Making Medical School Admissions More Equitable

[Lucca]

My contribution to this thread will be noting that the AAMC worked with Khan Academy to create a free MCAT prep course with 1,100 videos and 3,000 practice questions. It did this to lower the barrier to entry. The AAMC guide to creating a MCAT study plan can be found here.

Applicant spend a lot of money on MCAT prep courses, but they have no demonstrated value beyond forcing people to stick to a schedule. If you are capable of creating and adhering to a study schedule then a prep course gains you nothing.

KA isn’t a very good standalone MCAT prep resource. I disagree that prep courses only give you structure and nothing else.

One thing people gain from prep courses is a lot of info about test taking strategy. Now, someone with sufficiently good intrinsic test taking ability can develop the strategy on their own, but in a prep course it’s just spoon fed to you. On the McAT, there are certain tidbits of wisdom (like the highly specific way the CARS section uses very specific words) which alone might net you 1-2 points.

We also shouldn’t discount the value structure provides as it could potentially give an advantage to a student who would not have been able to score as well without that structure in place for a variety of reasons.

I agree that courses are not necessary, but I disagree that they won’t help you get a better score and can be beneficial for certain kinds of students. We live in a world where about 50% of test takers took a commercial course. Unfortunately, AAMC does not publish whether they score better than those who didn’t take it to my knowledge.

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[stayathomemom]

My contribution to this thread will be noting that the AAMC worked with Khan Academy to create a free MCAT prep course with 1,100 videos and 3,000 practice questions. It did this to lower the barrier to entry. The AAMC guide to creating a MCAT study plan can be found here.

Applicant spend a lot of money on MCAT prep courses, but they have no demonstrated value beyond forcing people to stick to a schedule. If you are capable of creating and adhering to a study schedule then a prep course gains you nothing.

Thank you for this counterpoint. It is a good one. Khan academy is absolutely amazing. They are filling a need that must be met if there is to be more equality. That being said, I feel I need more than what they can provide.
My breakdown of costs include:
Kaplan 7-book set $183
NextStep practice test bundle $99
UWorld question bank $200
Test itself $315
I got the 7-book set because I needed something physical. I am a non-trad and it's been ~15 years since I took the prerequisite classes; I've forgotten most of it. Everyone I have talked to says doing practice problems/practice tests is the way to go for MCAT prep. So that's why I got the practice tests and UWorld. And, I can now afford it.

I guess what gets my goat is that while a sharp young person who has been studious in class and has kept up with the material and uses these free resources and budgets their time super efficiently will probably do really well on the MCAT, low-SES status takes resources from MCAT prep, especially study time. Hence, students who are fortunate to be well-financially supported through college (ie don't have to work to support themselves AND have access to these test prep services/materials) simply have an advantage. I don't have an easy answer on how to remediate this though. Rich people just be rich.

 

[Med Ed]

KA isn’t a very good standalone MCAT prep resource. I disagree that prep courses only give you structure and nothing else.

One thing people gain from prep courses is a lot of info about test taking strategy. Now, someone with sufficiently good intrinsic test taking ability can develop the strategy on their own, but in a prep course it’s just spoon fed to you. On the McAT, there are certain tidbits of wisdom (like the highly specific way the CARS section uses very specific words) which alone might net you 1-2 points.

We also shouldn’t discount the value structure provides as it could potentially give an advantage to a student who would not have been able to score as well without that structure in place for a variety of reasons.

I agree that courses are not necessary, but I disagree that they won’t help you get a better score and can be beneficial for certain kinds of students. We live in a world where about 50% of test takers took a commercial course. Unfortunately, AAMC does not publish whether they score better than those who didn’t take it to my knowledge.

Strategies are available in written resources.

Other than that I fail to see much disagreement between us.

When I took the MCAT, prep courses were exotic entities that only a small subset of students undertook. I do object to their normalization without strong evidence of effectiveness.

 

[PTPuser]

those studies are weak at best and promote racial discrimination by patients at worst.

If we believed the premise you are pushing we would be trying to recruit only white doctors in primarily white areas, which is patently absurd and no one would ever ask for that.

I agree, it would never happen because whites are the factory default standard. Even if America is turning into a brown nation, the care that is received by Caucasians will not be compromised any time soon. If there was a significant racial discrimination by patients, I will bet that it's probably less than the discrimination that patients receive by their doctors and other caregiver. I'm not promoting discrimination in any form but my n=1 experience so far in healthcare for over a decade is one where the white patient didn't want to be treated by me cause I was Asian and have an accent. I've never met a person of colored asked for another doctor who look like them because the physician is not the same race. More time I've met lots of huffing and puffing from doctors when they are about to walk into a room knowing that there's going to be some barrier whether it's language or others from the patient.

 

[LizzyM]

I would check it out if I had access to scholarly journals. But alas, I am not a student, nor am I employed in an academic setting, and so some privileges are not afforded to me.

I find this fact just a little ironic.

If you are an employee or volunteer in a hospital, ask the hospital's librarian. Also check with your local public library. If they don't have a subscription (unless it is a huge city library, they are unlikely to have a subscription) then they should be able to obtain a copy of the article for you through interlibrary loan.

 

[bearcalbear2019]

I hope that AAMC prompts more discussion about SES equity in admissions so schools can work towards policies like UC Davis.. although I'm not sure how realistic that is, not sure how much AAMC and some med schools actually care. Like there are the SES checkboxes of E01/E02,self identifying as disadvantaged, and FAP system. I wonder how successful that has been in improving SES equity? Can AAMC collect some data or do they have recent data? I remember reading an article saying those with FAP had lower % of getting into med school, but compared with non-FAP people with the same MCAT, FAP people have 30% better chance of getting in. I do wish schools were more transparent on how they consider SES/disadvantaged other than simply saying its a ''holistic review''.

UCLA has a 3.4/512 cutoff now and med students there are fighting to re-incorporate the disadvantaged committee because only the top 5% of disadvantaged applicants even make the 512 cutoff. I imagine at schools like Northwestern the screen is something like 517 if you are not URM.

 

[premedalt]

I would check it out if I had access to scholarly journals. But alas, I am not a student, nor am I employed in an academic setting, and so some privileges are not afforded to me.

I find this fact just a little ironic.

SciHub my dude

 

[ginsengreset]

SciHub my dude

What I find interesting is that in my experience, "resources" like SciHub / Libgen / WolframAlpha for math homework were mostly used by students who were pretty advantaged, and could very much afford to not use those resources. Those who (in my opinion) could've stood to benefit from these the most generally weren't aware of them, I'm guessing because of more limited connections / different peer groups. This is my n=1 subjective assessment at a T20 school, though.

 

[dr_kateb]

The Pirate Bay has the full 2015 Kaplan 7 book set.

 

[LizzyM]

SciHub is ethically questionable. If you are in the US, use your public library. That's what it is there for.

 

[premedalt]

What I find interesting is that in my experience, "resources" like SciHub / Libgen / WolframAlpha for math homework were mostly used by students who were pretty advantaged, and could very much afford to not use those resources. Those who (in my opinion) could've stood to benefit from these the most generally weren't aware of them, I'm guessing because of more limited connections / different peer groups. This is my n=1 subjective assessment at a T20 school, though.

Personally, I found out about it through Reddit. I can see how the use of SciHub can be ethically questionable. To each their own I guess.

 

[deleted480308]

Personally, I found out about it through Reddit. I can see how the use of SciHub can be ethically questionable. To each their own I guess.

it's not questionable, it's theft.

 

[stayathomemom]

Those who (in my opinion) could've stood to benefit from these the most generally weren't aware of them, I'm guessing because of more limited connections / different peer groups.

DING DING DING. I think that the huge disparity in social capital (ie, knowing people who can help in some way or who know more than you do who can guide you) severely affects people of a low SES (which also disproportionately affects people of color). A person with big dreams, who is not well connected, doesn't do as well because they spend so many resources and waste so much time just to get to where the more advantaged students start out from.

This is why I like resources like SDN. (I'm not going to speak to less ethical online resources though.) But I think having actual face-to-face relationships with people who do what you dream to do is so important. Bonus points if they look like you or if they overcame obstacles similar to your own. It's just too bad that physicians are too busy (and of course have their own lives to live) to do community outreach to youth and young adults in this way. If I am so fortunate than my dream is realized, I would love to coordinate some kind of formal program for those with low social capital to be able to make those professional connections. We think if we can just throw money at the situation with FAP and whatnot, it levels the playing field--it doesn't. It's a complicated situation and it's going to take a multifaceted approach if we want to make more progress.

Edit: I just also want to mention that we have to start young. This process is already started in college. We need to mentor youth starting at the high school level at least.

 

[stayathomemom]

If you are an employee or volunteer in a hospital, ask the hospital's librarian. Also check with your local public library. If they don't have a subscription (unless it is a huge city library, they are unlikely to have a subscription) then they should be able to obtain a copy of the article for you through interlibrary loan.

Thank you, I will try that.

 

[Princeton Medical Student]

The entire activities process is quite ****ed when you think about it too tbh.

 

[Raryn]

Maybe I'm way off here since it's been a while since I looked at the numbers: don't we already admit the vast majority of URM applicants that have numbers predicting success per the AAMC? That is, groups like black males are already very likely to get into an MD school if they have an MCAT in the upper 20s / GPA in low to mid 3.0s?

If that's true then it would seem there's not much adcoms can do; change has to come at the high school and college levels to provide more qualified applicants

Sort of.

The AAMC has not put out a GPA and MCAT grid stratified by race since 2015-2016, but when they last did, they were very different:

Black

Hispanic

Asian

White

As far as I know, there have never been grids stratified by Race *and* Gender (to discuss your black male question) - but the acceptance rate even for African Americans overall isn't 100% for anything other than the 36+ MCAT and certain GPA categories. It's higher in any given cell than it is for other races - but it's hard to make a direct comparison (you can't just look at raw acceptance rates and saw "being black is worth 6 points on the MCAT" because it doesn't account for the fact that some but not all of them have disadvantaged status, different activities, etc)

What I find interesting is that in my experience, "resources" like SciHub / Libgen / WolframAlpha for math homework were mostly used by students who were pretty advantaged, and could very much afford to not use those resources. Those who (in my opinion) could've stood to benefit from these the most generally weren't aware of them, I'm guessing because of more limited connections / different peer groups. This is my n=1 subjective assessment at a T20 school, though.

I'm an attending physician in a non-academic practice and I regularly use scihub when I review the primary literature in journals I don't personally subscribe to. Could I afford to pay for individual articles? Sure. But the pricing is absurd, particularly given most of the research is publicly funded. It's theft, but I don't care.

 

[Matthew9Thirtyfive]

KA isn’t a very good standalone MCAT prep resource. I disagree that prep courses only give you structure and nothing else.

One thing people gain from prep courses is a lot of info about test taking strategy. Now, someone with sufficiently good intrinsic test taking ability can develop the strategy on their own, but in a prep course it’s just spoon fed to you. On the McAT, there are certain tidbits of wisdom (like the highly specific way the CARS section uses very specific words) which alone might net you 1-2 points.

We also shouldn’t discount the value structure provides as it could potentially give an advantage to a student who would not have been able to score as well without that structure in place for a variety of reasons.

I agree that courses are not necessary, but I disagree that they won’t help you get a better score and can be beneficial for certain kinds of students. We live in a world where about 50% of test takers took a commercial course. Unfortunately, AAMC does not publish whether they score better than those who didn’t take it to my knowledge.

I disagree that KA isn’t a good stand alone resource. I got way more out it KA than I did out of my prep course. I essentially got nothing but some practice exams out of it and a little bit of test strategy.

After the first few weeks, I completely stopped doing the stuff for the prep course because I wasn’t getting anything out of it. I found a list of the most high yield topics in each subject and KAed the **** out of them. I also used uworld. Basically those resources got me my score. I did a lot of FLs too which also helped, but half of them were from a company whose FLs were drastically different from the real exam (this also happened to be from the prep course I was taking).

 

[deleted480308]

I disagree that KA isn’t a good stand alone resource. I got way more out it KA than I did out of my prep course. I essentially got nothing but some practice exams out of it and a little bit of test strategy.

After the first few weeks, I completely stopped doing the stuff for the prep course because I wasn’t getting anything out of it. I found a list of the most high yield topics in each subject and KAed the **** out of them. I also used uworld. Basically those resources got me my score. I did a lot of FLs too which also helped, but half of them were from a company whose FLs were drastically different from the real exam (this also happened to be from the prep course I was taking).

hell, on occasion I used youtube to teach some of my med school topics better than professors did

 

[Stagg737]

conducting multiple mini-interviews

I find this interesting and to me this seems very counter-intuitive. I believe the time constraints of MMIs would likely just reinforce implicit racial biases as they would prevent deeper, meaningful conversation to allow those potential biases to be overcome. Did the authors give any explanation as to why they felt that way?

Really? Someone holding an admission offer from Princeton will choose to go to Gateway Community College to get a better gpa?

Maybe not someone holding the acceptance, but I had a few classmates go to CC first and transfer into Ivy caliber schools after their first or second year for financial and GPA reasons (wanted to ensure they would keep a 4.0 while working significant hours). What looks more damaging, getting a 4.0 at a CC then transferring to a 4 year UG and maintaining it or doing everything at a 4 year UG and having a 3.4 GPA the first year or two d/t having to work?

I've never met a person of colored asked for another doctor who look like them because the physician is not the same race.

It's happened to me twice and one of my med school classmates almost got expelled because of a situation regarding this. Was a really messed of situation and absolutely not the norm, but it happens. This happens with all races of patients. People in general are racist and racists come in all colors.

 

[Lucca]

I find this interesting and to me this seems very counter-intuitive. I believe the time constraints of MMIs would likely just reinforce implicit racial biases as they would prevent deeper, meaningful conversation to allow those potential biases to be overcome. Did the authors give any explanation as to why they felt that way?



Maybe not someone holding the acceptance, but I had a few classmates go to CC first and transfer into Ivy caliber schools after their first or second year for financial and GPA reasons (wanted to ensure they would keep a 4.0 while working significant hours). What looks more damaging, getting a 4.0 at a CC then transferring to a 4 year UG and maintaining it or doing everything at a 4 year UG and having a 3.4 GPA the first year or two d/t having to work?



It's happened to me twice and one of my med school classmates almost got expelled because of a situation regarding this. Was a really messed of situation and absolutely not the norm, but it happens. This happens with all races of patients. People in general are racist and racists come in all colors.

the cited other research Iirc. I've heard ppl say that the fact that a standardized rubric is used to "grade" the interview and each proctor receives the same training as to how to grade ppl that it helps remove implicit bias.

 

[Stagg737]

the cited other research Iirc. I've heard ppl say that the fact that a standardized rubric is used to "grade" the interview and each proctor receives the same training as to how to grade ppl that it helps remove implicit bias.

Interesting, I feel like it would only reinforce that bias in MMIs. Unless they're trying to create purely objective measures for an interview, which I think defeats the point of an interview as opposed to just using paper metrics which have been blinded for race.

 

[LizzyM]

Maybe not someone holding the acceptance, but I had a few classmates go to CC first and transfer into Ivy caliber schools after their first or second year for financial and GPA reasons (wanted to ensure they would keep a 4.0 while working significant hours). What looks more damaging, getting a 4.0 at a CC then transferring to a 4 year UG and maintaining it or doing everything at a 4 year UG and having a 3.4 GPA the first year or two d/t having to work?

I recall someone who applied >15 years ago who had been kicked out of the house and who ended up 1000+ miles from home working and going to CC where he had a 4.0. The guy reconciled with his family and had their support to continue his education He earned a 3.95 at an Ivy and some really crazy work experience as an EMT (not going to be specific but he helped with a very well known situation that required EMTs). I don't know what happened to him but I think he had many choices with regard to med school.

It is hard to know if someone who had a 3.4 at that Ivy for the first 2 years and then 3.95 would have been treated better or the same as the guy who did well in both settings. A 3.95+ is always going to get respect.

 

[lalalallala]

I bought the princeton review books because I thought that is what everyone used (either PR or kaplan), but they were really not helpful since I already knew most of the content. The content I didn't know I would have been better off googling (which is what I did most of the time). I think it would help if the test makers were more clear about

I recall someone who applied >15 years ago who had been kicked out of the house and who ended up 1000+ miles from home working and going to CC where he had a 4.0. The guy reconciled with his family and had their support to continue his education He earned a 3.95 at an Ivy and some really crazy work experience as an EMT (not going to be specific but he helped with a very well known situation that required EMTs). I don't know what happened to him but I think he had many choices with regard to med school.

It is hard to know if someone who had a 3.4 at that Ivy for the first 2 years and then 3.95 would have been treated better or the same as the guy who did well in both settings. A 3.95+ is always going to get respect.

I can imagine that for many others the transition from CCs to Ivies (or other schools) would not be so smooth. Even if CCs were comparable difficulty wise, which I do not at all believe they are, transitioning to a new schools requires academic and social adjustments that even the strongest students can struggle to make.

Financially taking classes at CCs makes sense, but from a 'if you go to a CC then you can do better at a top 4 year college' standpoint I do not think I necessarily agree. At a top 4th year there will be many opportunities for assistance: for example, my school provides unlimited 1 on 1 tutoring services to any students who need them, test banks for minority and low income students that white and asian students do not have access to, and personalized mentoring services and orientation programs to help minority and low income students adapt to their new environment - among other things.

I would argue that spending a semester or two taking easier classes and utilizing these services and then building up the difficulty of your courses would be a better plan than going to a CC and then uprooting your life again (keeping in mind that Ivies have very generous financial aid programs with no parental expected contribution for families with incomes less than 65k).

 

[Mad Jack]

Interesting. This is a tough call. I actually don’t blame medical schools for not accepting prerequisites from a community college. I think someone should be able to get as much credit from one as possible if need be like the general education requirements and maybe a couple prerequisite classes to cover the science requirement for an AA. But to take all your sciences (besides some upper divisions) at one just shouldn’t be done.

I went to a community college and took 3 science classes there. They were so easy and looking back I’m kinda embarrassed I took them there. Sorry if this is harsh but it’s just how I feel. Later I tutored at one. Students would routinely get take home tests, insane amount of extra credit, and tests were curved when the class average wasn’t bad at all. Then some of these students would later go to university (where I’m at) and then do worse in prerequisites or upper division level classes. It actually does them a disservice because they’re given false confidence from the community college and then later have to switch to something else. So they spent all that time and money with false hope. What’s worse is some of these people only take them at community college because they know it’s easier. SES should definitely be taken into account during admissions but someone taking prerequisites at a community college shouldn’t be treated the same as someone who took them at a university or Ivy League school.

As someone who took courses at both, I've got to say that my university prereq courses were substantially easier than my CC prereqs. And I had a 12/11/12 on the old MCAT and studied for it using only books, so clearly doing half of my prereqs at CC didn't kill me. Let the MCAT be the equalizer, and judge trends in higher level courses instead of prereqs that vary widely by professor and school.

 

[Stagg737]

As someone who took courses at both, I've got to say that my university prereq courses were substantially easier than my CC prereqs. And I had a 12/11/12 on the old MCAT and studied for it using only books, so clearly doing half of my prereqs at CC didn't kill me. Let the MCAT be the equalizer, and judge trends in higher level courses instead of prereqs that vary widely by professor and school.

I agree with the sentiment, but some of the higher level pre-reqs can be taken at CCs (like genetics or physiology) which are often substantially easier than universities. I don't really have a problem with classes like gen chem or intro bio courses at CCs, but for the more core science classes I'd still question the validity of them (though the MCAT can be an equalizer there).

 

[Mad Jack]

I agree with the sentiment, but some of the higher level pre-reqs can be taken at CCs (like genetics or physiology) which are often substantially easier than universities. I don't really have a problem with classes like gen chem or intro bio courses at CCs, but for the more core science classes I'd still question the validity of them (though the MCAT can be an equalizer there).

I don't know how they are doing it these days, but back when I was applying higher level courses had to be taken at a university which is fair, since CCs should not offer higher than 200 level courses

 

[atomi]

it's not questionable, it's theft.

Technically it's copyright infringement. This is a different crime than theft to be precise. Regardless, it is still illegal.

 

[deleted480308]

Technically it's copyright infringement. This is a different crime than theft to be precise. Regardless, it is still illegal.

You are correct in legal terms. I’m speaking morally, I should have been more clear, sorry

 

[Matthew9Thirtyfive]

I've never met a person of colored asked for another doctor who look like them because the physician is not the same race.

I’ve actually seen the opposite. I’ve seen a black patient refuse to see a black doctor because she thought he couldn’t be smart enough to be a real doctor.

 

[Matthew9Thirtyfive]

As someone who took courses at both, I've got to say that my university prereq courses were substantially easier than my CC prereqs. And I had a 12/11/12 on the old MCAT and studied for it using only books, so clearly doing half of my prereqs at CC didn't kill me. Let the MCAT be the equalizer, and judge trends in higher level courses instead of prereqs that vary widely by professor and school.

My n is extremely small, but I took calc 2 at a CC over a summer session because I started the calc sequence in the spring (decided on a math major late) and wanted to get caught up. The CC course was easily as rigorous as calc 1 and 3 that I took at a university. Not all CCs are equal though, which I think is part of the bias.

 

[Mad Jack]

My n is extremely small, but I took calc 2 at a CC over a summer session because I started the calc sequence in the spring (decided on a math major late) and wanted to get caught up. The CC course was easily as rigorous as calc 1 and 3 that I took at a university. Not all CCs are equal though, which I think is part of the bias.

Yeah, mine was nationally recognized for quality teaching and had received a couple of awards that normally only went to universities. Most of the faculty also taught at the big state universities, so there was plenty of high quality teaching due to you basically having the professors from the huge lecture classes teaching 30 people at a time and running the labs themselves instead of using TAs.

 

[deleted480308]

I’ve actually seen the opposite. I’ve seen a black patient refuse to see a black doctor because she thought he couldn’t be smart enough to be a real doctor.

I think more important than which direction it happens with more frequently is the fact that systems should not be adjusted to accommodate it. If you demand a particular race of doctor you can get in the back of the line and wait for one, if we have them. But we shouldn’t base hiring decisions on that

 

[PursuingHappy]

As someone who is both URM, Black to be specific, and low income, I would like to share my perspective.

As a low-income individual: I have had to overcome many hurdles to get to this point, but I think it has definitely strengthened me for the long run. I've worked summers and during the school year since middle school, helped my family pay some of the bills, and lived without basic necessities numerous times. I'm a first generation college student and I've had several close friends become locked up or died due to gun and gang violence. I do believe these experiences have built my resilience and given me the strength necessary to push forward. I honestly think that I have been blessed despite these obstacles. I still have the opportunity to make something of myself when so many others in similar positions don't. And I am grateful for that. Being low-SES growing up was just my way of life; I got accustomed to it. But I honestly do not believe I will ever be accustomed to the issues I face as an black woman living in America.

As a black woman: I constantly wonder if the people around me think I am incompetent. I wonder if they think I got here because of my skin color. I've even had someone say that to my face. I question my own abilities and am afraid to speak of because of the fear of sounding ignorant or like the stereotypical angry black woman. When I do voice my opinion, people think I am hostile. I get nervous every single time I see a police officer. If I am on the same side of the road as one, I cross the street. I don't want any trouble. I constantly worry that my little brother, who is only 10, will be shot and I will have to live without him. It is the only fear that I have. I wonder if doctors will listen to my complaints without bias. They speak to me as if I am uneducated. I can tell they are speaking down to me; I watch the interactions physicians have with white patients and I definitely notice the difference

There are countless others issues that I can mention, but I do think it is difficult to contextualize if one is not a person of color.

 

[OchemOficionado]

As someone who is both URM, Black to be specific, and low income, I would like to share my perspective.

As a low-income individual: I have had to overcome many hurdles to get to this point, but I think it has definitely strengthened me for the long run. I've worked summers and during the school year since middle school, helped my family pay some of the bills, and lived without basic necessities numerous times. I'm a first generation college student and I've had several close friends become locked up or died due to gun and gang violence. I do believe these experiences have built my resilience and given me the strength necessary to push forward. I honestly think that I have been blessed despite these obstacles. I still have the opportunity to make something of myself when so many others in similar positions don't. And I am grateful for that. Being low-SES growing up was just my way of life; I got accustomed to it. But I honestly do not believe I will ever be accustomed to the issues I face as an black woman living in America.

As a black woman: I constantly wonder if the people around me think I am incompetent. I wonder if they think I got here because of my skin color. I've even had someone say that to my face. I question my own abilities and am afraid to speak of because of the fear of sounding ignorant or like the stereotypical angry black woman. When I do voice my opinion, people think I am hostile. I get nervous every single time I see a police officer. If I am on the same side of the road as one, I cross the street. I don't want any trouble. I constantly worry that my little brother, who is only 10, will be shot and I will have to live without him. It is the only fear that I have. I wonder if doctors will listen to my complaints without bias. They speak to me as if I am uneducated. I can tell they are speaking down to me; I watch the interactions physicians have with white patients and I definitely notice the difference

There are countless others issues that I can mention, but I do think it is difficult to contextualize if one is not a person of color.

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

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

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

 

[dr_kateb]

Supporting something that benefits you.

shocked.gif

 

[OchemOficionado]

Supporting something that benefits you.

shocked.gif

Respectfully, the surprise can go both ways when people don’t support things that don’t benefit them personally. Sometimes, it’s about the bigger picture. I think we can all agree that making medical school admissions more equitable is a good thing. We just may disagree on one of the many ways to go about achieving that

 

[deleted480308]

Respectfully, the surprise can go both ways when people don’t support things that don’t benefit them personally. Sometimes, it’s about the bigger picture. I think we can all agree that making medical school admissions more equitable is a good thing. We just may disagree on one of the many ways to go about achieving that

If equitable means racial discrimination, then no we don’t agree that it’s a good thing

 

[Med Ed]

I think we can all agree that making medical school admissions more equitable is a good thing.

This statement is true, but it exposes a central problem in admissions: not everyone defines equitable the same way.

In my experience there are two major adcom camps that can be defined. I'll use two hypothetical applicants to illustrate the divide:

1. Sally has two physicians as parents, went to private school, attended a highly ranked undergraduate institution, has strong EC's and a 3.75/516.
2. Johnny is the first in his family to go to college, went to underperforming K-12 schools, attended a public university, worked 30 hours/week, has acceptable EC's, and a 3.45/504.

Some would say admit Sally because she's got the stronger application and she's the most prepared for the challenge. Others, however, would say admit Johnny, because his numbers are fine and he has demonstrated more grit.

Both have a point.

 

[Raryn]

If equitable means racial discrimination, then no we don’t agree that it’s a good thing

The problem you run into is defining racial discrimination. That's why this particular part of the conversation never goes anywhere. One side says "affirmative action is racist", the other side says "no way!", they're using two different definitions of racist, and it's 100% irreconcilable.

The OP is about what can be done to make med school admissions more equitable when it comes to race. My personal feeling is that a lot has been done, but there's very little more at the med school level that's going to make a significant bit of difference because it truly is a pipeline problem.

Whether I agree with affirmative action in principal is irrelevant here, and continuing *that* discussion would only get the thread sent to froopyland.

 

[OchemOficionado]

This statement is true, but it exposes a central problem in admissions: not everyone defines equitable the same way.

In my experience there are two major adcom camps that can be defined. I'll use two hypothetical applicants to illustrate the divide:

1. Sally has two physicians as parents, went to private school, attended a highly ranked undergraduate institution, has strong EC's and a 3.75/516.
2. Johnny is the first in his family to go to college, went to underperforming K-12 schools, attended a public university, worked 30 hours/week, has acceptable EC's, and a 3.45/504.

Some would say admit Sally because she's got the stronger application and she's the most prepared for the challenge. Others, however, would say admit Johnny, because his numbers are fine and he has demonstrated more grit.

Both have a point.

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

 

[deleted480308]

The problem you run into is defining racial discrimination. That's why this particular part of the conversation never goes anywhere. One side says "affirmative action is racist", the other side says "no way!", they're using two different definitions of racist, and it's 100% irreconcilable.

The OP is about what can be done to make med school admissions more equitable when it comes to race. My personal feeling is that a lot has been done, but there's very little more at the med school level that's going to make a significant bit of difference because it truly is a pipeline problem.

Whether I agree with affirmative action in principal is irrelevant here, and continuing *that* discussion would only get the thread sent to froopyland.

No one wants admit their racial discrimination, we totally agree on that

 

[Matthew9Thirtyfive]

No one wants admit their racial discrimination, we totally agree on that

Including you?

 

[bearcalbear2019]

As someone who is both URM, Black to be specific, and low income, I would like to share my perspective.

As a low-income individual: I have had to overcome many hurdles to get to this point, but I think it has definitely strengthened me for the long run. I've worked summers and during the school year since middle school, helped my family pay some of the bills, and lived without basic necessities numerous times. I'm a first generation college student and I've had several close friends become locked up or died due to gun and gang violence. I do believe these experiences have built my resilience and given me the strength necessary to push forward. I honestly think that I have been blessed despite these obstacles. I still have the opportunity to make something of myself when so many others in similar positions don't. And I am grateful for that. Being low-SES growing up was just my way of life; I got accustomed to it. But I honestly do not believe I will ever be accustomed to the issues I face as an black woman living in America.

As a black woman: I constantly wonder if the people around me think I am incompetent. I wonder if they think I got here because of my skin color. I've even had someone say that to my face. I question my own abilities and am afraid to speak of because of the fear of sounding ignorant or like the stereotypical angry black woman. When I do voice my opinion, people think I am hostile. I get nervous every single time I see a police officer. If I am on the same side of the road as one, I cross the street. I don't want any trouble. I constantly worry that my little brother, who is only 10, will be shot and I will have to live without him. It is the only fear that I have. I wonder if doctors will listen to my complaints without bias. They speak to me as if I am uneducated. I can tell they are speaking down to me; I watch the interactions physicians have with white patients and I definitely notice the difference

There are countless others issues that I can mention, but I do think it is difficult to contextualize if one is not a person of color.

This. So much this. At my free clinic I work with 60% URM patients - a good 30% being black. I can't tell you how many black patients said that their doctors talk to them like they are idiots and are condescending to them or judge them - particularly white doctors. When I explain certain topics to the URM patients they are able to effectively understand and communicate to me like anyone else... regardless of skin color. A lot of URMs unfortunately don't have the access to resources like some others but I think health care providers forget that and look down on them as inferior. We need more URMs, no doubt.

This statement is true, but it exposes a central problem in admissions: not everyone defines equitable the same way.

In my experience there are two major adcom camps that can be defined. I'll use two hypothetical applicants to illustrate the divide:

1. Sally has two physicians as parents, went to private school, attended a highly ranked undergraduate institution, has strong EC's and a 3.75/516.
2. Johnny is the first in his family to go to college, went to underperforming K-12 schools, attended a public university, worked 30 hours/week, has acceptable EC's, and a 3.45/504.

Some would say admit Sally because she's got the stronger application and she's the most prepared for the challenge. Others, however, would say admit Johnny, because his numbers are fine and he has demonstrated more grit.

Both have a point.

These 2 scenarios probably are dependent on the school. I would argue that at a top 20 school the former would be the easy winner, while at a service oriented school the latter would get serious consideration. Any thoughts from your perspective @Med Ed on how scenarios like this usually go during adcom meetings? Or are applicants being looked at individually in the context of their background rather directly compared to drastically different people?

 

[Matthew9Thirtyfive]

This. So much this. At my free clinic I work with 60% URM patients - a good 30% being black. I can't tell you how many black patients said that their doctors talk to them like they are idiots and are condescending to them or judge them - particularly white doctors. When I explain certain topics to the URM patients they are able to effectively understand and communicate to me like anyone else... regardless of skin color. A lot of URMs unfortunately don't have the access to resources like some others but I think health care providers forget that and look down on them as inferior. We need more URMs, no doubt.

I mean I don’t disagree, but we could also make doctors who don’t assume black people are too stupid to understand medical concepts.

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

 

[OchemOficionado]

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

I bet it depends on the physician. Probably also depends on the social status of the patient.

 

[deleted480308]

Including you?

As the minority in these discussions actually saying to not racially discriminate?

I’ll be fine

 

[bearcalbear2019]

I mean I don’t disagree, but we could also make doctors who don’t assume black people are too stupid to understand medical concepts.

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

I would argue they feel it's racial bias because of difference in skin color, and also in the way they appear that deviates from societal norms (wearing saggy pants, dreadlocks, etc.) that gives the physicians a subconscious bias just due to the way society perceives them. But these physicians could also just be douches to everyone, however I've seen 100+ patients and have never heard of a white patient complaining about being discriminated due to his race.

 

[Matthew9Thirtyfive]

I would argue they feel it's racial bias because of difference in skin color, and also in the way they appear that deviates from societal norms (wearing saggy pants, dreadlocks, etc.) that gives the physicians a subconscious bias just due to the way society perceives them. But these physicians could also just be douches to everyone, however I've seen 100+ patients and have never heard of a white patient complaining about being discriminated due to his race.

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

 

[Matthew9Thirtyfive]

As the minority in these discussions actually saying to not racially discriminate?

I’ll be fine

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

 

[Matthew9Thirtyfive]

I bet it depends on the physician. Probably also depends on the social status of the patient.

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