Do current 'unwritten requirements' select for the wealthy?

[Mad Jack]

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Yah I think affordable housing should be available to anyone working a low wage job in an expensive city and also for people who are mentally ill but cannot be permanently situated at their treatment facility. We can't prescribe a treatment plan to the homeless brought by police custody into our care and then send them back into the streets and expect them to follow the plan much less get better without some minimal support system in place. Shelter is the least we can do. Similarly, someone willing to work an honest job full-time shouldn't have to worry about having a roof over their head.

I'm actually fine with free housing for the homeless, with the stipulation that they must complete job training in exchange for their stay. In the case of the mentally ill, I'm also fine with providing housing. In both cases, it's actually far cheaper to provide housing than to let them rotate in and out of jails and hospitals. We once had a guy that was homeless and on Medicaid that cost the state over a quarter of a million dollars a year in hospital bills alone, plus over a hundred thousand more in ambulance bills- could've housed him, rehabilitated him, and got him back into the work force and off the bottle for less than one quarter of his yearly cost to the state. Same general pragmatic argument holds for the mentally ill- prisons aren't cheap, and that's where they usually end up, which is bad for them, bad for society, bad for everyone all around.

But I actually think that providing affordable housing to those in cities is counterproductive. If you do this, you are basically subsidizing businesses that would otherwise be unable to attract workers without raising wages. If they don't have employees, they can't function, so either they close down or they raise wages. Raising wages increases cost of living in the city, which incentivizes people to leave. Enough people leave, the cost of living in the city goes down, as there are less people pumping money into the economy and there is less demand for housing and services. Interfering with the natural order of things by having subsidized housing doesn't help people, it helps businesses and perpetuates the very inequality and problems it is trying to fight.

 

[Lucca]

I'm actually fine with free housing for the homeless, with the stipulation that they must complete job training in exchange for their stay. In the case of the mentally ill, I'm also fine with providing housing. In both cases, it's actually far cheaper to provide housing than to let them rotate in and out of jails and hospitals. We once had a guy that was homeless and on Medicaid that cost the state over a quarter of a million dollars a year in hospital bills alone, plus over a hundred thousand more in ambulance bills- could've housed him, rehabilitated him, and got him back into the work force and off the bottle for less than one quarter of his yearly cost to the state. Same general pragmatic argument holds for the mentally ill- prisons aren't cheap, and that's where they usually end up, which is bad for them, bad for society, bad for everyone all around.

But I actually think that providing affordable housing to those in cities is counterproductive. If you do this, you are basically subsidizing businesses that would otherwise be unable to attract workers without raising wages. If they don't have employees, they can't function, so either they close down or they raise wages. Raising wages increases cost of living in the city, which incentivizes people to leave. Enough people leave, the cost of living in the city goes down, as there are less people pumping money into the economy and there is less demand for housing and services. Interfering with the natural order of things by having subsidized housing doesn't help people, it helps businesses and perpetuates the very inequality and problems it is trying to fight.

That works only if employers actually raise wages and there aren't people available to work at lower wages. Employers don't tend to raise wages for low wage workers and there tend to be people available to work for lower wages in places like NYC and SF etc. you may be underestimating the difficulty of "just" leaving a city that has been your family's home for generations (meaning you have a place to live already but the neighborhood is becoming so expensive so quickly you're being threatened to give up your rightful property; if that is not coercion than Idk what is to coopt the libertarian vocab).

But in fine to agree to disagree on that point. I think every city might be a little different in that respect and I would have to take a closer look at available data to backup my position on that front. I do feel strongly about the mentally ill and homeless though.

 

[Mad Jack]

That works only if employers actually raise wages and there aren't people available to work at lower wages. Employers don't tend to raise wages for low wage workers and there tend to be people available to work for lower wages in places like NYC and SF etc. you may be underestimating the difficulty of "just" leaving a city that has been your family's home for generations (meaning you have a place to live already but the neighborhood is becoming so expensive so quickly you're being threatened to give up your rightful property; if that is not coercion than Idk what is to coopt the libertarian vocab).

But in fine to agree to disagree on that point. I think every city might be a little different in that respect and I would have to take a closer look at available data to backup my position on that front. I do feel strongly about the mentally ill and homeless though.

Eventually a city will become so expensive there will be no workers, so long as they keep pushing up real estate prices. While leaving one's home sounds terrible and all, that's life- their ancestors came to NYC to escape economic conditions in one place that lacked opportunity or wages, and it's only fitting that they once more have to do the same. The smarter amongst New Yorkers are getting out for places with more reasonable CoLs already:

http://www.twcnews.com/nys/new-york...o-grow--but-upstate-population-shrinking.html

Indeed, while data now show the city at a record of nearly 8.5 million people, with the greater metro area at about 20.1 million, largest in the nation, over the last four years, domestic migration – people relocating within the U.S. – was a net loss of about 529,000 people, while the area gained about 600,000 international immigrants.

The only reason NYC is still keeping its number of citizens up is immigration and births, while 1 in 17 New Yorkers continue to leave the state for greener locales each year.

 

[7331poas]

The employability of humans is only going to go down in the future as automation rises. Some of you are going to have to get very used to the government providing housing of some kind.

 

[takeurmeds02]

Certainly. I know many examples of students' whose family wealth, connections, positions have provided significant advantages. Perhaps the biggest problem for those outside of that minority is simply knowing of opportunities. Sure, one may have to ask more times to get into a lab, shadow, etc, but with persistence and good planning, those opportunities are not tremendously difficult to indulge for most people. Yet, one must have the knowledge of opportunities to pursue them; looking back, when I first entered college I was so "naive". I didn't realise undergrads could do research, that you had to even have volunteer experience as a pre-med, etc. That is why it is often very beneficial to seek out mentors who have been through what you are going through; however, I imagine many segments of society do not have ready access to those mentors which is another obstacle.

Also, I would like to point out that children coming from wealthier families often tend to have better developed social skills for settings such as interviews. There are many intangibles that come with status.

With regard to the stat about African Americans (NOT trying to shift nor start a debate about Affirmative Action or URMs), a big problem IMHO is that immigrant/foreign Africans detract from the more support that African Americans should receive. I've interviewed at many schools and 9 times out of 10, the black applicant would be African (not African American). Many of these immigrant families have the same mentality as other immigrant races such as Asians and are more successful/well-to-do than people may realize.

In the end, the advantage will always be there (or at least for a very long time). Life is a cumulative game and the successes of your ancestors or lack thereof do, whether desired or not, play a significant role in the following generations.

I'm so glad that someone else is aware of this phenomena...

 

[deleted480308]

That works only if employers actually raise wages and there aren't people available to work at lower wages. Employers don't tend to raise wages for low wage workers and there tend to be people available to work for lower wages in places like NYC and SF etc. you may be underestimating the difficulty of "just" leaving a city that has been your family's home for generations (meaning you have a place to live already but the neighborhood is becoming so expensive so quickly you're being threatened to give up your rightful property; if that is not coercion than Idk what is to coopt the libertarian vocab).

But in fine to agree to disagree on that point. I think every city might be a little different in that respect and I would have to take a closer look at available data to backup my position on that front. I do feel strongly about the mentally ill and homeless though.

coercion is "I'll beat you up if you don't leave"....."I can rent this property I own for 20% more than I am now so rent is going up next year whether you can afford it or not" isn't coercion. That's a property owner doing math.

Rent control is using the government's force for coercion, "I'll send men with guns to lock you up if you try to charge a market rate".

No one has a right to rent in a particular location for generations, you pay the owner what they want or you move on

 

[WingedOx]

https://en.wikipedia.org/wiki/Deurbanization
https://www.sciencedaily.com/releases/2009/09/090924093553.htm
http://www.bentley.edu/prepared/why-millennials-are-moving-suburbs-and-smaller-cities

It's a slow-but-sure process that is occurring all over the US, as people move from traditional powerhouse cities to smaller, more affordable cities throughout the country. As the youth flees places like NY and LA, these cities will enter decline as their workforce ages and their appeal to youthful new citizens decreases. It's also been happening in China for years as well, as migrants no longer find expensive, large cities to be desirable:

http://www.theatlantic.com/china/ar...re-abandoning-the-countrys-top-cities/274860/

And also in London:

http://www.theguardian.com/uk-news/2014/nov/29/young-londoners-flee-capital-region-house-prices

It's basically happening all over the world.

Sure, that's one side of the coin, but at the same time, what about the other half? Young people are still flocking into NY as gentrification spreads farther and farther out into the boroughs and the city gets less and less affordable. Even here in Chicago, a city that's technically losing population (mainly from the S and W sides to the southern burbs) I'm still surrounded by condo/apartment construction on all sides for people in their 20s and early 30s. When I started residency I could get a one bed in Wicker Park for ~900 a month. Now I don't recommend that area to residents since it's likely out of their price range. My area of the city was once just warehouses and public housing. Now I've had 3 breweries open in the last year and a half, and the price of our condo has likely doubled.

 

[Mad Jack]

Sure, that's one side of the coin, but at the same time, what about the other half? Young people are still flocking into NY as gentrification spreads farther and farther out into the boroughs and the city gets less and less affordable. Even here in Chicago, a city that's technically losing population (mainly from the S and W sides to the southern burbs) I'm still surrounded by condo/apartment construction on all sides for people in their 20s and early 30s.

On a macro level, however, more non-immigrant young people are leaving NYC than moving there. The ones that do relocate may be wealthier, but that is a pretty meaningless metric.

 

[Instatewaiter]

Really? Disappointing and self-serving tangential response to that very personal and thoughtful post.

No it wasn't; it was the truth.

Socialism and the corruption that almost universally goes with it, destroyed Venezuela. The populace tried to change too little and too late. Most of South America serves as a cautionary tale of the problems with Socialism

 

[Nietzschelover]

No it wasn't; it was the truth.

Socialism and the corruption that almost universally goes with it, destroyed Venezuela. The populace tried to change too little and too late. Most of South America serves as a cautionary tale of the problems with Socialism

So you possess the definitive view on "socialism and the corruption that almost universally goes with it"? Can you link me to your published works on the rise and fall of Venezuela?

 

[fancymylotus]

What did I just read from the OP's post? One large long whining paragraph? Get over it. There will always be someone smarter, someone with more money, someone with more advantages. Stop worrying about other people


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[7331poas]

What did I just read from the OP's post? One large long whining paragraph? Get over it. There will always be someone smarter, someone with more money, someone with more advantages. Stop worrying about other people


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What kind of logic is that? We are compared relative to our peers.

 

[Dr. Death]

What kind of logic is that? We are compared relative to our peers.

Well read her post again. What is it benefiting anyone to worry about what anyone else is doing? The rich kids GPA isn't going to be on the MCAT so concerning yourself with it doesn't benefit anyone.

 

[Mad Jack]

So you possess the definitive view on "socialism and the corruption that almost universally goes with it"? Can you link me to your published works on the rise and fall of Venezuela?

Here's a good paper on it. (Corruption as it relates to socialism and its effects on productivity)

 

[Mad Jack]

What kind of logic is that? We are compared relative to our peers.

If you are constantly comparing yourself to others you'll never be happy.

 

[Mad Jack]

What did I just read from the OP's post? One large long whining paragraph? Get over it. There will always be someone smarter, someone with more money, someone with more advantages. Stop worrying about other people


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SD was in kind of a unique and ****ty situation where a lack of funds for the application process screwed him over. To him it's not just whining- it's his life, and how the financial aspects of the process affected him personally, essentially.

Totally agree with the sentiment in general though.

 

[7331poas]

If you are constantly comparing yourself to others you'll never be happy.

What am I living in a teenage girl's movie right now? Are you saying you dont work harder based on your peers? Presumably you were going to put in the same amount of ECs for medical school regardless of what the standard has already been set by your peers and the medical institution?

 

[Mad Jack]

What am I living in a teenage girl's movie right now? Are you saying you dont work harder based on your peers? Presumably you were going to put in the same amount of ECs for medical school regardless of what the standard has already been set by your peers and the medical institution?

I really don't compare myself with other people, I'm pretty type B. If that's what gets you through the day though, I guess that's fine. I'm also a nontrad though- comparing myself to a bunch of people nearly a decade younger than me would just feel silly anyway.

 

[ZedsDed]

One of the things I truly enjoy about this site is how f&^#ing smart some of you young folks are. Wow. Can't wait to see how many top med schools will be begging you to come to their school. You are an example of @Med Ed being right.....the power dynamics in your case will be in your favor.

I take issue with his characterization of those who criticize the modern "micro-aggression" movement. But yes, he is an exceedingly bright individual who I'm sure would be an asset to any school that would have him.

 

[Mansamusa]

And just a heads up @Spinach Dip, with how competitive med school to residency has become, there are unwritten requirement emerging that help wealthy students get into their residency of choice as well.

More and more students are doing research fellowships to match into competitive surgical fields. If I do a 3 yr residency, my 10 yr loan payment is $6.3K/month (76K/yr). If I do an 8 yr residency the payment is $18K/month (216K/yr). So wasting a year on research is not really feasible since every year of residency adds a ton of debt

 

[7331poas]

I really don't compare myself with other people, I'm pretty type B. If that's what gets you through the day though, I guess that's fine. I'm also a nontrad though- comparing myself to a bunch of people nearly a decade younger than me would just feel silly anyway.

It doesn't make sense. So you just happen by total coincidence to have put in the proper amount of effort to get into med school.

We are always judged relative to our peers. Whether you choose to do it yourself is irrelevant to the issue at hand. Even the admissions body is going to accept or decline a person based on what they think they can get otherwise.

 

[fancymylotus]

It doesn't make sense. So you just happen by total coincidence to have put in the proper amount of effort to get into med school.

We are always judged relative to our peers. Whether you choose to do it yourself is irrelevant to the issue at hand. Even the admissions body is going to accept or decline a person based on what they think they can get otherwise.

You missed the point. I'm not talking about judging your clinical skills or your bedside mannerisms or whatever, I'm talking about whining and moping because the rich kids can afford (insert whatever here) and you can't. What's the point? Make the best of what you have, figure out a way to get to where you need to be, and there are probably many people who had it harder than you that made it.

When I say "you" I'm not directly referring to you, the person I quoted, or you, the OP, obviously.



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[ZedsDed]

I won't lie to you though. I don't like our university socialist group. Lots of people who call themselves "socialists" are unwilling to accept the many ways in which capitalism is good and better than alternatives, including socialist ideas. I mostly find them annoying. I do think that education, housing, health and the national defense should be provided for by the government. I don't mind private industry existing in the same space though. (Except for the defense, I don't like private militaries and I don't think they can possibly have anyone's best interests in mind)

I found myself in the same spot in undergrad. I don't have time to go into a detailed analysis but I'll say that most hard-line socialists underestimate quite how revolutionary capitalism is. Further reform of our current system (real reform) is what's needed in my view.

 

[FutureD.O]

Responding mostly to spinach's post (I stopped reading when the debates began, so please excuse me if I missed something), I wholeheartedly agree with your viewpoint on this, although I thought this issue was already pretty obvious.

Throughout high school and undergrad it was extremely easy to spot the advantaged pre-Meds. I come from a Muslim community that has its fair share of doctors. There are real and almost tangible advantages coming up and being raised in a family of physicians. I've personally benefitted from having friends whose family members were doctors, or who knew doctors that allowed me to extensively shadow them. Although I utilized that advantage, I worked my a** off for my letters and gained incredibly valuable insight. My friends whose parents were both doctors had a leg up on me throughout high school and undergrad. The Arab and Indian/Pakistani doctor families in my community are VERY well aware of the game that we call being a pre-med. These advantages range from having the most top notch private school educations and study materials to being extremely well versed in the medical school admissions process well before they begin their undergrad orientation class. I saw firsthand how the children of doctors prospered from what their parents had done for them in terms of giving their children the absolute best chance of being admitted in medical school. One quick anecdote, I know someone with less than a 3.2 undergrad gpa, 27 ACT be admitted into a BS-MD program that had median stats of 31 ACT, 3.7 high school gpa, and 3.5 undergrad gpa CUTOFF, because their father worked at the university medical center.

Here's a systemic issue I see no solution to..

How do you adjust medical school admissions to evenly AND fairly select prospective students without affecting an individual who:

A. comes from a wealthy family of doctors who confer no advantage other than a proper education (an advantage in itself) and want to see their child succeed on their own

B. comes from a wealthy family of doctors who ensure that their children utilize every possible resource available to their family (including but not limited to unlimited financial resources, extensive shadowing/letter opportunities, connections, etc)

People do not choose which SES they are born into and as a result, how can they be discriminated against in the medical school admissions process? Particularly in scenario A (which I've seen once), it would also be unfair to discrimate against that student because they are being grouped with others in scenario B, regardless of how unlikely scenario A is.

I had to work in undergrad, and my parents were not doctors. I definitely believe that had I been given the same upbringing many of my friends were granted, my journey to becoming a physician would have been SIGNIFICANTLY easier. Would I trade my upbringing for theirs? Absolutely not. Many of the struggles I had to overcome molded my personality and the individual I have become. Will I do my best to give my children the best shot at pursuing whatever livelihood they are interested in taking part in? Absolutely.

Again, the underlying issue that keeps popping at me is that there seemingly is no way for this admissions process to be fair. Therefore the medical school admissions process is and will remain inherently unfair, providing those who are rich an advantage while leaving those who are not on an unleveled playing field.

Also, I'd really appreciate not being subjected to any fallacious arguments. This post is only a drop of the things I've seen and experienced firsthand. None of us are in middle school so ad-hominem attacks should be a thing of the past..

 

[7331poas]

You missed the point. I'm not talking about judging your clinical skills or your bedside mannerisms or whatever, I'm talking about whining and moping because the rich kids can afford (insert whatever here) and you can't. What's the point? Make the best of what you have, figure out a way to get to where you need to be, and there are probably many people who had it harder than you that made it.

When I say "you" I'm not directly referring to you, the person I quoted, or you, the OP, obviously.



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That's fine on a small scale but I doesn't hold up to reality. When there is inequality someone had to step up and speak on it rather than just accept it. All social change in history has worked that way.

Even in economic systems we do this to an extent. If the barrier to creating a small business is too high and it affects the economy, we don't say suck it up and jus try harder. We try and address the issue and find whether it can be resolved.

 

[fancymylotus]

That's fine on a small scale but I doesn't hold up to reality. When there is inequality someone had to step up and speak on it rather than just accept it. All social change in history has worked that way.

Even in economic systems we do this to an extent. If the barrier to creating a small business is too high and it affects the economy, we don't say suck it up and jus try harder. We try and address the issue and find whether it can be resolved.

I guess the working hard and stop worrying about the inequalities of the world option has been totally tossed out of the window. Cool.

I know I sound harsh. I just don't understand the point of moping and complaining when it's just time and efforts wasted.


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[pageantry]

I guess the working hard and stop worrying about the inequalities of the world option has been totally tossed out of the window. Cool.

I know I sound harsh. I just don't understand the point of moping and complaining when it's just time and efforts wasted.


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Honestly this is one of the questions that I really appreciate seeing the AAMC try to answer with the changing medical school admissions process.

The question being: how can doctors do a better job of helping people who have spent their entire lives being poor, depressed, sick... See and seize the opportunities they have?

I know so many brilliant people who are so depressed the only options they see ahead of them are sheer misery. Sunk-cost fallacy (I.e. facing unnecessary years of wasted time) keeps them there.

Not trying to be a jerk. That's exactly where I started. Thank god for emergency hotlines and free therapy. Slowly, slowly I started to see all the hands reaching out to help me to my feet.

 

[fancymylotus]

Honestly this is one of the questions that I really appreciate seeing the AAMC try to answer with the changing medical school admissions process.

The question being: how can doctors do a better job of helping people who have spent their entire lives being poor, depressed, sick... See and seize the opportunities they have?

I know so many brilliant people who are so depressed the only options they see ahead of them are sheer misery. Sunk-cost fallacy (I.e. facing unnecessary years of wasted time) keeps them there.

Not trying to be a jerk. That's exactly where I started. Thank god for emergency hotlines and free therapy. Slowly, slowly I started to see all the hands reaching out to help me to my feet.

And look at what being proactive and positive and reaching out and working hard did for you 🙂 I'm aware of the inequalities and also that things aren't always as transparent or easy as I make them seem.

I just have a hard time empathizing with most of this when the parents of many people I know(and mine) are immigrants who came from rural villages in third world countries to this country with nothing.




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[pageantry]

And look at what being proactive and positive and reaching out and working hard did for you 🙂 I'm aware of the inequalities and also that things aren't always as transparent or easy as I make them seem.

I just have a hard time empathizing with most of this when the parents of many people I know(and mine) are immigrants who came from rural villages in third world countries to this country with nothing.




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I don't blame you. Depression is a weird thing. If you've never been depressed, it seems crazy. And I'm definitely proud of myself for overcoming where I was, but honestly... I got lucky. If that hotline hadn't known of a study that would take me and give me free therapy, idk what I would have done.

That said, I've since handheld probably a dozen people into calling studies offering free therapy. Not a lot end up taking the opportunity. I don't know why. They say things like "I have to ride too far on the subway." And "I didn't like that my free therapist was a man." To me it's like, goddam, can't you see this is about life or death for you?

But I do want to say, if your parents came to the country with a ride-or-die, can-do, family-focused mentality and the capacity to cook and eat healthy food for cheap, hell, that is half the battle right there. If they had no major drug or alcohol addictions, that is huge. Not that immigrant families lack problems of their own, but they're maybe a different flavor? Idk what do you think? (Tho there actually is quite a bit of undiagnosed depression in immigrant communities, I want to say.)

I think there are a lot of reasons why the American poor are so depressed, and it's not because there is no hope out there. But I do think our problems are at least partly systemic.

 

[fancymylotus]

I don't blame you. Depression is a weird thing. If you've never been depressed, it seems crazy. And I'm definitely proud of myself for overcoming where I was, but honestly... I got lucky. If that hotline hadn't known of a study that would take me and give me free therapy, idk what I would have done.

That said, I've since handheld probably a dozen people into calling studies offering free therapy. Not a lot end up taking the opportunity. I don't know why. They say things like "I have to ride too far on the subway." And "I didn't like that my free therapist was a man." To me it's like, goddam, can't you see this is about life or death for you?

But I do want to say, if your parents came to the country with a ride-or-die, can-do, family-focused mentality and the capacity to cook and eat healthy food for cheap, hell, that is half the battle right there. If they had no major drug or alcohol addictions, that is huge. Not that immigrant families lack problems of their own, but they're maybe a different flavor? Idk what do you think? (Tho there actually is quite a bit of undiagnosed depression in immigrant communities, I want to say.)

I think there are a lot of reasons why the American poor are so depressed, and it's not because there is no hope out there. But I do think our problems are at least partly systemic.

Boatloads of undiagnosed depression, but it's not something that discussed or addressed in our culture for the most part. It's mostly a "we came here with nothing and made something of ourselves so you have no room or reason to complain, we'll support you and help you however we can as long as you become a professional and give us grandchildren that we can distract ourselves with"




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[pageantry]

Boatloads of undiagnosed depression, but it's not something that discussed or addressed in our culture for the most part. It's mostly a "we came here with nothing and made something of ourselves so you have no room or reason to complain, we'll support you and help you however we can as long as you become a professional and give us grandchildren that we can distract ourselves with"




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Where/how does that depression end up manifesting then, if there is no room for its expression? Suicide, would be my guess.

Either way, we're describing the depression of people who feel like they have no agency in their own lives. Hard to recover from that. And it seems like this is most doctor's least favorite patient to deal with. But to me this issue is everything.

 

[Instatewaiter]

What kind of logic is that? We are compared relative to our peers.

Actually it is solid logic and great advice. When you waste your energy on worrying about what others think about you, what others are doing or what small slights you have had, you have less energy to put into striving to do and be your best. You do worse. Nose to the grindstone and 100% effort always get your further.

And just a heads up @Spinach Dip, with how competitive med school to residency has become, there are unwritten requirement emerging that help wealthy students get into their residency of choice as well.

First, this is not true. Second, you know what works better than a research year- doing well in your coursework, your boards and the wards. The people who do a research year are those who don't match (or know they won't match) because their grades and scores weren't good enough to match in their desired specialty.

This isn't really directed at you but rather at a prevalent attitude. Are students next going to try and explain their poor med school grades by blaming it on wealthy students? The new victimhood of failure is repugnant. It has become, if at first you don't succeed, blame it on someone else's "privelege"

And look at what being proactive and positive and reaching out and working hard did for you 🙂 I'm aware of the inequalities and also that things aren't always as transparent or easy as I make them seem. I just have a hard time empathizing with most of this when the parents of many people I know(and mine) are immigrants who came from rural villages in third world countries to this country with nothing.

Agreed. My family came to this country to escape a genocide in which many of my family member were forced into a river and drowned. Those who escaped and came to the US saw opportunity in what people are now seeing as oppression. If they instead said they couldn't succeed because they weren't white or wealthy or already successful, they would have gone no where. Attitude will get you far and most importantly keep your kids going far.

 

[fancymylotus]

I feel like a lot of us first gen kids have the same mentality that others may not understand. Depression and poverty are truly horrible, but just as horrible is showing up in a foreign land with nothing knowing nothing with massive odds stacked against you. Success and strength in the face of that doesn't come from whining complaining or moping around about how everyone has it better than you do.

My grandfather died of TB that he got during his tenth or eleventh jail sentence for being a freedom fighter in India. My grandmother raised my dad and his siblings in dirt poor middle of nowhere India. My parents were arranged married to each other as they were coming here to attend the same school. FF 30 something years later, you'd better believe that I did everything I could to make them proud. Probably explains the OCD type A personality that I share with so many of my fellow immigrant children.


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[7331poas]

Actually it is solid logic and great advice. When you waste your energy on worrying about what others think about you, what others are doing or what small slights you have had, you have less energy to put into striving to do and be your best. You do worse. Nose to the grindstone and 100% effort always get your further.

Really. You are honestly saying that you havent dont anything in order to look better in light of admissions committees. This isnt a happy world where everyone gets in if you try hard. You have to be in the top x percentiles.

I dont compare myself to other premeds. But you better believe I think about how my application lines up against AAMC data and profiles on MDApplicants. Thats just playing smart.

 

[Lucca]

I understand the first gen "we did it, why can't they" attitude because I'm first gen. But you have to look at things in a complete context. Think about the motivational difference between someone who comes into this country with no support network and knows that he only way out is to work extremely hard to provide for your kids. Now think about someone who has been poor for generations, knows everyone in the same neighborhood, knows that 90% of the kids can't make it out of high school into college and many of them just become part of the institutionalized violence that keeps others trapped. Or think about the kids who have no idea that they are poor. I don't know about y'all but until you are about 13 you don't even really get the idea of poor and it's not until you go to college and meet the super-elite that you know what being "uber rich" is. We're all sitting here looking back and rationalizing as educated college students or professionals, not as teenagers shouldering the responsibility of doing better for ourselves and our family while barely having the wherewithal to understand your place in society to begin with. It is easier to navigate that journey from rags to riches when, like me, you have educated parents or when, like others, you have parents who have escaped such extreme circumstances that they will push their kids as hard as possible (even if they don't know why or what they are even supposed to measure) in every category so that they can have a better life. I'm very proud of being an immigrant and making it this far. Nobody helped me apply to college, nobody told me I had to buy an expensive SAT prep course so I never did but did well anyways, nobody helped me navigate college, etc. However, I too have been extremely privileged. I had good role models. Both of my parents actually loved me and were interested in my future and not just their own. Both of my parents were present in my life. I had a home to go to even though there wasn't much in it so I was safe at night. During the day I could walk from school to my house and be safe. Privilege does not only come in the form of material wealth but comes from the entire context of our upbringing, everything that gives us a leg up and is absent from another's life.

Privilege is not inherently bad (like some media outlets may lead you to believe). I wish everyone was as privileged as me and more. Acknowledging your privilege is the moment when you look back at your life and say, "Oh, ****" and commit to the idea that no one should have to overcome the same hurdles as you, that people deserve better than they are getting, that our society should be kinder and gentler and more open to all people. It is not sufficient to dismiss the truths of other people's lives as they see it without taking a critical eye to why they might feel one way or another. It is more important to imagine a better state of affairs for everyone.

 

[Nietzschelover]

I understand the first gen "we did it, why can't they" attitude because I'm first gen. But you have to look at things in a complete context. Think about the motivational difference between someone who comes into this country with no support network and knows that he only way out is to work extremely hard to provide for your kids. Now think about someone who has been poor for generations, knows everyone in the same neighborhood, knows that 90% of the kids can't make it out of high school into college and many of them just become part of the institutionalized violence that keeps others trapped. Or think about the kids who have no idea that they are poor. I don't know about y'all but until you are about 13 you don't even really get the idea of poor and it's not until you go to college and meet the super-elite that you know what being "uber rich" is. We're all sitting here looking back and rationalizing as educated college students or professionals, not as teenagers shouldering the responsibility of doing better for ourselves and our family while barely having the wherewithal to understand your place in society to begin with. It is easier to navigate that journey from rags to riches when, like me, you have educated parents or when, like others, you have parents who have escaped such extreme circumstances that they will push their kids as hard as possible (even if they don't know why or what they are even supposed to measure) in every category so that they can have a better life. I'm very proud of being an immigrant and making it this far. Nobody helped me apply to college, nobody told me I had to buy an expensive SAT prep course so I never did but did well anyways, nobody helped me navigate college, etc. However, I too have been extremely privileged. I had good role models. Both of my parents actually loved me and were interested in my future and not just their own. Both of my parents were present in my life. I had a home to go to even though there wasn't much in it so I was safe at night. During the day I could walk from school to my house and be safe. Privilege does not only come in the form of material wealth but comes from the entire context of our upbringing, everything that gives us a leg up and is absent from another's life.

Privilege is not inherently bad (like some media outlets may lead you to believe). I wish everyone was as privileged as me and more. Acknowledging your privilege is the moment when you look back at your life and say, "Oh, ****" and commit to the idea that no one should have to overcome the same hurdles as you, that people deserve better than they are getting, that our society should be kinder and gentler and more open to all people. It is not sufficient to dismiss the truths of other people's lives as they see it without taking a critical eye to why they might feel one way or another. It is more important to imagine a better state of affairs for everyone.

Love this.

We can't just wash away disadvantages with movie-like stories of people who watched their whole family be murdered and then swam 25 miles in dirty, disease-infested waters to avoid the soldiers savaging all of the innocents in a war-torn country who then go on to work five jobs, learn six languages, pay their way through a state university and land at HMS. I'm reminded of those with cancer and other very serious medical conditions being chastised about how things could be much worse as they are encouraged to think about how truly fortunate they are compared to a double-amputee quadriplegic. Any of us can play the "what you're going through isn't that bad compared to X" game and the search for outliers game to make others see that they could have "made it" if they simply had tried hard enough.

Now none of that is to suggest that the "wealthy" should feel guilty or not make use of their advantages. After all, isn't that a big part of becoming wealthy and/or maintaining wealth...trying to make sure your family does have as many advantages as possible precisely beause those advantages are, well, advantages? As some who came from difficult backgrounds have noted, part of their goal is to do well in hopes of creating advantages for their offspring. Nothing sinister about that kind of motivation. Let's just not deny that advantages are indeed advantages.

 

[fancymylotus]

Life is easier with lots of money. Mostly. No ones denying that. While there are always people who have it better, there are always people who have it worse.

You choose to make what you will out of the circumstances that are handed to you. If that's too difficult of a concept, then I'm not sure how much more I can dumb it down.


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[Lucca]

Life is easier with lots of money. Mostly. No ones denying that. While there are always people who have it better, there are always people who have it worse.

You choose to make what you will out of the circumstances that are handed to you. If that's too difficult of a concept, then I'm not sure how much more I can dumb it down.


Sent from my iPhone using SDN mobile app

I don't disagree with that, that's just trivially true. What I'm saying is that it is not worthless to look forward and say, "Well things should be better and we can fix this". It's not useless posturing, it's an attitude which shapes your behavior and the behavior of others and has a real impact. Otherwise, progress would never happen and women would still be traded like cattle and slavery would still be around. Changing people's attitudes is the "hearts and minds" battlefront of politics.

 

[fancymylotus]

I don't disagree with that, that's just trivially true. What I'm saying is that it is not worthless to look forward and say, "Well things should be better and we can fix this". It's not useless posturing, it's an attitude which shapes your behavior and the behavior of others and has a real impact. Otherwise, progress would never happen and women would still be traded like cattle and slavery would still be around. Changing people's attitudes is the "hearts and minds" battlefront of politics.

I agree. I was mostly disagreeing with some of the incessant whining that often makes the rounds in this forum


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[Trismegistus4]

I think the OP is confused about the meaning of the term "independently wealthy." It has a specific meaning. It doesn't just mean or "affluent" or "professional class." It means not needing to work, possessing sufficient wealth that one could, if one chose, live very comfortably off of nothing but interest for the rest of one's life. Heirs and trust fund babies are independently wealthy. I dare say that most medical students are not born to independently wealthy parents.

That said, I agree about the stupidity of shadowing and medical missions trips. If I were in charge of an adcom, shadowing would be irrelevant, I'd instantly reject everyone who had ever even been to a third world country, and move everyone who had ever worked a minimum wage job to the top of the list.

 

[Spinach Dip]

I understand the first gen "we did it, why can't they" attitude because I'm first gen. But you have to look at things in a complete context. Think about the motivational difference between someone who comes into this country with no support network and knows that he only way out is to work extremely hard to provide for your kids. Now think about someone who has been poor for generations, knows everyone in the same neighborhood, knows that 90% of the kids can't make it out of high school into college and many of them just become part of the institutionalized violence that keeps others trapped. Or think about the kids who have no idea that they are poor. I don't know about y'all but until you are about 13 you don't even really get the idea of poor and it's not until you go to college and meet the super-elite that you know what being "uber rich" is. We're all sitting here looking back and rationalizing as educated college students or professionals, not as teenagers shouldering the responsibility of doing better for ourselves and our family while barely having the wherewithal to understand your place in society to begin with. It is easier to navigate that journey from rags to riches when, like me, you have educated parents or when, like others, you have parents who have escaped such extreme circumstances that they will push their kids as hard as possible (even if they don't know why or what they are even supposed to measure) in every category so that they can have a better life. I'm very proud of being an immigrant and making it this far. Nobody helped me apply to college, nobody told me I had to buy an expensive SAT prep course so I never did but did well anyways, nobody helped me navigate college, etc. However, I too have been extremely privileged. I had good role models. Both of my parents actually loved me and were interested in my future and not just their own. Both of my parents were present in my life. I had a home to go to even though there wasn't much in it so I was safe at night. During the day I could walk from school to my house and be safe. Privilege does not only come in the form of material wealth but comes from the entire context of our upbringing, everything that gives us a leg up and is absent from another's life.

Privilege is not inherently bad (like some media outlets may lead you to believe). I wish everyone was as privileged as me and more. Acknowledging your privilege is the moment when you look back at your life and say, "Oh, ****" and commit to the idea that no one should have to overcome the same hurdles as you, that people deserve better than they are getting, that our society should be kinder and gentler and more open to all people. It is not sufficient to dismiss the truths of other people's lives as they see it without taking a critical eye to why they might feel one way or another. It is more important to imagine a better state of affairs for everyone.

👍 👍



I think the point of this thread is being lost on a lot of you who think I'm just complaining for the sympathy or whatever. If I was looking for sympathy I could whine for a couple pages about how my father left the day after his youngest turned 18, bragged that now he wouldn't have to pay child support, and drove off with his new gf, leaving us with nothing but $50,000 in overdue credit card bills.

I've been trying to overcome that lot. I am the 5th(?) (out of 20-30) in my family to complete a bachelors degree, and the 1st(!) to complete a masters degree. I know what I was born into (an apartment infested with cockroaches) and I am doing everything I can to make it better. I aspire to the highest profession in the land because I KNOW I CAN DO IT.



But to return to the point at hand:

Let's assume the quote at the bottom of the first post is true. It gives values for the bottom 2, middle, and top 2 quintiles. This means med school matriculants are broken down by SES something like this:

Bottom.....5 %
Low..........5 %
Mid...........15 %
Mid-high..37 %
Top...........38 %

But this divides numbers between the bottom 2 classes and top 2 classes evenly. I assume growth is more formulaic and actual numbers are probably something more like this:

Bottom.....3 %
Low...........7 %
Mid...........15 %
Mid-high..30 %
Top...........45 %

(This distribution does have the attractive math that each quintile is 2x the previous (+/-1), until the last, which is 1.5x. I would like to check these numbers against the original paper, but I can unfortunately not find it.)



Of course I don't expect a distribution with 20's across the board. That would be a dreamworld in which the circumstances of one's birth have no bearing whatsoever on their future aspirations.

What I have a problem with is that we (as a group) assume that these things (shadowing/research/sports/volunteering/etc/etc) are indicative of merit when they are more indicative of wealth and knowledge. We are deluding ourselves into believing that the system chooses the best when in actuality it selects for those with the best parents.

 

[terra330]

It's actually even more lopsided: https://www.aamc.org/download/102338/data/aibvol8no1.pdf though it is worth noting that the trend isn't exclusive to medicine.

 

[The-Dreamer]

The AMA wrote a nice oped on the issue in the Journal of Ethics and offers possible solutions that this bottom quintilee (?) 😉 agrees with. journalofethics.ama-assn.org/2015/02/pdf/oped1-1502.pdf

 

[Instatewaiter]

What I have a problem with is that we (as a group) assume that these things (shadowing/research/sports/volunteering/etc/etc) are indicative of merit when they are more indicative of wealth and knowledge. We are deluding ourselves into believing that the system chooses the best when in actuality it selects for those with the best parents.

First, if getting a shadowing or volunteering gig is anything more than a hiccupin your application process, medical education is going to be a bumpy ride. Second, these things aren't going to magically make someone an attractive candidate if their grades and scores blow. There is much more in the application process that is merit based

 

[Oh_Gee]

If I could super-like this I would!

this ain't tinder 🙂