okay, lol.

Current research especially in prediatric pain management has shown that discrimination does exist. The issue is that discrimination is not always overt so it’s very hard to quantify. My experience may be different from most but I work in an urban city with extreme racial divide, the majority of the health providers in my hospital do not represent the patient population we serve. The stark differences in provision of care is so apparent that I almost quit within months of working there. As a URM who is also a foreigner, I have different views on race relations than most Americans but I would be lying if I didn’t say that healthcare completely opened my eyes to just how poorly minorties are viewed and treated especially at the hands of those who are trusted to care for them.

 

[Princeton Medical Student]

I think at the very least med schools should recognize that the current URM/ORM issue is more about the patient, and less about making the admissions protocol fair. If they wanted admissions to be fair, there are much better things then the color of your skin which may indicate SES and the challanges a student faced. It's pretty silly for med schools to pretend that URM/ORM does anything but at the very least produce minority doctors.

 

[Matthew9Thirtyfive]

Current research especially in prediatric pain management has shown that discrimination does exist. The issue is that discrimination is not always overt so it’s very hard to quantify. My experience may be different from most but I work in an urban city with extreme racial divide, the majority of the health providers in my hospital do not represent the patient population we serve. The stark differences in provision of care is so apparent that I almost quit within months of working there. As a URM who is also a foreigner, I have different views on race relations than most Americans but I would be lying if I didn’t say that healthcare completely opened my eyes to just how poorly minorties are viewed and treated especially at the hands of those who are trusted to care for them.

Right I’m not saying it doesn’t exist. I’m not even saying that every case isn’t discrimination. I’m just thinking out loud about how there might be multiple factors contributing to something seeming like discrimination when it really isn’t (in individual instances, not as a whole). I’ve been discriminated against plenty outside of healthcare, so I am sure it happens in healthcare as well.

 

[Nurse2MD2018]

Right I’m not saying it doesn’t exist. I’m not even saying that every case isn’t discrimination. I’m just thinking out loud about how there might be multiple factors contributing to something seeming like discrimination when it really isn’t (in individual instances, not as a whole). I’ve been discriminated against plenty outside of healthcare, so I am sure it happens in healthcare as well.

I get what you’re saying but often times even providers who are dicks will not display unethical bedside manners/plan of care to those who they don’t feel superior to. If a pt then interpret such behavior as discrimination are they not right in their judgement?

 

[Matthew9Thirtyfive]

I get what you’re saying but often times even providers who are dicks will not display unethical bedside manners/plan of care to those who they don’t feel superior to. If a pt then interpret such behavior as discrimination are they not right in their judgement?

They are, but that’s not what I was talking about.

 

[deleted480308]

I think the article points out a lot of the main issues, but I feel like one of the most important things (that hasn't been mentioned yet) that is always forgotten is if the environment you're entering feels habitable as a URM. If students see a field as hostile and don't feel like they can be happy and succeed in a field, the majority won't enter it. I also like the emphasis on equity because I feel like most people miss out on how we get from equity to equality. I also recently came across this opinion article which I feel like hits on this idea to a degree, not that I necessarily agree with everything in it. Edit: the article went in strangely so for those interested the title is Why aren’t there more Black Doctors? Racism, Classism, or Apathy?

My background is as a black female growing up in the very white suburbs. Graduated top of my class in high school with the highest ACT score (99th percentile) which was fairly well known and became something of a talking point of the class, and still people would ask if the only reason I was getting admissions and scholarships was due to my race. In college I've had issues with stereotypes and preconceptions (among others), and I think this is the problem where persistence within the major/career goal begins. I do work in this topic on campus and the general consensus is students have issues accessing supportive professors (whereas the same profs have been more receptive to non-URM students), work/school balance, and being first-gen is dramatically more common as a URM so you're going in completely blind. Disproportionate lower income also creates a barrier at MCAT and throughout school if you're working and trying to keep your grades up. I know personally on campus I've missed out on a LOR opportunity and potentially a research opportunity (can't tie the research to anything else because I know the other person taken) simply do to race and this is two different instructors. On the academic side of things, I have a strong GPA that puts me in at least the top 7% of my class year. Good EC's and lots of research. And yet, I know next year once I apply others will think the only reason (or main reason) I can get in is being a URM and likely that preconception will later affect how I am treated. And that gets tiring, because at the end of the day I'm reduced to my race once again. I can't be a great applicant and be a URM, I'm only a great applicant because I'm a URM. You could say AA promotes this and blame it, but it's looking completely at the wrong end of the stick. And I think this attitude has been repeatedly represented even in this thread.

I also can't blame minority patients for wanting a doctor that looks like them. I feel like most minorities understand differences of power structures, and when your health and life potentially is on the line, it's one less barrier to overcome. My mom had this issue before, she went to a non-black doctor who diagnosed her with something that is typical for black people. She looked it up, didn't feel like it was the correct diagnosis, treated as recommended by the doctor and it didn't work. Went to another doctor who happened to be black which she didn't plan, re-diagnosed with a totally different issue, treated it, and fixed it. I don't pick my doctors by race and I can't say I know any minority that does, unless there's been a previous issue.

I think to change it and move towards a positive direction involves a lot of public education and working on the pipeline and creating a welcoming environment for URM students and career persons.I feel like most people think Brown v. Board was the end of it and now everyone has an equal footing in education which I think plays into people not understanding AA and stereotypes surrounding race and education which produces a less habitable field to enter as a URM. Increasing funding for more urban schools especially in low income and/or URM focused areas with actual counseling to encourage students to enter 4 year universities vs. vocational schools. Making college more affordable. There's enough case study papers to understand that these approaches work. Also, what I really wish I could find is an article on URM students not in the US to see how the disparity changes. I recently did a research presentation related to this topic and most of the articles from the 70s and 80s echo the sentiment of today with how URM students feel disenfranchised in STEM fields and drop out of the pipeline especially for medicine. So in almost 50 years, nothing has changed. I feel like it will take something revolutionary to really produce results.

It is absolutely incorrect to claim nothing has changed in 50years. That kind of hyperbole doesn’t help the conversation

 

[deleted480308]

I get what you’re saying but often times even providers who are dicks will not display unethical bedside manners/plan of care to those who they don’t feel superior to. If a pt then interpret such behavior as discrimination are they not right in their judgement?

In the absurdly rare situation when a patient accurately knows how a doctor treats patients of various races solely on that characteristic? Yes

A lot more docs are jerks than are racist

 

[OchemOficionado]

It is absolutely incorrect to claim nothing has changed in 50years. That kind of hyperbole doesn’t help the conversation

Maybe "nothing" is a stretch. Maybe better wording should have been "not much".

A lot more docs are jerks than are racist

I don't think there is a way for you to know this.

 

[dr_kateb]

There’s always going to be wealth inequality as long as the country is a capitalistic society regardless of race.

 

[Nurse2MD2018]

In the absurdly rare situation when a patient accurately knows how a doctor treats patients of various races solely on that characteristic? Yes

A lot more docs are jerks than are racist

After my provider views my chart, they walk into the room and start speaking to my family slowly and enunciating words in a unnatural manner solely based on my name. Do I need to take into account that they treat all pts like this prior to coming to the conclusion that I am being treated differently?

I definitely will agree with you about your last statement lol. Being racist is not the only premise for discrimination. Implicit bias pose more of a threat to patients than racism in healthcare settings.

 

[dr_kateb]

After my provider views my chart, they walk into the room and start speaking to my family slowly and enunciating words in a unnatural manner solely based on my name. Do I need to take into account that they treat all pts like this prior to coming to the conclusion that I am being treated differently?

Yes...?

 

[deleted480308]

I don't think there is a way for you to know this.

In the same manner that there are more plants than vegetables, yes there is

 

[jhamaican]

Differential GPAs and MCAT play a large role in inequity, and reflect the same patterns as robustly demonstrated IQ differences among groups (see Intelligence: Knowns and Unknowns written by APA task force in 1996). It is unclear the extent to which GPA and MCAT are mediated by IQ (compared to SES, related educational opportunities, stereotype threat, personality traits that manifest as work ethic) - but it is my sense that IQ is a strong predictor. It has already been determined that IQ tests are not significantly biased by SES and educational opportunities. The causes of these IQ differences have not yet been determined either, but prior efforts to raise IQ have been ineffective by late adolescence. Effective interventions to equalize IQ for all groups could lead to more fair representation in medical school admissions.**

I understand that this is a very politically charged topic, and I will likely be censored/dismissed as a pseudoscientist or racist - but really, the science behind predictive value of IQ tests, and group differences therein, is undisputed among psychometricians and leading intelligence researchers. If we are truly concerned about inequity, then we must be free to honestly and dispassionately consider its causes to manifest appropriate and effective solutions. As demonstrated by this article, the efforts of the past 30+ years haven't made the cut.

edit: Obligatory acknowledgment that group differences have absolutely no bearing on how we should evaluate individuals, as there is significantly more variation within groups than among groups. Thus, an individual's membership in any group tells us absolutely nothing about their individual academic prowess.

** although I'm not sure what this would look like for Eastern Asians or Ashkenazi Jews, who both score higher than the mean.

Careful.

The closer to the truth you get the louder they protest.

 

[jhamaican]

We shouldn't be tracking race percentages as a goal. Lack of racial discrimination should be the goal.

Community college credits would be a great way to allow poorer or more rural students to apply.

Allowing skype interview would absolutely be a way to try and calm down the financial arms race of applying. I'd be all for that and actually asked my school to consider it when I was a student there, I was told no

nah bro.

Your thoughts are way to logical for the admissions committees.

The purpose is to allow preferential admissions based on lower standards just because of skin color.

 

[OchemOficionado]

In the same manner that there are more plants than vegetables, yes there is

Any sources you could share? Or, is it just your hunch that there are more jerk doctors than racist doctors? It may be better for me to PM you, because I'm very curious as to how you can quantify something that you don't experience. Are you basing it on the non-URM docs you know and deciding if they are more jerky or more racist?

 

[dr_kateb]

Any sources you could share? Or, is it just your hunch that there are more jerk doctors than racist doctors? It may be better for me to PM you, because I'm very curious as to how you can quantify something that you don't experience. Are you basing it on the non-URM docs you know and deciding if they are more jerky or more racist?

How are you going to prove that more doctors are racist than jerks?

 

[OchemOficionado]

How are you going to prove that more doctors are racist than jerks?

That was what I was questioning. How can one know either way?

 

[Nurse2MD2018]

Yes...?

So even after hearing them speak to staff normally I should assume that my analysis of differential treatment is just not so?

 

[dr_kateb]

So even after hearing them speak to staff/bedside normally I should assume that my analysis of differential treatment is just not so?

Most patients/parents have little medical knowledge compared to other medical personnel and doctors will try to dumb things down so that they can understand it. So yes you do need to know if he/she talks to other patients the same way.

 

[Nurse2MD2018]

Most patients/parents have little medical knowledge compared to other medical personnel and doctors will try to dumb things down so that they can understand it. So yes you do need to know if he/she talks to other patients the same way.

Refraining from using medical jargon is one thing, making the assumption that I don’t understand English based solely on my last name, country of origin, ethnicity is another. I The amount of times I’ve witness this done to my family,as well as my Hispanic and Middle Eastern patients is cringeworthy.

 

[Nurse2MD2018]

Here we go again.

More propaganda from the peak of the ivory castle.

Probably will get banned for this post but it needs to be said:

Having lower admission standards simply for the sake of diversity is not only wrong, it clearly doesn't work. This is evidenced by the absurd preference for minority candidates yet still decreasing rates of minorities in medical school.

Take a look at the following figures:





There is no way you can justify these statistics. It is simply racism. Lower standards based on the color of an individuals skin.

Fortunately society is coming around and race-conscious admissions policies are being outlawed. 8 states have woken up thus far. This is a step in the right direction.

Medical school admission slots are a limited resource. Medical school and residency slots are in a large part funded by government subsidies. Inappropriate handouts given to minorities who are less qualified are at the expense of society as a whole and better qualified candidates.

This is a cultural issue. Giving handouts for medical school admissions will not change certain cultures that value rap music, NBA/NFL aspirations and SWAG/YOLO over parenthood, education and family.

You are not going to fix malignant cultures by giving handouts! It only propagates the issue.

It is not the job of the government, academic institutions or society as a whole to have to subsidize certain communities and races whose poor culture results in poor socioeconomic outcomes.

Is it any wonder that Indians and Asians earn the most of any group in the united states? They have strong cultures based on family and education. And is it fair we punish these groups with higher standards? Thankfully society is finally waking up to this racism. Looking forward to the day Students for Fair Admissions v. Harvard makes it to the Supreme Court.

Society will naturally stratify itself into groups and cultures. Some of these cultures will place more emphasis on achievement and education. This is the natural order of the world. Let us stop trying to swim upstream. Statistics show that trying to do so clearly doesn't work.

Frankly, if I was Black or Latino, I would be embarrassed and angry by this preferential treatment in the name of diversity. There will be forever a stain on a minorities academic career. People, for right or wrong, will assume you were admitted based on lesser standards (even if this was not the case). It does more harm than good to everyone!

We need RACE and SEX BLIND admissions.

..............Stop.

 

[Melanogaster]

Here we go again.

More propaganda from the peak of the ivory castle.

Maybe it we repeat something enough times it will become true:
"Racist Like Me — A Call to Self-Reflection and Action for White Physicians"

Probably will get banned for this post but it needs to be said:

Having lower admission standards simply for the sake of diversity is not only wrong, it clearly doesn't work. This is evidenced by the absurd preference for minority candidates yet still decreasing rates of minorities in medical school.

Take a look at the following figures:





There is no way you can justify these statistics. It is simply racism. Lower standards based on the color of an individuals skin.

Fortunately society is coming around and race-conscious admissions policies are being outlawed. 8 states have woken up thus far. This is a step in the right direction.

Medical school admission slots are a limited resource. Medical school and residency slots are in a large part funded by government subsidies. Inappropriate handouts given to minorities who are less qualified are at the expense of society as a whole and better qualified candidates.

This is a cultural issue. Giving handouts for medical school admissions will not change certain cultures that value rap music, NBA/NFL aspirations and SWAG/YOLO over parenthood, education and family.

You are not going to fix malignant cultures by giving handouts! It only propagates the issue.

It is not the job of the government, academic institutions or society as a whole to have to subsidize certain communities and races whose poor culture results in poor socioeconomic outcomes.

Is it any wonder that Indians and Asians earn the most of any group in the united states? They have strong cultures based on family and education. And is it fair we punish these groups with higher standards? Thankfully society is finally waking up to this racism. Looking forward to the day Students for Fair Admissions v. Harvard makes it to the Supreme Court.

Society will naturally stratify itself into groups and cultures. Some of these cultures will place more emphasis on achievement and education. This is the natural order of the world. Let us stop trying to swim upstream. Statistics show that trying to do so clearly doesn't work.

Frankly, if I was Black or Latino, I would be embarrassed and angry by this preferential treatment in the name of diversity. There will be forever a stain on a minorities academic career. People, for right or wrong, will assume you were admitted based on lesser standards (even if this was not the case). It does more harm than good to everyone!

We need RACE and SEX BLIND admissions.

I disagree.

That being said, actual black doctors are very underrepresented. What you have at elite medical schools are Nigerians/other Africans. There was that one article posted about a patient, in the first 30 second encounter with the Nigerian doctor, waxing poetic about finally getting a black doctor.

Yeah. Right.

Maybe you could make that mistake in a brief, 30 second encounter like described in the article, but in the real world there are huge cultural divides.

You wouldn't get stuff like this: Black Student Group Complains Ivy League School Is Letting In Too Many African Students

I can also tell you from extensive volunteering in various communities, that within seconds of walking into a room, I can immediately tell which people are Black and which are African. Hint: the Africans separate themselves from everyone else.

 

[dr_kateb]

making the assumption that I don’t understand English based solely on my last name, country of origin, ethnicity is another.

I don’t see this as racism. Go to China as a white, black, etc and they’ll probably think you don’t speak Chinese. Go to any place as a minority and you’ll be seen differently. It’s how things are.

 

[Nurse2MD2018]

I don’t see this as racism. Go to China as a white, black, etc and they’ll probably think you don’t speak Chinese. Go to any place as a minority and you’ll be seen differently. It’s how things are.

Racism and discrimation are not synonymous. Being seen differently and being treated differently are two different things. Also things in here are headed left from what the OP intended so I’m going to bounce. This forum just proved exactly why more diversity is needed in medicine, not sure how Adcoms will make things better in the future but my God I pray it gets better in my lifetime.

 

[jhamaican]

..............Stop.

Thank you for your intricate and well-thought out response.

Excellent argument.

 

[dr_kateb]

Racism and discrimation are not synonymous. Being seen differently and being treated differently are two different things. Also things in here are headed left from what the OP intended so I’m going to bounce. This forum just proved exactly why more diversity is needed in medicine, not sure how Adcons will make things better in the future but my God I pray it gets better in my lifetime.

I never said they were synonymous but in some cases it can be. Racism is a specific form of discrimination

Also how exactly does this thread prove more diversity is needed?

 

[Nurse2MD2018]

I never said they were synonymous but in some cases it can be. Racism is a specific form of discrimination

Also how exactly does this thread prove more diversity is needed?

“This is a cultural issue. Giving handouts for medical school admissions will not change certain cultures that value rap music, NBA/NFL aspirations and SWAG/YOLO over parenthood, education and family.” If I have to explain why this is wrong, as well as why making unfair assumption about your patients is wrong it’s time to go.

 

[deleted480308]

Any sources you could share? Or, is it just your hunch that there are more jerk doctors than racist doctors? It may be better for me to PM you, because I'm very curious as to how you can quantify something that you don't experience. Are you basing it on the non-URM docs you know and deciding if they are more jerky or more racist?

It’s just logic. Being a racist makes you a jerk so all racists are jerks. It is also possible to be a jerk and not a racist

Therefore, there are more jerks than racists

 

[dr_kateb]

“This is a cultural issue. Giving handouts for medical school admissions will not change certain cultures that value rap music, NBA/NFL aspirations and SWAG/YOLO over parenthood, education and family” This is view held by someone who posted above. And if I have to explain why this is wrong as well as why making unfair assumption about your patients is wrong it’s time to go.

I actually missed that part. I skimmed through his post because it was pretty lengthy. The post itself is inflammatory but the point is correct: more black doctors won’t fix the societal problems that exist.

Everyone makes assumptions even about things they don’t know or understand. Making assumptions about a person based on their name and skin color doesn’t automatically make a person racist. Example: when I moved into my dorm as a freshman my RA from Vietnam thought I was actually my roommate. I am Asian but I have a British name. My roommate that never showed up had a Korean name. That assumption doesn’t make my RA racist.

 

[jhamaican]

Wow! I can relate, 110%. The sad part, that’s only the tip of the iceberg. Unfortunately, I’ve found that sharing our experiences to help others understand, usually just gives them ammo to downplay/discredit said experiences. Hopefully any responses to you are supportive, but if not, I hear ya. I know you’re speak facts.

BTW, I work in higher ed and have to bite my tongue all the time or ask a coworker of a different race to share my feedback all the time to ensure I’m not coming off as angry/ghetto/aggressive/hostile. Du Bois hit the nail on the head when he coined the term double consciousness.

I think it’s great that medical school admissions takes both race and SES into account, but something has to change if the number of Black physicians has only decreased over the years. (I’ve read conflicting stats, one said in the last 50 years the percent has increased from 3 to 6%.) There’s a need that must be addressed. I agree with the posters that stated efforts should begin in primary school.

So you think it is great that medical schools take into account the color of a persons skin, something they have no control over?

Can you elaborate on why you think this is such a good thing?

How is this not the very definition of racism?

The statistics clearly show brazen preference for race at the expense of more objectively well qualified candidates has failed to have any effect...

Just to clarify:

you believe that because the original initiative to heavily sway medical school admissions based on race is not working, we should double down and initiate preference for race even earlier in schooling?​

Are you out of your mind?

Is it possible that racist admission policies are not the answer to economic and academic disparities? What will it take to convince you of this? clearly objective data is not enough...

 

[jhamaican]

The mental contortions people go through to try to convince themselves and others that racist admission policies are beneficial are mind boggling.

differential socioeconomic and academic achievement by race is a cultural phenomenon.

It is not the systems fault. The system bends over backwards to accommodate (see graphics and admission statistics above).

You are not going to fix a culture issue with government mandates or academic handouts.

A cultural problem requires a cultural solution! The change must come from within!

 

[Raryn]

Refraining from using medical jargon is one thing, making the assumption that I don’t understand English based solely on my last name, country of origin, ethnicity is another. I The amount of times I’ve witness this done to my family,as well as my Hispanic and Middle Eastern patients is cringeworthy.

If I see a patient named Jose Martinez, I may ask another member of the staff (say, the MA who roomed them) whether they speak English. Why? Well, I'd like to know so that I can be prepared going into the room - either with a Spanish speaking staff member or the translation service on the line, to make sure I give the same quality of care to Mr. Martinez as I would to John Smith. This is not discrimination.

If he does speak English but has a heavy enough accent that it's clear it's his second language, I may be more careful in how I explain things to him. Why? Well, it's super easy to get lost in medical jargon, and even if someone is fluent in English they may not know words less commonly used. I'm careful in how I explain things to everyone, but I'm probably still more careful with patients who speak English as a second language. This is not discrimination either.

I'm an immigrant myself, and used to help take my grandmother - who spoke minimal English - to doctor's visits. The above is a courtesy, not a slight.

Do I have a bias against patients who don't speak English? Sure. I know that the visit is going to take 2-3x as long to get the same quality of encounter (1x for either me or the patient to speak, 1x for the translator, and then probably 1x more to go back and forth when someone misunderstands someone else). When faced with a non-English speaking patient, my immediate gut reaction is to internally groan. And then I consciously make the decision to be even more conscientious during the visit, to make sure I give that person the same quality of care I'd give them if they were anyone else. This is the same if they're Jose Martinez, Aleksandr Ivanov, Abdul Mohammed, or any other person.

 

[OchemOficionado]

So you think it is great that medical schools take into account the color of a persons skin, something they have no control over?

Can you elaborate on why you think this is such a good thing?

How is this not the very definition of racism?

The statistics clearly show brazen preference for race at the expense of more objectively well qualified candidates has failed to have any effect...

Just to clarify:

you believe that because the original initiative to heavily sway medical school admissions based on race is not working, we should double down and initiate preference for race even earlier in schooling?​

Are you out of your mind?

Is it possible that racist admission policies are not the answer to economic and academic disparities? What will it take to convince you of this? clearly objective data is not enough...

If you aren't going to respond to me respectfully please do not respond at all. This thread has been civil and I would like to keep it that way.

To answer your questions, not necessarily skin color as it varies, but race. Yes, I do think taking that into account helps make medical school admissions more equitable. I don't believe that is racism. It seems we disagree on this and that is fine. Why do you think taking race into account has had no effect? Health outcomes of URM patients show that it helps.

I didn't imply that preference for race should begin earlier. Not sure how that would work. What I meant was that the problem will not be solved at the graduate level and that different measures should be taken to encourage and support learning and STEM fields for URM students well before then.

I don't think our goal here should be to convince each other of anything. Just sharing our perspectives.

 

[solitarius]

Too many privileged white kids.

 

[Stagg737]

I get what you’re saying but often times even providers who are dicks will not display unethical bedside manners/plan of care to those who they don’t feel superior to. If a pt then interpret such behavior as discrimination are they not right in their judgement?

How someone interprets behavior doesn't really matter in terms of the discrimination. Sure it can affect the relationship, but saying I think I'm being discriminated against doesn't mean I'm actually being discriminated against. For example, regardless of color, age, sex, gender identity, education level, etc, I always assume my patient knows nothing about their medical condition when I see them. If a highly educated minority individual is seen by me and feels they are being discriminated against because I'm explaining things at a fifth grade level (which I try to do with all patients), then they are indeed wrong in their judgment regarding whether or not I am being discriminatory.

 

[863168]

@LizzyM Out of curiosity, are race selection factors utilized by adcoms when it comes to admissions and how are those factored into your own decision making? This article following the one you linked a month ago from Doctor Mbaku about the need for more African American representation within medicine has made me curious how you factor racial, cultural, and sociopolitical considerations when it comes or came to your admitting class.

 

[Med Ed]

Very true. Totally agree. Do you think something standardized should be put in place regarding this problem? (Is that even possible?) Part of me thinks, oh there’s room for everyone to make it. Butttt that isn’t true in this regard. Should one type of school pick Sally and another type pick Johnny?

It's not necessarily a "problem" that needs to be solved. Most schools end up with a mixture of Sallys and Johnnys, with the ratio varying based on mission.

I will say that, overall, the forces that would push Sally to be admitted above Johnny are very, very strong.

 

[863168]

I'm concerned that the focus from adcoms might actually be choosing the right colors to fit into the Crayola Box and making sure that they equally represent every single rung on the tax bracket rather than actually choosing based on merit. As an ORM, I've never thought I was being compared to anybody else aside from other high performing ORMs. As much as objective metrics like GPA & MCAT have attempted to even the playing field for individuals since Anti-Semitism in the 1920s, it is only realistic to know that a collective commune of intellectuals selecting students solely based on "merit" is too simplistically barbaric of a decision. It must be a rich, diverse, and enlightened decision in which the Crayola Box represents a rainbow of not only racial diversity, but life experiences and merit so there is no single defining factor of significance being used to evaluate any single applicant or the applicants as a collective whole.

 

[Med Ed]

I'm concerned that the focus from adcoms might actually be choosing the right colors to fit into the Crayola Box and making sure that they equally represent every single rung on the tax bracket rather than actually choosing based on merit.

Construct a universally accepted definition of "merit" and get back to us.

 

[863168]

Construct a universally accepted definition of "merit" and get back to us.

A quick starting point would be for it to be a variable that is not contingent on: gender, race, or age.

 

[OchemOficionado]

I'm concerned that the focus from adcoms might actually be choosing the right colors to fit into the Crayola Box and making sure that they equally represent every single rung on the tax bracket rather than actually choosing based on merit. As an ORM, I've never thought I was being compared to anybody else aside from other high performing ORMs. As much as objective metrics like GPA & MCAT have attempted to even the playing field for individuals since Anti-Semitism in the 1920s, it is only realistic to know that a collective commune of intellectuals selecting students solely based on "merit" is too simplistically barbaric.

I don’t think you have to be too concerned as equal representation of race and socioeconomic class has yet to happen at Med schools across the nation.

I think people forget that merit can include more than objective stats and that nobody is entitled to a seat at a medical school. The process has never been and will likely never be deemed fair to all applicants. Steps to remedy this make some happy and upset others. Like life, it ain’t always fair.