Affirmative Action in medical schools?

[drizzt3117]

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My point was that URMs who are admitted to medical school despite lesser academic qualifications will most likely be "relegated" to FM, IM, peds, ob/gyn. These are the fields in which the need for URM practitioners is greatest. As a result, you accomplish the same end by default.

This, of course, presupposes that candidates that are admitted with lower qualifications are also less capable, which isn't necessarily the case. I don't have any information about URM test score performance in medical school, but since certain schools have first choice match percentages > 90%, even with self-selection, I would anticipate that a significant percentage of URM medical students aren't going into primary care.

Where did you find numbers on physician participation in free clinics?

Every medical school that I've visited has at least one free clinic which is staffed by faculty volunteers. Some have far more than that. Of course this evidence is anecdotal but I would guess that this practice is not limited to the 10% of medical schools I've visited.

Statistics show that minority patients prefer minority physicians:

http://content.healthaffairs.org/cgi/reprint/19/4/76.pdf

and that URM physicians are more likely to practice in areas predominantly populated by racial minorities:

http://books.nap.edu/openbook.php?record_id=10186&page=57

That's fine but the current strategy makes assumptions that aren't a good way to dictate policy, namely, that URM candidates are going to serve underserved populations after graduating. Certainly they might be more likely to, but that doesn't mean that they will, or even that they should. Just because you happen to be a URM doesn't mean that you should be helping underserved populations.

Giving preference in admissions to URM candidates in return for a commitment to serve underserved areas is a much better way to achieve this goal because it rewards those that WANT to serve underserved populations.

 

[batman1983]

This is not true. The majority of people who come from impoverished areas/backgrounds can usually receive a large amount of financial aid and/or scholarships that will cover most of the costs that they will incur during undergraduate and probably during medical school. However, I do agree that people who come from impoverished areas may have to worry about providing for their family, although this is not always the case. I think that the problem for people coming from impoverished areas is financial responsibility. If your parents, role models, etc. never taught you how to balance your budget and keep track of bills and spending, you are going to have major problems when you pursue higher education. Unless you have data on the average income of URM matriculants, you should probably not be making any assumptions here. I am trying to figure out what your point was when you brought up financial hardship. Were you trying to imply that URMs who are wealthy get to slack off in thanks to their poor counterparts? Or were you trying to argue that admissions should be based on economic status? Simply going on economic status alone would not be enough since the majority of impoverished people in America are, surprise surprise, Caucasian. By snuffing out "racial" considerations in favor of only economic considerations you effectively increase the amount of Caucasians attending medical school and decrease the amount of "racial" minorities attending, although the population would be more economically diverse. Again, I really do not think that there is a completely sound involving AA, and I do not think that there will be one until so-called "racial and cultural" relations are resolved beforehand.

Im not saying that URMs cant or wont incur debt to go to grad/professional school, and I agree if anything, they probably can incur less financial costs relative to nonURMs due to grants/scholarships/etc. My argument was that many (if not most) poor ppl(URM or non URM), would have a harder time pursuing a medical / professional education due to the financial situation it incurs(even with financial aid), and this is reflected in the economic status of medical schools' student bodies. My point was in regards to addressing an earlier post about the economic/wealth status for medical students.

For both, URM and nonURM, the composition is tilted towards the well off/wealthy because of the financial hardships caused by medical/professional education. Even AAMC agrees that the financial hardships dissuade many poor ppl from attending medical school.

My point was similar to winterlights, that poorer people, especially URMs are going to find the money if it's really for them, whether it's extra financial aid or taking out loans, and i think they're more willing to take out loans when need be to get out of the situation they grew up in.

Furthermore, URMs and nonURMs don't need a medical or professional degree to get get out of the situation they grew up in(which based on the context, I will assume is poverty). Let me clarify financial hardship caused by medical school. Besides high tuition costs for 4-8 years, there is also the possible forgone income for that time period. In addition, for many poor ppl, there is also financial support/pressure to provide to the family (not necessarily all, but Im willing to bet for most poor ppl this is the case). Hence, after college, many poor ppl will past up going to medical school / professional school to start working immediately. Im not arguing about the financial responsibility of poor vs wealthy ppl, but rather, there is not as much financial distress for a person whose parents are wealthy to attend medical school than there is for a person whose family is poor.

 

[aaj117]

That's fine but the current strategy makes assumptions that aren't a good way to dictate policy, namely, that URM candidates are going to serve underserved populations after graduating. Certainly they might be more likely to, but that doesn't mean that they will, or even that they should. Just because you happen to be a URM doesn't mean that you should be helping underserved populations.

Giving preference in admissions to URM candidates in return for a commitment to serve underserved areas is a much better way to achieve this goal because it rewards those that WANT to serve underserved populations.

This is what Howard does; they don't require a commitment, but gives admissions to students who they feel have shown a commitment to underserved populations and who are most likely to serve in these areas and fulfill thier mission statement. Although they have lower average stats for acceptees, they are looking for a very specific type of applicant and it creates a great environment to learn and work in, I felt.

 

[drizzt3117]

This is what Howard does; they don't require a commitment, but gives admissions to students who they feel have shown a commitment to underserved populations and who are most likely to serve in these areas and fulfill thier mission statement. Although they have lower average stats for acceptees, they are looking for a very specific type of applicant and it creates a great environment to learn and work in, I felt.

I think this is a good idea, if the mission of the program is to improve health care for underserved populations. I think a good way to do what I mentioned would be something like the NSA program where URM candidates receive preference in admission and their tuition and living expenses are paid for in return for say, a 8 year commitment to serve underserved populations. This would be in addition to AA for economically disadvantaged candidates of all races (many of whom would be URM) that doesn't require a service commitment.

 

[aaj117]

I think this is a good idea, if the mission of the program is to improve health care for underserved populations. I think a good way to do what I mentioned would be something like the NSA program where URM candidates receive preference in admission and their tuition and living expenses are paid for in return for say, a 8 year commitment to serve underserved populations. This would be in addition to AA for economically disadvantaged candidates of all races (many of whom would be URM) that doesn't require a service commitment.

I agree, the only problem with things ilke the NSA program (correct me if i'm wrong, this is just what i've heard) is that it's only for people who know going in that they want to do primary care. I want to do cardiology, which I feel is extremely important in both minority communities (blacks genetically higher rates of cardiovascular disease) and economically disadvantaged (poor often eat poorly b/c whatever they can afford; fast food cheaper than healthy balanced meals) areas. Unfortunately, this isn't covered by NSA and the program leaves you no option to explore other interests and maybe go into pathology, anesthesiology, radiology, etc etc etc all needed in underserved areas as well.

 

[Jolie South]

I agree, the only problem with things ilke the NSA program (correct me if i'm wrong, this is just what i've heard) is that it's only for people who know going in that they want to do primary care. I want to do cardiology, which I feel is extremely important in both minority communities (blacks genetically higher rates of cardiovascular disease) and economically disadvantaged (poor often eat poorly b/c whatever they can afford; fast food cheaper than healthy balanced meals) areas. Unfortunately, this isn't covered by NSA and the program leaves you no option to explore other interests and maybe go into pathology, anesthesiology, radiology, etc etc etc all needed in underserved areas as well.

I've heard that the NSA recruits people after med school for problems within specific specialty areas that disproportionately affect the disadvantaged. Just FYI.

It's not advertised before because these needs change and who knows if 8 years in the future there will still be a shortage

 

[drizzt3117]

I agree, the only problem with things ilke the NSA program (correct me if i'm wrong, this is just what i've heard) is that it's only for people who know going in that they want to do primary care. I want to do cardiology, which I feel is extremely important in both minority communities (blacks genetically higher rates of cardiovascular disease) and economically disadvantaged (poor often eat poorly b/c whatever they can afford; fast food cheaper than healthy balanced meals) areas. Unfortunately, this isn't covered by NSA and the program leaves you no option to explore other interests and maybe go into pathology, anesthesiology, radiology, etc etc etc all needed in underserved areas as well.

I think there are two different programs. There's one that's a loan program that has low interest rates for students who go into primary care residencies, and one that gives you free tuition in return for serving in underserved populations. Cardiology is a speciality that you get into by doing an internal medicine residency, then cardiology fellowship. I'm not sure if it's eligible, IM is a primary care residency, but I'm not sure if the terms of the loan program change if you do a fellowship, and I'm not sure if you would have to serve in underserved areas doing internal medicine after doing your residency in IM before you could do a fellowship. This is something you could probably find out from the individual programs, though.

 

[Jolie South]

I think there are two different programs. There's one that's a loan program that has low interest rates for students who go into primary care residencies, and one that gives you free tuition in return for serving in underserved populations. Cardiology is a speciality that you get into by doing an internal medicine residency, then cardiology fellowship. I'm not sure if it's eligible, IM is a primary care residency, but I'm not sure if the terms of the loan program change if you do a fellowship, and I'm not sure if you would have to serve in underserved areas doing internal medicine after doing your residency in IM before you could do a fellowship. This is something you could probably find out from the individual programs, though.

I read on the NHSC forum that you have to complete service before you can start a fellowship.

 

[drizzt3117]

I read on the NHSC forum that you have to complete service before you can start a fellowship.

In that case, you'd have to evaluate whether the years of service are worth it to you compared to the money saved from tuition and stipend.