DEI is ruining UCLA. Seems the DEI pendulum swings too far the wrong way.

[adamkiewicz]

'A Failed Medical School': How Racial Preferences, Supposedly Outlawed in California, Have Persisted at UCLA

Long considered one of the best medical schools in the world, the University of California, Los Angeles's David Geffen School of Medicine receives as many as 14,000 applications a year. Of those, it accepted just 173 students in the 2023 admissions cycle, a record-low acceptance rate of 1.3...

freebeacon.com

"Those tests, known as shelf exams, which are typically taken at the end of each clinical rotation, measure basic medical knowledge and play a pivotal role in residency applications. Though only 5 percent of students fail each test nationally, the rates are much higher at UCLA, having increased tenfold in some subjects since 2020, according to internal data obtained by the Free Beacon.

That uptick coincided with a steep drop in the number of Asian matriculants and tracks the subjective impressions of faculty who say that students have never been more poorly prepared.

One professor said that a student in the operating room could not identify a major artery when asked, then berated the professor for putting her on the spot. Another said that students at the end of their clinical rotations don't know basic lab tests and, in some cases, are unable to present patients.

"I don't know how some of these students are going to be junior doctors," the professor said. "Faculty are seeing a shocking decline in knowledge of medical students.""

"Lucero has even advocated moving candidates up or down the residency rank list based on race. At a meeting in February 2022, according to two people present, Lucero demanded that a highly qualified white male be knocked down several spots because, as she put it, "we have too many of his kind" already. She also told doctors who voiced concern that they had no right to an opinion because they were "not BIPOC," sources said, and insisted that a Hispanic applicant who had performed poorly on her anesthesiology rotation in medical school should be bumped up. Neither candidate was ultimately moved."



Wow, any truth to this? It's scary if that's what's happening at other institutions.

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[GassYous]

I thought things were starting to move back towards the other way. MIT just got rid of their loyalt...I mean diversity statements

 

[Ronin786]

Medical schools are so motivated nowadays to pass students because they want them to appear as attractive as possible to residency programs in order to meet their "match metrics".

It's not just a DEI issue, it's a quality issue with everybody in medical school nowadays.

 

[2buckchuck]

It does sound a little boomer-ish, with the trite “the kids these days couldn’t cut it like back in my day”.

 

[pgg]

College professors have been complaining since at least the 90s about the declining quality of matriculants, and their inability to do entry level STEM courses, or even write or communicate effectively. So many require remediation just to get them to the level that high school should've prepared them.

You can blame DEI because it's an easy target but the problem is deeper and older than this.

 

[rowsdower88]

Though only 5 percent of students fail each test nationally, the rates are much higher at UCLA, having increased tenfold in some subjects since 2020, according to internal data obtained by the Free Beacon.

Pretty weak evidence as presented that affirmative action (or whatever OP thinks DEI is - DEI wasn't mentioned in the article aside from it being Lucero's job title) is causing this. If you look at their graphs there has been an increase in rotation failure rates since 2020 but the article (and OP) is entirely speculating on the cause. It would be interesting to see failure rates prior to that period to see if this is truly an outlier or if there is a general trend, hard to lay the blame of entire class scores on one person getting hired. It's not like AA/DEI/racial consideration practices have only been around for the past 4 years, notwithstanding CA law.

A med student not knowing a major artery is not an indication of a "failing medical school", lol.

All that said, it is wild to me that about 50% of a class failed Peds, EM, FM and IM in 2022-2023.

 

[anonperson]

Is this even remotely surprising?

They watered down admissions in order to get a more "diverse" class and then end up admitting sub standard students.

Schools hope they can get students into shape and then become competent doctors but we know that this doesn't always happen.

Keep rejecting qualified Asian and White applicants in order to fill some bizarre quota.

 

[UscGhost]

'A Failed Medical School': How Racial Preferences, Supposedly Outlawed in California, Have Persisted at UCLA

Long considered one of the best medical schools in the world, the University of California, Los Angeles's David Geffen School of Medicine receives as many as 14,000 applications a year. Of those, it accepted just 173 students in the 2023 admissions cycle, a record-low acceptance rate of 1.3...

freebeacon.com

"Those tests, known as shelf exams, which are typically taken at the end of each clinical rotation, measure basic medical knowledge and play a pivotal role in residency applications. Though only 5 percent of students fail each test nationally, the rates are much higher at UCLA, having increased tenfold in some subjects since 2020, according to internal data obtained by the Free Beacon.

That uptick coincided with a steep drop in the number of Asian matriculants and tracks the subjective impressions of faculty who say that students have never been more poorly prepared.

One professor said that a student in the operating room could not identify a major artery when asked, then berated the professor for putting her on the spot. Another said that students at the end of their clinical rotations don't know basic lab tests and, in some cases, are unable to present patients.

"I don't know how some of these students are going to be junior doctors," the professor said. "Faculty are seeing a shocking decline in knowledge of medical students.""

"Lucero has even advocated moving candidates up or down the residency rank list based on race. At a meeting in February 2022, according to two people present, Lucero demanded that a highly qualified white male be knocked down several spots because, as she put it, "we have too many of his kind" already. She also told doctors who voiced concern that they had no right to an opinion because they were "not BIPOC," sources said, and insisted that a Hispanic applicant who had performed poorly on her anesthesiology rotation in medical school should be bumped up. Neither candidate was ultimately moved."



Wow, any truth to this? It's scary if that's what's happening at other institutions.

Seems like a pretty difficult connection to make without actual data. Average gpa? Mcat scores? Extracurriculars?

USC has always had a highly diverse class and little problems with exam failures. USC revamped the curriculum a few years before me and subsequently had a significant improvement in scores.

Given the political energy surround DEI, I would highly suspect that there are other causes for the decline in exam scores but those involved are using DEI to divert attention away from the root causes.

Does UCLA offer review courses? Time to study? Structured curriculum to focus on the important topics for exam prep?

 

[secretasianman]

Well don’t you know all these exams are biased for whites and Asians to perform better, therefore they are not fair?

 

[RockClimberMed]

Pretty weak evidence as presented that affirmative action (or whatever OP thinks DEI is - DEI wasn't mentioned in the article aside from it being Lucero's job title) is causing this. If you look at their graphs there has been an increase in rotation failure rates since 2020 but the article (and OP) is entirely speculating on the cause. It would be interesting to see failure rates prior to that period to see if this is truly an outlier or if there is a general trend, hard to lay the blame of entire class scores on one person getting hired. It's not like AA/DEI/racial consideration practices have only been around for the past 4 years, notwithstanding CA law.

A med student not knowing a major artery is not an indication of a "failing medical school", lol.

All that said, it is wild to me that about 50% of a class failed Peds, EM, FM and IM in 2022-2023.

View attachment 387119

Is this graph for all USMDs? Or specific to UCLA?

 

[pierty]

Is this graph for all USMDs? Or specific to UCLA?

Specific to UCLA. It's not a small problem. The pass rate nationwide is 95% (the pass range is determined by percentile).

 

[drmwvr]

Starts way before medical school. It's just trickling up. But when major medical associations, the AMA being the most visible, embrace disparate impact thinking, denying that it's affecting US medical education is really whistling past the graveyard. It's endemic in academia in general. How can it not have made it's way into medicine? Guaranteed admissions, early assurance, waived MCAT. Then a P/F Step One? Why? It's not just medicine. State bar associations are doing the same type stuff. It's a terrible ideology that has gotten legs and anonymous internet forums are the only places folks feel safe enough to say anything and it's why DJT is threatening a win in the Fall. So necrotic on so many levels...

 

[Ezekiel2517]

A more interesting and insightful read than that dumb article imo

UCLA Medical School in Crisis

I am a faculty member at UCLA and while this is my first post I think everyone will quickly understand why I want to remain anonymous. I also realize that when someone posts something like this as their first post everyone should be openly skeptical of the post and try to understand what motives...

forums.studentdoctor.net

 

[nimbus]

I thought things were starting to move back towards the other way. MIT just got rid of their loyalt...I mean diversity statements

They also require SAT again. Too many in the non-SAT cohort were failing required classes.

 

[nimbus]

For a lot of undergrad science majors, many of the subjects in the preclinical years are review. I was a biochemistry/molecular biology major and that was the case for me. One of my friends who was an EE/CS major struggled mightily because his first exposure to courses like genetics, immunology, and physiology was in medical school. And when I went to medical school, almost everybody came directly out of undergrad so most of us were still in the habit of studying and cramming. Nowadays it seems many people have 1-4 gap years after undergrad before starting medical school. I think it would be difficult to resume studying those dry topics intensely after 2-3 years working as a scribe or in a lab.

 

[BLADEMDA]

You guys can pontificate about the cause of the decline and increased failure on exams. I don’t care as to why it is happening just the consequences. Everyone regardless of race, sex, gender, etc should be held to the same standards. This means if you fail your exams you don’t get promoted to the next level and you don’t graduate. If the students need a 5th year to remediate then that’s what needs to happen. As for kids who can’t write any longer, in my day I had to hand write an essay at my med school interview to prove my proficiency in communication. There were no computers or tablets or word correct used for that essay. I recommend a return to the standards of the past in terms of what we demand from the students of all colors and backgrounds. A student who can’t meet the standards shouldn’t graduate.

Our meritocracy is an experiment worth keeping alive; that can only happen if we continue our march towards a color blind society and one where those deserving of promotion based on objective criteria are rewarded. This nation must move beyond race, gender and ideology if we are to continue to be competitive with the rest of the world like China and Japan.

 

[ucladoc2b]

This isn’t DEI. This is new curriculum.

I went through something similar at my med school when they redesigned the preclinical curriculum (at a top 20 school). It ended up being kind of a cluster. I remember pharm being taught before biochem and relevant physiology, for example, a randomly divided anatomy curriculum, and other quirks first year that made things difficult to learn. Second year was much better.

It was not an easy being one of the first few classes through it. If I recall, something like 25-30% of the class had to remediate a block.

I felt that if you had a good background in the med school subject matter from undergrad, you had an advantage. But if it was your first exposure, it was a painful experience.

 

[pgg]

A more interesting and insightful read than that dumb article imo

UCLA Medical School in Crisis

I am a faculty member at UCLA and while this is my first post I think everyone will quickly understand why I want to remain anonymous. I also realize that when someone posts something like this as their first post everyone should be openly skeptical of the post and try to understand what motives...

forums.studentdoctor.net

I've been skeptical of the medical school curriculum changes (earlier and earlier clinical exposure at the expense of classroom academics) from the start.

It's a recruiting point. After four years of undergrad classroom work, applicants definitely like the idea of getting out of the classroom ASAP and into clinical work to learn real doctoring.

Going to pass/fail on the USMLE was idiotic. So are ungraded and pass/fail preclinical courses. Anyone smart enough to get into medical school is smart enough to see that removing these standards and shifting residency competition away from academics would result in students shifting their efforts to the things that still do matter for residency applications. Of course medical students' book knowledge suffered. Of course it did. The amazing thing is that the faculty and administrators who bought into these monumentally stupid ideas surely understood this also, but they did it anyway.

Getting medical students exposure to clinical work earlier and earlier is especially weird, since the other undeniable trend of the last 20-30 years has been to delay the time until trainees are actually allowed to DO anything. I graduated from medical school in 2002. As a medical student I was taught to do lines, close in surgeries. I was left alone in ORs during anesthesia rotations as a MS4. Practically none of that happens now - medical students are glorified observers. Interns and R2s are fighting for the procedures they weren't allowed to do as medical students. Med students on anesthesia rotations aren't double diluting their own phenylephrine and giving it to patients while the attending is seeing the next patient.

Just seems marvelously weird to me that we're cutting academic time from medical school curricula in order to get the students into clinical spaces earlier to do less than they were before the classroom time was cut.

And here we are.

 

[rowsdower88]

Is this graph for all USMDs? Or specific to UCLA?

Got it from OP's article. Presumably UCLA med school.

 

[anonperson]

This isn’t DEI. This is new curriculum.

I went through something similar at my med school when they redesigned the preclinical curriculum (at a top 20 school). It ended up being kind of a cluster. I remember pharm being taught before biochem and relevant physiology, for example, a randomly divided anatomy curriculum, and other quirks first year that made things difficult to learn. Second year was much better.

It was not an easy being one of the first few classes through it. If I recall, something like 25-30% of the class had to remediate a block.

I felt that if you had a good background in the med school subject matter from undergrad, you had an advantage. But if it was your first exposure, it was a painful experience.

Why did they drastically change the curriculum? It can't be because the prior cohort of medical students were struggling on Step 1/2 etc or having a difficult time matching or being good residents.

Probably had to dumb the curriculum down because they are not choosing stellar students.

 

[ucladoc2b]

Why did they drastically change the curriculum? It can't be because the prior cohort of medical students were struggling on Step 1/2 etc or having a difficult time matching or being good residents.

Probably had to dumb the curriculum down because they are not choosing stellar students.

They can get whoever they want. It’s one of the most competitive schools in the country.

It’s likely either new admin or accreditation body requirements.

 

[anonperson]

I recommend a return to the standards of the past in terms of what we demand from the students of all colors and backgrounds. A student who can’t meet the standards shouldn’t graduate.

The problem with this very reasonable thought is there is a very vocal segment of progressives/liberals etc who think a meritocracy is sexist, racist, classiest, and every other type of ist you can think of.

They know in a true meritocracy, some races would be left behind.

We must drag everyone down so we can all be equal.

 

[anonperson]

They can get whoever they want. It’s one of the most competitive schools in the country.

It’s likely either new admin or accreditation body requirements.

I didn't say the curriculum was a recruiting tool.. That was someone else.

They have no shortage of qualified applicants from even California alone.

 

[Spikebd]

College professors have been complaining since at least the 90s about the declining quality of matriculants, and their inability to do entry level STEM courses, or even write or communicate effectively. So many require remediation just to get them to the level that high school should've prepared them.

You can blame DEI because it's an easy target but the problem is deeper and older than this.

It’s literally facts that DEI generates worse matriculants based off of GPA and standardized tests.

They’re not perfect, but they’re no different than the NFL combine using height, weight, 40-yard dash time, bench press as some of their metrics for that sport.

DEI may not be the only factor in the worsening of the matriculants to our profession, it is certainly an important factor and it has being going on for decades now.

 

[Spikebd]

You guys can pontificate about the cause of the decline and increased failure on exams. I don’t care as to why it is happening just the consequences. Everyone regardless of race, sex, gender, etc should be held to the same standards. This means if you fail your exams you don’t get promoted to the next level and you don’t graduate. If the students need a 5th year to remediate then that’s what needs to happen. As for kids who can’t write any longer, in my day I had to hand write an essay at my med school interview to prove my proficiency in communication. There were no computers or tablets or word correct used for that essay. I recommend a return to the standards of the past in terms of what we demand from the students of all colors and backgrounds. A student who can’t meet the standards shouldn’t graduate.

Our meritocracy is an experiment worth keeping alive; that can only happen if we continue our march towards a color blind society and one where those deserving of promotion based on objective criteria are rewarded. This nation must move beyond race, gender and ideology if we are to continue to be competitive with the rest of the world like China and Japan.

Bravo, 💯 agree. The discrimination against white and Asian applicants should end immediately.

 

[rowsdower88]

The problem with this very reasonable thought is there is a very vocal segment of progressives/liberals etc who think a meritocracy is sexist, racist, classiest, and every other type of ist you can think of.

They know in a true meritocracy, some races would be left behind.

We must drag everyone down so we can all be equal.

If we could create a true meritocracy without externalities, that would be great. But we can't, so we have created systems to blunt the impact of aspects of the imperfect meritocracy we created that we don't like.

One reason America has moved away from a meritocratic ideal is medical student depression and suicide. We can debate the costs/benefits of the change to P/F systems but I know that for my alma mater reducing stress on med students was a primary driver for moving to P/F. There's even some evidence that these systems (depending on implementation) reduce stress and don't cause a significant impact on academic outcomes. I haven't looked into it at all, but I would assume this motivated USMLE as well wrt Step 1 scoring.

Differences in Medical Students' Academic Performance between a Pass/Fail and Tiered Grading System - PubMed

Overall academic performance was similar. The potential for an enhanced learning environment associated with pass/fail grading does not create an important decrement in academic performance.

pubmed.ncbi.nlm.nih.gov

Arguments for race based considerations stem from the same concern: there are aspects of our imperfect meritocracy that result in outcomes we don't like that won't be fixed by closing our eyes to inequalities and pretending we can create a perfect meritocratic system.

In any case, it would be interesting to see what impact undergraduate grade inflation has had on medical student outcomes. I would suspect that has a bigger impact than all race based considerations, but that's my gut impression and not based on research. I'm not sure why undergraduate grade inflation and the impacts on graduate education aren't talked about more.

https://www.gradeinflation.com/tcr2012grading.pdf

 

[aneftp]

DEI makes things even worse. Too much wiggling to try to fit an agenda. The non dei grads are not that tough either. I think it should be mandatory to go an average of q2 calls 120- hrs a week for at least first 3 months in internship year to weed everyone out. Most of us who are older than 50 know what a real residency with real hours means. And surgery residents had it even worse.

If people can make it out the first 3 months. They can coast the rest of the way because they will know what tough work is light.

We take it too light on students and residents these days.

 

[Maz777]

I've been skeptical of the medical school curriculum changes (earlier and earlier clinical exposure at the expense of classroom academics) from the start.

It's a recruiting point. After four years of undergrad classroom work, applicants definitely like the idea of getting out of the classroom ASAP and into clinical work to learn real doctoring.

Going to pass/fail on the USMLE was idiotic. So are ungraded and pass/fail preclinical courses. Anyone smart enough to get into medical school is smart enough to see that removing these standards and shifting residency competition away from academics would result in students shifting their efforts to the things that still do matter for residency applications. Of course medical students' book knowledge suffered. Of course it did. The amazing thing is that the faculty and administrators who bought into these monumentally stupid ideas surely understood this also, but they did it anyway.

Getting medical students exposure to clinical work earlier and earlier is especially weird, since the other undeniable trend of the last 20-30 years has been to delay the time until trainees are actually allowed to DO anything. I graduated from medical school in 2002. As a medical student I was taught to do lines, close in surgeries. I was left alone in ORs during anesthesia rotations as a MS4. Practically none of that happens now - medical students are glorified observers. Interns and R2s are fighting for the procedures they weren't allowed to do as medical students. Med students on anesthesia rotations aren't double diluting their own phenylephrine and giving it to patients while the attending is seeing the next patient.

Just seems marvelously weird to me that we're cutting academic time from medical school curricula in order to get the students into clinical spaces earlier to do less than they were before the classroom time was cut.

And here we are.

Disagree with that post. I chose my medical school solely because they had only one year of preclinical. I much preferred getting to my clinical year earlier and learning hands on. I have forgotten 99% of what I was taught during my preclinical year. It seems so irrelevant nowadays. Very few countries have a medical education system like we do and for good reason.

The goal of medical school is to figure out what field to go into and pass some stupid tests. Residency is for the real learning. My only gripe with medical school curriculums is that most don't get exposed to every specialty. I had no exposure to more than 50% of specialities even with electives. I didn't even have an anesthesia rotation. How do you make an educated decision about your career if you haven't seen every specialty?

 

[hippieskippy]

DEI makes things even worse. Too much wiggling to try to fit an agenda. The non dei grads are not that tough either. I think it should be mandatory to go an average of q2 calls 120- hrs a week for at least first 3 months in internship year to weed everyone out. Most of us who are older than 50 know what a real residency with real hours means. And surgery residents had it even worse.

If people can make it out the first 3 months. They can coast the rest of the way because they will know what tough work is light.

We take it too light on students and residents these days.

love a good modest proposal

 

[rowsdower88]

DEI makes things even worse. Too much wiggling to try to fit an agenda. The non dei grads are not that tough either. I think it should be mandatory to go an average of q2 calls 120- hrs a week for at least first 3 months in internship year to weed everyone out. Most of us who are older than 50 know what a real residency with real hours means. And surgery residents had it even worse.

If people can make it out the first 3 months. They can coast the rest of the way because they will know what tough work is light.

We take it too light on students and residents these days.

You're joking, but suppose we moved to your system with a tough 3 months to "weed out" people.

Let's speculate that it weeds out 3% of otherwise acceptable residents and results in a 0.5% increase in residents developing severe depression/suicide attempts (roughly 100 individuals across the US). The remaining residents finish residency without issue.

Would you say the outcomes are better or worse than the status quo? It seems like this is a calculation that administrators and governing bodies are forced into. You can argue the status quo is "coddling" but arguably it is reducing morbidity/mortality.

Edit: Just read your reply. You weren't joking.

 

[aneftp]

You're joking, but suppose we moved to your system with a tough 3 months to "weed out" people.

Let's speculate that it weeds out 3% of otherwise acceptable residents and results in a 0.5% increase in residents developing severe depression/suicide attempts (roughly 100 individuals across the US). The remaining residents finish residency without issue.

Would you say the outcomes are better or worse than the status quo? It seems like this is a calculation that administrators and governing bodies are forced into. You can argue the status quo is "coddling" but arguably it is reducing morbidity/mortality.

I have no sympathy for people who can’t handle stress. Call me old fashion. But if you can’t take the heat. Leave. Find another career that suits you. It’s the cold harsh truth.

I’m not a believer in mental health. Again. People are free to do with however they want to handle stress. But if they can’t handle the stress. They shouldn’t be in this profession. Go into something less demanding. Like making Starbucks coffee for a living. But even some Starbucks coffee baristas can’t even handle that.

You are being brain wash to treating people with kid gloves. You push people to the edge. See how they perform. That’s how you make strong doctors. Or do you want to be the next vontae Davis. A very good football player who literally quit in the middle of an nfl game. He was widely criticized for quitting. Same thing should happen to doctors in training. If they can’t perform. There is an exit door and they don’t have to come back.

 

[powermd]

The goal of medical school is to figure out what field to go into and pass some stupid tests. Residency is for the real learning. My only gripe with medical school curriculums is that most don't get exposed to every specialty. I had no exposure to more than 50% of specialities even with electives. I didn't even have an anesthesia rotation. How do you make an educated decision about your career if you haven't seen every specialty?

I think the goal of medical school is to build a foundation for lifelong learning in medicine. I can say the intense competition for grades at my school with people far more talented than me leveled up my abilities in every way. I'm a much better doctor for it, and I'm sure if I had a crutch like pass or fail classes/USMLE my patient care skills would have suffered in some way.

 

[Maz777]

I think the goal of medical school is to build a foundation for lifelong learning in medicine. I can say the intense competition for grades at my school with people far more talented than me leveled up my abilities in every way. I'm a much better doctor for it, and I'm sure if I had a crutch like pass or fail classes/USMLE my patient care skills would have suffered in some way.

Depends on your background. That foundation should have started much earlier. If you are starting that in med school, you're too late and will be prone to struggling.

Undergraduate was way more difficult for me. Studied at a hardcore tech school, average GPAs were around 2.5. The highest score on my first semester calculus course was a raw score of 30% in the entire class. 30% of people failed out during their first two years. Med school and its rote memorization of facts paled in comparison.

 

[aneftp]

Depends on your background. That foundation should have started much earlier. If you are starting that in med school, you're too late and will be prone to struggling.

Undergraduate was way more difficult for me. Studied at a hardcore tech school, average GPAs were around 2.5. The highest score on my first semester calculus course was a raw score of 30% in the entire class. 30% of people failed out during their first two years. Med school and its rote memorization of facts paled in comparison.

That was my point about pushing med students and residents hard

If you were pushed hard in undergrad. U were prepared in med school already.

People get behind the 8 ball being cuddled too much and can’t deal with adversity.

 

[anonperson]

If we could create a true meritocracy without externalities, that would be great. But we can't, so we have created systems to blunt the impact of aspects of the imperfect meritocracy we created that we don't like.

One reason America has moved away from a meritocratic ideal is medical student depression and suicide. We can debate the costs/benefits of the change to P/F systems but I know that for my alma mater reducing stress on med students was a primary driver for moving to P/F. There's even some evidence that these systems (depending on implementation) reduce stress and don't cause a significant impact on academic outcomes. I haven't looked into it at all, but I would assume this motivated USMLE as well wrt Step 1 scoring.

Differences in Medical Students' Academic Performance between a Pass/Fail and Tiered Grading System - PubMed

Overall academic performance was similar. The potential for an enhanced learning environment associated with pass/fail grading does not create an important decrement in academic performance.

pubmed.ncbi.nlm.nih.gov

Arguments for race based considerations stem from the same concern: there are aspects of our imperfect meritocracy that result in outcomes we don't like that won't be fixed by closing our eyes to inequalities and pretending we can create a perfect meritocratic system.

In any case, it would be interesting to see what impact undergraduate grade inflation has had on medical student outcomes. I would suspect that has a bigger impact than all race based considerations, but that's my gut impression and not based on research. I'm not sure why undergraduate grade inflation and the impacts on graduate education aren't talked about more.

https://www.gradeinflation.com/tcr2012grading.pdf

You can create a meritocracy.

If you have the grades and MCAT score, you should have the admission advantage over someone with lower scores.

Simple.

But there constantly has to be mental gymnastics to justify what is essentially racist policies.

Just like in the NBA or NFL, if you're a better player, you will play in the league. Doesn't matter if you grew up poor or had a wealthy upbringing. Best person gets in. The end result is a good product. Strange how there is no DEI push in pro sports. We need more Whites and Asians in the NBA and NFL!
----------------------------------------------------------------

Regarding P/F grading and a P/F step 1. Why not go all the way? Make Step 2 and Step 3 pass/ fail.

All they've accomplished with making Step 1 P/F is put more emphasis on Step 2 and personal connections etc for residency and fellowship.

It's probably because it is perfectly reasonable to have scored tests and determine some ability based on this.

 

[Spikebd]

You can create a meritocracy.

If you have the grades and MCAT score, you should have the admission advantage over someone with lower scores.

Simple.

But there constantly has to be mental gymnastics to justify what is essentially racist policies.

Just like in the NBA or NFL, if you're a better player, you will play in the league. Doesn't matter if you grew up poor or had a wealthy upbringing. Best person gets in. The end result is a good product. Strange how there is no DEI push in pro sports. We need more Whites and Asians in the NBA and NFL!
----------------------------------------------------------------

Regarding P/F grading and a P/F step 1. Why not go all the way? Make Step 2 and Step 3 pass/ fail.

All they've accomplished with making Step 1 P/F is put more emphasis on Step 2 and personal connections etc for residency and fellowship.

It's probably because it is perfectly reasonable to have scored tests and determine some ability based on this.

If doctors want to be distinct from NPs and PAs this is the only way. Adopt more of the surgery M&M model and don’t be afraid to hold residents feet to the fire. I learned best in residency when I had people give me negative feedback about my presentations or grilled me during those presentations. If I looked like an idiot I took it personally and studied my ass off or spent an extra 5 hours preparing my grand rounds talk. If medicine is mostly rote memorization than that’s even more evidence we don’t need DEI, we need DRIVEN and HARDWORKING people in medicine and two very good metrics are GPA and MCAT (same with the USMLE).

 

[Spikebd]

We are talking about people’s lives here. I recently had to be on the receiving end of patient care and got to see that unfortunately, there are occasionally really bad doctors that can do serious harm in a short amount of time (85% were really great, some amazing). But those bad ones can be truly dangerous.

 

[anonperson]

You've already said you're "not a believer in mental health" and don't seem to be willing to grant that other people might reasonably place higher value on it than you do. You even seem to bite the bullet and say a more harda** system (with questionable effects on resident resilience) that results in ~100 more residents having severe depression/suicidality would be preferable to the status quo.

If those are the positions that you already hold, I'm not going to bother trying to persuade you with any racial critiques of the American healthcare system.

You're responding to the wrong poster.

Aneftp is the one you're referring to.

 

[BLADEMDA]

Can we at least agree you should pass your shelf exams on the second attempt? Shouldn't there be some standards after the DEI candidate gets admitted?
This dumbing down of the entire curriculum doesn't help patients or the country. We all deserve better in terms of making sure everyone who graduates meets a minimum level standard. The problem is that standard is constantly being lowered to fit an ideology.

 

[rowsdower88]

Regarding P/F grading and a P/F step 1. Why not go all the way? Make Step 2 and Step 3 pass/ fail.

All they've accomplished with making Step 1 P/F is put more emphasis on Step 2 and personal connections etc for residency and fellowship.

It's probably because it is perfectly reasonable to have scored tests and determine some ability based on this.

I'm not a big fan of the pass/fail system, but I understand the rationale for doing it. Depression and burnout are big reasons for why many med students don't finish. I think if you want to argue against P/F, you should at least recognize that that is at least one of the problems they were trying to address (med student stress). So why didn't they move all the Steps to P/F? I don't know, they're probably trying to find a balance between reducing stressors and maintaining some criteria for residencies to use.

 

[rowsdower88]

You can create a meritocracy.

If you have the grades and MCAT score, you should have the admission advantage over someone with lower scores.

Simple.

I would prefer your hypothetical system to the status quo that places some value on scholarly publication, clinical shadowing/recommendations, and mission trips.

Those sources of merit signify wealth and class more than MCAT and GPA.

That said, I recognize that there exist other forms of merit besides tests and grades that should be considered when talking about creating a class of medical students.

For example, if it is the case that having a racially diverse class of medical students results in better healthcare outcomes for a population, then we could (among other things) make policy decisions on med school admissions that recognize that. If you want to argue that preserving "true meritocracy" outweighs those benefits, you can, but at least recognize that this decision likely does affect healthcare outcomes.

(This would require looking into practice patterns of minority physicians, studies on racial concordance between physician and patient, and racial disparities in healthcare in general among other things.)

 

[dozitgetchahi]

Medical schools are so motivated nowadays to pass students because they want them to appear as attractive as possible to residency programs in order to meet their "match metrics".

It's not just a DEI issue, it's a quality issue with everybody in medical school nowadays.

Yeah I agree. The quality of medical students is getting worse, but I don’t think it’s a DEI thing.

Even when I was in medical school (graduated 2013), I was surprised at how many of my colleagues (of every race) didn’t seem to have their **** together.

 

[kidthor]

I think it’s two different things - the quality of medical students (and residents) is going down, and these places are also simultaneously ramming DEI into everything. They’re overlapped but not fully cause and effect.

I will say that awhile ago when I was looking for academic jobs I had to write DEI tribute statements for most applications, and I had to interview with DEI executives at more than one job. One of said execs was absolutely condescending to me based on my incorrect race and gender. I am very in favor of equity and treating all people with respect - but I really dislike this “kiss the DEI ring” requirement.

 

[hippieskippy]

I think it’s two different things - the quality of medical students (and residents) is going down, and these places are also simultaneously ramming DEI into everything. They’re overlapped but not fully cause and effect.

I will say that awhile ago when I was looking for academic jobs I had to write DEI tribute statements for most applications, and I had to interview with DEI executives at more than one job. One of said execs was absolutely condescending to me based on my incorrect race and gender. I am very in favor of equity and treating all people with respect - but I really dislike this “kiss the DEI ring” requirement.

That's a pretty high horse you're sitting on. Objectively, the quality of medical students and residents has never been higher. Especially for anesthesiology.

There's a reason Step 1 became a pass/fail exam, and it wasn't because the quality of medical students went down.

50% of test takers in 1992-1993 would have failed.

 

[rowsdower88]

I will say that awhile ago when I was looking for academic jobs I had to write DEI tribute statements for most applications

What? Do you still have any of the statements you wrote? I would be interested in what prompts they gave you.

 

[kidthor]

That's a pretty high horse you're sitting on. Objectively, the quality of medical students and residents has never been higher. Especially for anesthesiology.

All I know is that the residents now compared to 5-7 years ago are worse in terms of clinical skills, common sense, and work ethic. There are plenty of great ones, but there are far more duds.

 

[Agast]

All I know is that the residents now compared to 5-7 years ago are worse in terms of clinical skills, common sense, and work ethic. There are plenty of great ones, but there are far more duds.

Are you seeing a correlation with the residents with lower skills being in the DEI group? Whereas the great ones are consistently white males? Just curious no snark.

 

[pgg]

I have forgotten 99% of what I was taught during my preclinical year.

No you haven't.

We have a name for people in our field who skimped on depth and breadth of book knowledge in favor of "exposure" type clinical experience: CRNA.

There's nothing wrong with being a CRNA, but they're not doctors.

Depression and burnout are big reasons for why many med students don't finish. I think if you want to argue against P/F, you should at least recognize that that is at least one of the problems they were trying to address (med student stress).

Before P/F became trendy, did "many" med students not finish? I would argue that wasn't the case. A few percent attrition is an acceptable loss rate, especially considering that the figure also includes people who drop out for non-academic reasons.

According to some, vaguely defined "stress" is a modern bogeyman that must be countered at all costs. I don't agree. Stress and pressure in training is useful and necessary: it's undeniable that it has motivating power and drives most people to excel, at the cost of weeding out some.

I'm not quite on @aneftp level of wishing for the return 100-120 hr/week residencies (which was and is ridiculous, if for no other reason than well-documented patient safety risks that accompany that level of fatigue) but he's not wholly wrong. We're in a profession that demands more of us than the cheese packaging factory manager who lives down the street.

I suppose it's possible that what the country actually needs to maximize positive health outcomes per dollar spent is more "providers" of generally adequate quality. If that's the case we should be funneling more people into NP and PA and CRNA programs, rather than lowering standards and expectations of physicians.

Because that's what P/F and abbreviated preclinical time are really about, when you strip away the foggy misdirection of medical student stress and pandering to misguided premeds' desire to get to the "real doctorin' stuff" ASAP.

 

[hippieskippy]

All I know is that the residents now compared to 5-7 years ago are worse in terms of clinical skills, common sense, and work ethic. There are plenty of great ones, but there are far more duds.

The children now love luxury; they have bad manners, contempt for authority; they show disrespect for elders and love chatter in place of exercise.

 

[kidthor]

Are you seeing a correlation with the residents with lower skills being in the DEI group? Whereas the great ones are consistently white males? Just curious no snark.

Absolutely not.