My thoughts on the medical school admissions process...

[BurberryDoc]

---

Members don't see this ad.

If the accrediting body for medical schools (LCME) assessed schools' efforts to recruit and matriculate low SES candidates as they do URM candidates, then we might have some traction in getting low SES applicants in the door in greater numbers. However, why would these candidates be better for society than any other candidates? Should they be admitted in larger numbers despite evidence that they have more difficulty in medical school. (AAMC data) In all likelihood, these students require more services (tutoring, counseling, etc) to be successful. Will you argue that a medical school should put its resources toward that population? We know that URM docs serve populations that are seeking to be cared for by physicians from their own group and you can tell by their faces (and sometimes their names) that they are "one of us". There is nothing to distinguish a non-URM physician who grew up poor from any other physician,, is there?

Check and mate.

 

[SunsFun]

Of course, schools will have criteria that supersede SES. Do you think we'd say, "Oh, the MCAT is a 16 but this guy's a EO1 (first in family to graduate college) so that's ok." No, an MCAT >16 is likely to be a requirement regardless of SES. Does it seem wise to admit low SES applicants who are unlikely to succeed? On the other hand, if an applicant impresses us with a great distance traveled and is 0.1 gpa and 2 MCAT points from our average for matriculants, we might consider what else the applicant brings to the table and one of those things can be the viewpoint of a student who grew up in a low SES home and who may understand that culture (working class and/or welfare class) from first hand experience. That can be an asset in a class discussion about health policy or motivating patients for behavior change or any number of topics. That applicant might get an interview whereas the suburban raised applicant of high SES with the same scores might not (those folks are a dime a dozen).

I was referring to this comment in particular and there is couple more but I don't think I will be able to find them.

I know the boost is different for different URM but to be honest with you I don't know what should SES boost be like. Maybe have different degree of SES have different boosts? Just a suggestion because I don't know the answer.

Well, I hope we can both agree that AAMC could start with producing the data for SES and go from there.

 

[markmark]

Lost track of how many times you contradicted yourself

 

[LizzyM]

I was referring to this comment in particular and there is couple more but I don't think I will be able to find them.

I know the boost is different for different URM but to be honest with you I don't know what should SES boost be like. Maybe have different degree of SES have different boosts? Just a suggestion because I don't know the answer.

Well, I hope we can both agree that AAMC could start with producing the data for SES and go from there.

This is the first year that AAMC is using parents educational attainment and occupation to categorize applicants. Give 'em a few years and they'll have some data on admissions and 4-6 years after that they'll have some information on success in finishing med school and finishing in 4-5 yrs.

 

[BlueLabel]

If the accrediting body for medical schools (LCME) assessed schools' efforts to recruit and matriculate low SES candidates as they do URM candidates, then we might have some traction in getting low SES applicants in the door in greater numbers. However, why would these candidates be better for society than any other candidates? Should they be admitted in larger numbers despite evidence that they have more difficulty in medical school. (AAMC data) In all likelihood, these students require more services (tutoring, counseling, etc) to be successful. Will you argue that a medical school should put its resources toward that population? We know that URM docs serve populations that are seeking to be cared for by physicians from their own group and you can tell by their faces (and sometimes their names) that they are "one of us". There is nothing to distinguish a non-URM physician who grew up poor from any other physician,, is there?

Brilliant. I will say that there might be some life skills/experiences/ability to communicate that I might guess low SES background physicians would possess that others might not, this point confirms the problem that I pointed out initially: economic status actually translates into tangible differences in applicant quality. SES admissions disparities are the symptoms that can only be addressed by fighting the real disease - not institutional bias, but poverty itself.

 

[markmark]

Check and mate.

Huh?

 

[BlueLabel]

Lost track of how many times you contradicted yourself

Contribute something worthwhile or go away.

 

[Davida]

If the accrediting body for medical schools (LCME) assessed schools' efforts to recruit and matriculate low SES candidates as they do URM candidates, then we might have some traction in getting low SES applicants in the door in greater numbers. However, why would these candidates be better for society than any other candidates? Should they be admitted in larger numbers despite evidence that they have more difficulty in medical school. (AAMC data) In all likelihood, these students require more services (tutoring, counseling, etc) to be successful. Will you argue that a medical school should put its resources toward that population? We know that URM docs serve populations that are seeking to be cared for by physicians from their own group and you can tell by their faces (and sometimes their names) that they are "one of us". There is nothing to distinguish a non-URM physician who grew up poor from any other physician,, is there?

Just a question to clarify your response. Data indicates that URM are more likely to go back and work in underserved communities. My understanding is that this is one of many reasons why URM are recruited by medical schools. Are you saying that the data doesn't indicate that this is the case for low SES students, or that there isn't any data about this for low SES students? (From the newer posts, it sounds like you're saying the latter.)

I ask because I do come from a low SES background, and it definitely plays a big role in why I want to go into primary care for underserved populations. I would think that this is a mission-based reason to admit low SES students, if this in fact was true at the population level.

 

[LizzyM]

Brilliant. I will say that there might be some life skills/experiences/ability to communicate that I might guess low SES background physicians would possess that others might not, this point confirms the problem that I pointed out initially: economic status actually translates into tangible differences in applicant quality. SES admissions disparities are the symptoms that can only be addressed by fighting the real disease - not institutional bias, but poverty itself.

I agree. Go way down the pipeline to early childhood education, elementary school, middle school, high school... change the culture that denigrates academic achievement... get parents involved in working with teachers to change classroom deportment... develop educational models that work for underachieving kids, particularly in poor communities.

Also, we need to go back to the way things used to be... HS diploma first, then marriage, then baby. That is one of the biggest predictors of success for the next generation.

 

[deleted480308]

to the earlier question on if current evaluation (mcat/gpa) predicts success... (admittedly this address comlex and med school gpa, not the subjective "good doctor")

http://www.jaoa.org/content/107/4/157.long

 

[SunsFun]

If the accrediting body for medical schools (LCME) assessed schools' efforts to recruit and matriculate low SES candidates as they do URM candidates, then we might have some traction in getting low SES applicants in the door in greater numbers. However, why would these candidates be better for society than any other candidates? Should they be admitted in larger numbers despite evidence that they have more difficulty in medical school. (AAMC data) In all likelihood, these students require more services (tutoring, counseling, etc) to be successful. Will you argue that a medical school should put its resources toward that population? We know that URM docs serve populations that are seeking to be cared for by physicians from their own group and you can tell by their faces (and sometimes their names) that they are "one of us". There is nothing to distinguish a non-URM physician who grew up poor from any other physician,, is there?

This is a very good question that I don't the answer to. Is there? Is there data to see how those two groups are different? If there is, it certainly would be interesting to look at.

Overall, however, this is someone different line of argument in support of URM boost. I personally support it because of my egalitarian beliefs and wanting to give people equal opportunity. I think growing up a minority in America regardless of SES adds enough challenges to warrant a boost to level the paying field. In other words I would still support URM boost even if thee was no evidence that URM physicians served minority population better.

I think giving boost to low SES warrants spending more resources even of those students have more difficulty in medical school. Leveling out the playing field is of key importance to me. Plenty of people will probably disagree.

 

[BurberryDoc]

Contribute something worthwhile or go away.

This is @markmark right now:

 

[LizzyM]

Just a question to clarify your response. Data indicates that URM are more likely to go back and work in underserved communities. My understanding is that this is one of many reasons why URM are recruited by medical schools. Are you saying that the data doesn't indicate that this is the case for low SES students, or that there isn't any data about this for low SES students? (From the newer posts, it sounds like you're saying the latter.)

I ask because I do come from a low SES background, and it definitely plays a big role in why I want to go into primary care for underserved populations. I would think that this is a mission-based reason to admit low SES students, if this in fact was true at the population level.

I do believe that we do not yet have the data on whether low SES students go back to serve their underserved communities or if they are looking for a ticket out of whatever backwater place they come from. That has been the theory behind the self-designation of "disadvantaged" but it depended on self-designation and we had some folks too proud to say that they were disadvantaged even if they were first in the family to attend college and were poor growing up, and others who reported being disadvantaged despite having a daddy practicing a lucrative subspecialty in a tony suburb. (She thought that daddy should catch a break on med school tuition after paying for an expensive college... particularly because her big city apartment was costing her an awful lot during her gap year -- the mind boggles and the absurdity of it all).

 

[Mt Kilimanjaro]

If the accrediting body for medical schools (LCME) assessed schools' efforts to recruit and matriculate low SES candidates as they do URM candidates, then we might have some traction in getting low SES applicants in the door in greater numbers. However, why would these candidates be better for society than any other candidates? Should they be admitted in larger numbers despite evidence that they have more difficulty in medical school. (AAMC data) In all likelihood, these students require more services (tutoring, counseling, etc) to be successful. Will you argue that a medical school should put its resources toward that population? We know that URM docs serve populations that are seeking to be cared for by physicians from their own group and you can tell by their faces (and sometimes their names) that they are "one of us". There is nothing to distinguish a non-URM physician who grew up poor from any other physician,, is there?

Agree that institutions will not make this a priority until the LCME does. However, there is evidence that medical students who are older, from low-SES backgrounds (especially rural), and female disproportionately end up matching into primary care and practicing in rural and/or underserved areas after residency. Isn't the maldistribution of primary care physicians one of the few key healthcare problems that can be solved at the undergraduate medical education/admissions level?

I think the underlying disagreement is over whether one ascribes more importance to race or SES regarding opportunities in society. People like myself and the OP tend to think that SES has a far greater impact on one's opportunities than does race. Other people put more weight on race. Where you stand on that issue probably has a lot to do with how and where you grew up.

I think the irony is that everyone is really arguing for the same thing. In my opinion, the current system just uses "URM status" as a proxy for "low-SES." Since low-SES applicants of any race will tend to have less competitive applications, if you lower the bar for any racial group, you will end up with a greater number of low-SES medical students from that group and, in turn, end up with more physicians from that group working in underserved communities and matching into primary care.

If there's any evidence that controls for SES and demonstrates that race itself (rather than SES or other factors) is independently responsible for decisions to serve in rural or underserved areas, please share.

 

[LizzyM]

URM is not a proxy for low SES. The two are correlated but not well and I'd be willing to bet that those URM who are admitted are disproportionately from the higher SES applicants within the URM pool.
I would not expect URM to go to rural areas unless no other option were open to them.

What proportion of the US population lives in rural areas?

 

[Lucca]

I agree. Go way down the pipeline to early childhood education, elementary school, middle school, high school... change the culture that denigrates academic achievement... get parents involved in working with teachers to change classroom deportment... develop educational models that work for underachieving kids, particularly in poor communities.

Also, we need to go back to the way things used to be... HS diploma first, then marriage, then baby. That is one of the biggest predictors of success for the next generation.

How do you provide systemic change for a system that is largely made up of independent bodies? We can only refine standards and curricula so much but the success of a high school is going to boil down to community and parental involvement; both factors that increase with an areas average income level.

The US educational system is flawed but works at higher levels of income. Otherwise there would be a negative trend in competition for undergrad (and in a sense, also medical school) but competition also increases. Average educational attainment is going up in the country and these children will face greater pressures towards higher education, making class mobility even more difficult and more cost-prohibitive.

What is an educational model that will work for poor children? Boarding schools to get them out of their violent neighborhoods? Better teachers doesnt solve the problem as Teach for America has had limited success, although I support their mission. Im not asking these questions with the intent of receiving an answer since they are entirely too complex to be summarily answered, but instead I want to make the point that the US is marching towards heavier stratification and systemic changes will only be more difficult down the road.

My best bet would be community empowerment programs and public education initiatives (like public education at large, not just schoolchildren).

Here are our problems in education:
Serving an incredibly diverse population.
Serving poor populations.
Providing a system that keeps students from falling through the cracks while adequately challenging and preparing high-achieving students.
Fixing the higher education bubble: providing different training paths for different types of learners, students. I.e more trade schools, subsidizing higher education cost, give students practical skills straight out of high school, etc.

How do you promote this type of systemic, grassroots reform in a heavily divided country that refuses to work together on something as basic as providing healthcare for the entire population? Not an attack, I'm legitimately interested in how we would even start about doing this considering the conversation only happens at higher educational institutions.

 

[sourdoughllama]

Agree that institutions will not make this a priority until the LCME does. However, there is evidence that medical students who are older, from low-SES backgrounds (especially rural), and female disproportionately end up matching into primary care and practicing in rural and/or underserved areas after residency. Isn't the maldistribution of primary care physicians one of the few key healthcare problems that can be solved at the undergraduate medical education/admissions level?

I don't think people are lining up to do primary care in the boonies, no matter what background they're from (and I'm arguing FOR low SES being a disadvantage, so your side). Let's be real, most applicants do go into the profession with finances at least in their minds

I think the irony is that everyone is really arguing for the same thing. In my opinion, the current system just uses "URM status" as a proxy for "low-SES." Since low-SES applicants of any race will tend to have less competitive applications, if you lower the bar for any racial group, you will end up with a greater number of low-SES medical students from that group and, in turn, end up with more physicians from that group working in underserved communities and matching into primary care.

SES vs URM isn't really the argument - yes it's mentioned, but people are just wondering if SES is being taken into account to the same extent as URM; low SES vs high SES's effects on admissions is. Some people are arguing the fact that the long term effects of being from poor vs rich families inherently produces different quality of applicants. Some people are arguing whether compensation should be given to low SES vs high SES

 

[fw5tape6kq]

Here's my somewhat frank opinion of the medical school application process: becoming a doctor is hard, even if you happen to have ample financial resources at your disposal. Surely, it is even more difficult for someone who does not have the money to pay for MCAT prep classes, the "connections" to shadow a physician, or the free time to engage in a retinue of extra-curricular activities. Such is the case with nearly every facet of life. Nevertheless, I think it is rare for someone to matriculate into medical school who has not worked to secure that position. Long gone are the days when status and legacy alone could make you a doctor. The field today is simply to competitive, and the stakes (human lives) are simply too high. Does money give you an advantage? Absolutely. Does it make the process a walk in the park? No way.

 

[UofMpremed]

LizzyM: You seem to be under the impression that there is not a problem with the distribution of accepted SES, there most definitely is. Equal opportunity should be afforded to everyone, if they are more likely to be excellent doctors or not, only as long as they are equally as likely as physicians. Your assertion that SES shouldn't be counted towards admission because it doesn't predict success yet is like me saying playing a college varsity sport shouldn't count for anything in an application because data has not shown anything. If anything low SES should be counted like a hobby, albeit an unfun hobby, as my poverty has taken time and energy I could have spent in other pursuits.

As for solutions to the statistics about medical school matriculation being so divided among SES:

Things to change before considered medical school admissions:
Raise standards for ATTENDING certain public schools. If you get expelled, miss so many days you forfeit your right to an education other schools have a right to deny you access to attending. Hate to say it but if you create a dangerous environment for other students you should not attend that school any more, (schools shouldn't be punished financially for expelling those who make others want to dropout). Forget no child left behind, it is impossible not to leave some children behind. Better school busses: figure out a system to have a centralized bus system that allows you to go to whichever school you want in a 20 mile radius (otherwise only the children with parents with cars and time can truly choose their school). More money for school counselors and have a specific proportion of staff focused on only college career counseling. The truth is lower SES schools counseling offices are filled with students who have dysfunctional families and counselors' time and energy is spent dealing more with emotional and family issues than schools with higher SES kids. Also, believe it or not, our "welfare system" is a safety net with a lot of holes a far cry from the "hammock" conservatives view it as. As such, despite being abusive for years, I waited until my dad was literally homicidal as probable homelessness was only better than a probable death, I wish I was kidding. Too many people have to endure abusive environment or let work crowd out their education because our safety net isn't comprehensive. (More aid in form of living expenses rather than tuition (which inflates college prices) would pay dividends to our economy down the road and is cheaper than having young adults spend time in jail).

Tl DR: Let schools pick students and students pick schools. Create a better welfare system than exists currently that protects those especially vulnerable (kids)

Medical schools/ AAMC:
Medical schools have a tendency to keep hush-hush their actual admittance criteria and instead give the blank answer: take whatever class you want/ do what interests you. But research/volunteering clinically will get you farther than an equal time commitment in most things you would consider fun/ most jobs.
Therefore, if each school made their rubrics very clear about what factors make a competitive applicant in their eyes everyone rather than those in the know (read: high SES) would be able to maximize their efforts in a chance to admission. Case in point: of the applicants I know those of higher SES applicants apply earlier in the cycle than low SES applicants due to the difference in knowledge of the application process and importance of timeliness. I also think that not enough people know about AAMC's Fee Assistance Program which is kind of awesome. Also possibly limits to how many schools applicants apply to (applicants who apply to 30+ schools drown out the lower SES applicants who apply late and not as broadly).

What people on this board can do to take control of this situation:
1. Create quality content.
2. Maybe funnel your angst towards something productive as a volunteer experience in education/ after school programs, I promise it would look better on an app than "SDN forum troll" (no one specific in mind🙂 ).

 

[sourdoughllama]

Here's my somewhat frank opinion of the medical school application process: becoming a doctor is hard, even if you happen to have ample financial resources at your disposal. Surely, it is even more difficult for someone who does not have the money to pay for MCAT prep classes, the "connections" to shadow a physician, or the free time to engage in a retinue of extra-curricular activities. Such is the case with nearly every facet of life. Nevertheless, I think it is rare for someone to matriculate into medical school who has not worked to secure that position. Long gone are the days when status and legacy alone could make you a doctor. The field today is simply to competitive, and the stakes (human lives) are simply too high. Does money give you an advantage? Absolutely. Does it make the process a walk in the park? No way.

But no one's saying it's easier because people are rich. Rich people get in because the resources/opportunities make them empirically better candidates. I believe this has been said several times

 

[BlueLabel]

LizzyM: You seem to be under the impression that there is not a problem with the distribution of accepted SES, there most definitely is. Equal opportunity should be afforded to everyone, if they are more likely to be excellent doctors or not, only as long as they are equally as likely as physicians. Your assertion that SES shouldn't be counted towards admission because it doesn't predict success yet is like me saying playing a college varsity sport shouldn't count for anything in an application because data has not shown anything. If anything low SES should be counted like a hobby, albeit an unfun hobby, as my poverty has taken time and energy I could have spent in other pursuits.

As for solutions to the statistics about medical school matriculation being so divided among SES:

Things to change before considered medical school admissions:
Raise standards for ATTENDING certain public schools. If you get expelled, miss so many days you forfeit your right to an education other schools have a right to deny you access to attending. Hate to say it but if you create a dangerous environment for other students you should not attend that school any more, (schools shouldn't be punished financially for expelling those who make others want to dropout). Forget no child left behind, it is impossible not to leave some children behind. Better school busses: figure out a system to have a centralized bus system that allows you to go to whichever school you want in a 20 mile radius (otherwise only the children with parents with cars and time can truly choose their school). More money for school counselors and have a specific proportion of staff focused on only college career counseling. The truth is lower SES schools counseling offices are filled with students who have dysfunctional families and counselors' time and energy is spent dealing more with emotional and family issues than schools with higher SES kids. Also, believe it or not, our "welfare system" is a safety net with a lot of holes a far cry from the "hammock" conservatives view it as. As such, despite being abusive for years, I waited until my dad was literally homicidal as probable homelessness was only better than a probable death, I wish I was kidding. Too many people have to endure abusive environment or let work crowd out their education because our safety net isn't comprehensive. (More aid in form of living expenses rather than tuition (which inflates college prices) would pay dividends to our economy down the road and is cheaper than having young adults spend time in jail).

Tl DR: Let schools pick students and students pick schools. Create a better welfare system than exists currently that protects those especially vulnerable (kids)

Medical schools/ AAMC:
Medical schools have a tendency to keep hush-hush their actual admittance criteria and instead give the blank answer: take whatever class you want/ do what interests you. But research/volunteering clinically will get you farther than an equal time commitment in most things you would consider fun/ most jobs.
Therefore, if each school made their rubrics very clear about what factors make a competitive applicant in their eyes everyone rather than those in the know (read: high SES) would be able to maximize their efforts in a chance to admission. Case in point: of the applicants I know those of higher SES applicants apply earlier in the cycle than low SES applicants due to the difference in knowledge of the application process and importance of timeliness. I also think that not enough people know about AAMC's Fee Assistance Program which is kind of awesome. Also possibly limits to how many schools applicants apply to (applicants who apply to 30+ schools drown out the lower SES applicants who apply late and not as broadly).

What people on this board can do to take control of this situation:
1. Create quality content.
2. Maybe funnel your angst towards something productive as a volunteer experience in education/ after school programs, I promise it would look better on an app than "SDN forum troll" (no one specific in mind🙂 ).

Wait I don't follow your first paragraph. Equal opportunity should be afforded to all regardless of their potential to be a successful physician? You said

"Equal opportunity should be afforded to everyone, if they are more likely to be excellent doctors or not, only as long as they are equally as likely as physicians"

That sentence is practically indecipherable. In any event, you haven't yet established exactly why broader SES inclusion is a worthwhile goal in and of itself (I embrace it inasmuch that it could have some marginal benefits to ability to communicate with/relate to patients but there is virtually no data demonstrating this as there is for URMs, who actually return to areas with other URMs predominantly, according to published statistics).

Again I don't see why the publicity of admissions criteria is at all relevant. General guidelines are given on the AAMC site, on each schools site, and is implicit in the application itself. You've got far, far more to work with than with any application for professional employment, as anyone who has ever searched for a real job can attest.

Nobody ever said SES Shouldn't be taken into consideration for admission, certainly not LizzyM. No clue where you got that from. I have nothing to say about your recommendations for what I would assume is high school reform? It's hard to tell. Except to say that they seem idealistic and infeasible

 

[astromfs]

But no one's saying it's easier because people are rich. Rich people get in because the resources/opportunities make them empirically better candidates. I believe this has been said several times

Edit : read wrong...

 

[badgerbimmer]

It appears that what should be the primary objective of medical schools is consistently being overlooked in these discussions. It would be difficult to dispute that the overarching objective of the system is to produce the best medical practioners/researchers to serve the broadest population possible in a fiscally responsible manner. The objective is not to serve other ill-defined social missions.
URM’s are given an edge due to empirical evidence that upon completion of their education they will go on to serve under-served populations. Hence accomplishing an overarching objective of the system. Providing a seat to a white SES who likely in most circumstances can hardly wait to finish school, move to the suburb, join the country club and take care of the "wealthy" does not serve the overarching goals. Will there be the occasional SES that has the desire to serve the poor after graduation, of course there will, is it worth lowering the standards of the system for the few, of course not.
I also find OP’s use of “egalitarian” in the medical school admission process quite amusing. In the event “egalitarianism” where to be applied in the context of medical school admissions there would be no consideration of sex, race, URM, SES etc., etc.. Egalitarianism would require the best applicants based on demonstrated achievement be given the seats regardless of any other factor. That my friend is egalitarian, everyone is equal in the eyes of the Adcom and the most qualified get the spot. What OP is advocating is social engineering.
On to other points. “Wealth” is only a small factor in the demographic class that OP seems to believe is oppressing him. Let’s agree that the “wealthy class” being referred is the working wealthy not the inherited wealthy. Let’s face it if you were going to inherit real wealth there are a lot better things you could do with your time than toil through medical school. Let’s diagnose the working wealthy. Generally speaking they are college educated (perhaps grad school), hardworking, value education, more likely to provide a stable home environment, encourage achievement and intelligent. Is it a surprise to anyone that most (including URM) medical school students come from this background? Of course it is not surprising. The only meaningful way to change this fact is to change the unfortunate shift away from family values and the responsibility of raising a family in a caring and nurturing fashion. Wealth has very little to do with that.
Finally OP’s assertion “But the majority of applicants are neither extremely hard-working nor extremely intelligent” shows a level of ignorance that is truly astounding. Given the difficulty of achieving admittance to medical school today and the scrutiny of the Adcoms this is an astonishing statement that can only be attributed to some deep seated emotional distress experience be OP at some point in his life. I hope you reconcile your emotions with respect to these issues or I fear you will have a very unhappy life. It is truly discomforting to know that there are individuals who may actually practice medicine someday who are so self-possessed that they and they alone are the arbiters of who does and does not “deserve” admittance to medical school.

 

[SunsFun]

It appears that what should be the primary objective of medical schools is consistently being overlooked in these discussions. It would be difficult to dispute that the overarching objective of the system is to produce the best medical practioners/researchers to serve the broadest population possible in a fiscally responsible manner. The objective is not to serve other ill-defined social missions.
URM’s are given an edge due to empirical evidence that upon completion of their education they will go on to serve under-served populations. Hence accomplishing an overarching objective of the system. Providing a seat to a white SES who likely in most circumstances can hardly wait to finish school, move to the suburb, join the country club and take care of the "wealthy" does not serve the overarching goals. Will there be the occasional SES that has the desire to serve the poor after graduation, of course there will, is it worth lowering the standards of the system for the few, of course not.
I also find OP’s use of “egalitarian” in the medical school admission process quite amusing. In the event “egalitarianism” where to be applied in the context of medical school admissions there would be no consideration of sex, race, URM, SES etc., etc.. Egalitarianism would require the best applicants based on demonstrated achievement be given the seats regardless of any other factor. That my friend is egalitarian, everyone is equal in the eyes of the Adcom and the most qualified get the spot. What OP is advocating is social engineering.
On to other points. “Wealth” is only a small factor in the demographic class that OP seems to believe is oppressing him. Let’s agree that the “wealthy class” being referred is the working wealthy not the inherited wealthy. Let’s face it if you were going to inherit real wealth there are a lot better things you could do with your time than toil through medical school. Let’s diagnose the working wealthy. Generally speaking they are college educated (perhaps grad school), hardworking, value education, more likely to provide a stable home environment, encourage achievement and intelligent. Is it a surprise to anyone that most (including URM) medical school students come from this background? Of course it is not surprising. The only meaningful way to change this fact is to change the unfortunate shift away from family values and the responsibility of raising a family in a caring and nurturing fashion. Wealth has very little to do with that.
Finally OP’s assertion “But the majority of applicants are neither extremely hard-working nor extremely intelligent” shows a level of ignorance that is truly astounding. Given the difficulty of achieving admittance to medical school today and the scrutiny of the Adcoms this is an astonishing statement that can only be attributed to some deep seated emotional distress experience be OP at some point in his life. I hope you reconcile your emotions with respect to these issues or I fear you will have a very unhappy life. It is truly discomforting to know that there are individuals who may actually practice medicine someday who are so self-possessed that they and they alone are the arbiters of who does and does not “deserve” admittance to medical school.

Says a guy whose only comment here is in he issue of admission favoritism. You should let adcoms, who you defend so much, to decide whether OP has what it takes to be a doctor or not. Amateur psychoanalysis is unnecessary.

Also, you are dead wrong about egalitarianism. What you described here is the polar opposite. And if you want to have a serious discussion here and be taken serious please avoid terms like "social engineering".

 

[TalinAagam]

We are all familiar with the criteria that medical schools use to evaluate prospective students. Students are expected to excel or at least be proficient in each of these areas to be granted an interview. Doing so is supposed to show that you, as a pre-med, are capable of handling the tough coursework that will be thrown at you during medical school. The truth is, while success in the above factors does make for a successful medical student, it also implicitly suggests something else: that the student is well off.

I took an entire summer off to study for the MCAT. I did practically nothing but study from May until the beginning of August, yet I still did not feel ready to take my MCAT in September. I ended up taking another month and a half (from December to January) to study to really ace the MCAT. Additionally, to boost my application, I spent about 4 weeks in total shadowing doctors, and another 10-15 hours a week as an unpaid research assistant throughout the first three years of my college career. Thankfully, I was able to do this because I received a full scholarship to my state school.

I was fortunate enough to gain admission to my medical school of choice very early in the application season; however, many students aren't so lucky. Many students are wait-listed or are rejected point-blank from every school they apply to. Faced with rejection, many students pursue other interests. If I were to not get accepted this cycle, I believe I would join the ranks of students who pursue other interests. Why? While I would like to take a year off to boost my application and retake the MCAT, the truth is, I lack the resources to provide for myself in that gap year.

However, the students who do have the resources to take a gap year fully take advantage of those resources. They spend months doing research (often for free). They spend thousands of dollars on outreach trips abroad. They spend thousands on expensive MCAT review courses. And then, when the reapply in the following cycle, they are accepted. It's been shown that students who take a year off have a substantially higher chance of getting accepted into medical school. This is expected to be the obvious result - if a student has an additional year (that's 25% longer than the average college student who graduates in 4 years) to boost their application - they're bound to at least marginally increase their chances). As a result of this, many of these privileged pre-meds get into medical school.

The question that I ask is this: if those students who did not get accepted from medical school had the resources to go on lavish medical missions in Guatemala or to enroll in expensive Kaplan MCAT preparatory classes, would they have gotten accepted to medical school? How much of a factor did Daddy's money have on a given privileged kid gaining admission?

I believe money plays a tremendous factor. As a recently admitted student, I feel surrounded by students who are sons or daughters of to-do medical professionals, researchers, lawyers, etc. I would go so far as to say that more than half of my future classmates I have met so far come from households with income in the top 5% of society.

For example, I received a phone call from my med school "peer mentor". He was a third year medical student who gave me a call congratulating me on gaining acceptance, and told me that he was here for me had I any questions for him, etc. I asked him questions about the curriculum and the environment, to which he gave excellent and helpful responses. However, the moment I asked him about FAFSA - the free application for federal student aid - he told me frankly that he was "fortunate enough that family could cover the cost of attendance." He then offered to put me in touch with on the financial aid officers that the school had hired. I politely refused his offer. When I probed him about his place of residence, the response was similar. He had no idea about anything - he was living in a $1200/month studio apartment fully paid for by daddy. I knew then that he was in a total state of disconnect. He simply didn't see money the same way as the rest of us did.

There's something wrong with this picture. Isn't America supposed to be a country where upward mobility is encouraged? What exactly does the American dream promise? Why is it that the bulk of America's future doctors are rich, spoiled, disconnected people? How can this generation of people be taught to empathize with and care for those who have nothing when they themselves have unfairly snatched admission by flashing their store-bought resumes to the admissions staff?

As a senior who has been talking to pre-med students for my entire college career, I know the tell-tale signs of a pre-med who isn't going to make it. Do they have to take a part-time job so they can pay the bills? Probably not going to be able to afford the time to work in a research lab for free 10-15 hours a week. Definitely not going be able to afford a KAPLAN test prep course. Can't take classes over the summer because their scholarship doesn't cover it? Probably not going to be able to take all of the classes they need to take to take their MCAT on time (during junior year).

Now, there are the few students who do make it despite coming from a middle-class family. These are often your extremely hard-workers. Other middle-class students are simply lucky. Perhaps they went to a great high school which prepared them well and they were able to secure a scholarship, or a paid internship, etc. And of course, there are hard-working and intelligent students who come from well to-do families who deserve their admission to medical school.

But the majority of applicants are neither extremely hard-working nor extremely intelligent. They are simply your run-of-the-mill applicant. And for those applicants who are struggling to stand out amongst their peers, a lot of cash goes a long way. Ten hours a week of research instead of waiting tables is not only going to make them more competitive, but it's also going to make them smarter and more capable.

Sure, you might say that medical school committees often take note when students are having to support themselves through school and give them extra consideration when making admissions decisions, but the number of students admitted through such means is few and far between. The standard that medical schools set for admission can only be afforded by the children of the top 5-10% of society. If medical schools wanted to truly create an admissions process that is more conscious of socioeconomic barriers, then the medical schools would have already done so. But that is not the priority. So long as the AMA and the medical schools are able to produce capable physicians, they are content.

I didn't write this piece with the hope of inciting a rebellion. I wrote this as a reflective piece based on my personal experience. Next time you hear news of a young student gaining acceptance to medical student on his second, third, or fourth try, I hope you view his story as more than one of perseverance and indomitable spirit. I see that acceptance more as a credit to his parents' success in providing the best opportunities for their child.

I'm quoting it so I may read it again some day.

 

[TalinAagam]

I'm quoting it so I may read it again some day.

 

[badgerbimmer]

Definition of EGALITARIANISM
1
: a belief in human equality especially with respect to social, political, and economic affairs
2
: a social philosophy advocating the removal of inequalities among people

Thus in the context of medical school admissions egalitarianism requires the removal of all social, political and economic inequalities. Hence in this context no "favoritism" based upon social, political, race, gender, religion etc. in the admissions process. Perhaps a class in philosophy would have helped.

 

[SunsFun]

Definition of EGALITARIANISM
1
: a belief in human equality especially with respect to social, political, and economic affairs
2
: a social philosophy advocating the removal of inequalities among people

Thus in the context of medical school admissions egalitarianism requires the removal of all social, political and economic inequalities. Hence in this context no "favoritism" based upon social, political, race, gender, religion etc. in the admissions process. Perhaps a class in philosophy would have helped.

Egalitarians recognize the existence of inequalities and advocate for the removal of them by leveling the playing filed. In other words egalitarianism advocates for distributing the public good by prioritizing the interests of the least advantaged in society. Unless you're living on Mars, you should know that SES and URMs are least advantaged in our society. Therefore leveling out the playing field by prioritizing their interests is justified.

 

[DokterMom]

More than anything, the biggest advantage I've enjoyed after "becoming wealthy" is mentors. Wealthy people are generally successful and educated. Generally. They have great advice. They open doors. They offer you internships, tutoring, they teach you about stocks, they teach you about foreign languages. They tell you how you can better manage your money, how you can save it. They tell you what schools to go to, and where, and how to apply. The application process, especially as an immigrant, was a complete and total mystery to my family and I relied entirely on friends and the parents of friends who had attended elite institutions. Mentorship is the greatest boon anyone can have in their education.

This - exactly this. Prospective students from low SES (or immigrant) households simply don't know the ropes and have the built-in support systems that students from upper SES households do. When I compare the college-application support at our high school to that of my friends', there is, quite simply, no comparison. Our students sign up for and take the PLAN, PSAT and SAT tests in school during class time. If they need a fee waiver, the school gets them one. Our students are coached on how to put together a resume and CV, starting freshman year. There are volunteer opportunities out the wazoo and every club has a dozen or so officers, so every student has a chance to demonstrate leadership. Parent meetings feature time-lines and To Do lists. College application essays are required assignments in Senior English classes. You think our students get into good colleges? You bet they do. (This is a public high school by the way, though certainly not a poor one.)

 

[deleted480308]

Egalitarians recognize the existence of inequalities and advocate for the removal of them by leveling the playing filed. In other words egalitarianism advocates for distributing the public good by prioritizing the interests of the least advantaged in society. Unless you're living on Mars, you should know that SES and URMs are least advantaged in our society. Therefore leveling out the playing field by prioritizing their interests is justified.

To arbitrarily equalize everything requires taking from those that "have"...which is not ok

 

[sourdoughllama]

It appears that what should be the primary objective of medical schools is consistently being overlooked in these discussions. It would be difficult to dispute that the overarching objective of the system is to produce the best medical practioners/researchers to serve the broadest population possible in a fiscally responsible manner. The objective is not to serve other ill-defined social missions.
URM’s are given an edge due to empirical evidence that upon completion of their education they will go on to serve under-served populations.

Where is the source to your claim? LizzyM brought up a similar point saying URMs go back to serve their own populations, but not what you said, so I'd like to see the empirical evidence.

Providing a seat to a white SES who likely in most circumstances can hardly wait to finish school, move to the suburb, join the country club and take care of the "wealthy" does not serve the overarching goals. Will there be the occasional SES that has the desire to serve the poor after graduation, of course there will, is it worth lowering the standards of the system for the few, of course not.

That is extremely ignorant. Not all white people live in country clubs and play golf. Not all URMs live in a shack in Compton. How do you know people's intentions and goals in life?

 

[sourdoughllama]

Generally speaking they are college educated (perhaps grad school), hardworking, value education, more likely to provide a stable home environment, encourage achievement and intelligent. Is it a surprise to anyone that most (including URM) medical school students come from this background? Of course it is not surprising. The only meaningful way to change this fact is to change the unfortunate shift away from family values and the responsibility of raising a family in a caring and nurturing fashion. Wealth has very little to do with that.

Change what fact? I am unable to decipher what you mean with this at all

Finally OP’s assertion “But the majority of applicants are neither extremely hard-working nor extremely intelligent” shows a level of ignorance that is truly astounding. Given the difficulty of achieving admittance to medical school today and the scrutiny of the Adcoms this is an astonishing statement that can only be attributed to some deep seated emotional distress experience be OP at some point in his life. I hope you reconcile your emotions with respect to these issues or I fear you will have a very unhappy life. It is truly discomforting to know that there are individuals who may actually practice medicine someday who are so self-possessed that they and they alone are the arbiters of who does and does not “deserve” admittance to medical school.

A GPA of 3.6 and a 31 MCAT is hardly "extremely intellengent and hard working," but these are just opinions. How does that difference in opinion suddenly jump to deep seated emotional distress? Your entire post is based on nothing really

 

[Tommyguns89]

If the accrediting body for medical schools (LCME) assessed schools' efforts to recruit and matriculate low SES candidates as they do URM candidates, then we might have some traction in getting low SES applicants in the door in greater numbers. However, why would these candidates be better for society than any other candidates? Should they be admitted in larger numbers despite evidence that they have more difficulty in medical school. (AAMC data) In all likelihood, these students require more services (tutoring, counseling, etc) to be successful. Will you argue that a medical school should put its resources toward that population? We know that URM docs serve populations that are seeking to be cared for by physicians from their own group and you can tell by their faces (and sometimes their names) that they are "one of us". There is nothing to distinguish a non-URM physician who grew up poor from any other physician,, is there?

I dont know if this is relevant but I think making social status a factor(even separate from income) might have some benefit. My dad is a carpenter, I know a lot of working class/skilled trade people. Some of them make a lot of money, some dont but the one thing they all have in common is a massive distrust for professionals, especially lawyers and doctors. A physician who has experience with their concerns(or outright paranoia in some cases) might be at an advantage. And a lot of these people are the type who fall for the "natural remedy" crap. Maybe if we had more doctors who come from a working class background this will be less of an issue, maybe not.

 

[boboyahoo]

Each group has good and hard-working kids. As they say, it may seem like grass is always greener on the other side. Yes, kids that are not financially secure will have a harder time (in fact, sometimes you will feel very pressured to drop all your studies not because you decided but because circumstances did even if you are fueling at it 400%). But the single best thing I've learned from hardship is to keep going at it and being the best human being you can possibly imagine. I envision a doctor that doesn't go to abroad trips to take pics with poor kids and post them on facebook for show of hard labor, but to keep those in his/her memory so that they continue such type of philanthropic work because maybe at some point in their life, they were that kid or that they could see themselves in those types of kids. Be content with what you have and always consider yourself as an asset because of your unique experience. I've had doctors that struggled growing up to and they ended up being some of the kindest people I have met. The same goes to physicians that I thought came from higher up families. I appreciate the 2 sides of the coin type of experience and thought to myself that if I were to be a professional, I should be very similar to these people. If there is anything that gets people out of a financially unstable life, it is our education; and up to atleast grade 12 we have that for free unlike a lot of foreign countries abroad. It's true that not knowing the ropes and not being able to appoint tutors because I cared for my parents' finances did hinder me a lot but atleast I was able to depart that information to my siblings who did cross that barrier. I've seen a woman use several tutors for her 5 yr old daughter and claim that kids with older siblings were unfairly taking advantage because they had big brother/sister to show them the hoops. I have to say, some ppl truly have great excuses. Sometimes I find myself making awful excuses for myself too and that's when I realize that no amount of money could cure that but only myself. As someone said to me "surround yourself with good people and your life will be good too". 🙂

 

[BurberryDoc]

It appears that what should be the primary objective of medical schools is consistently being overlooked in these discussions. It would be difficult to dispute that the overarching objective of the system is to produce the best medical practioners/researchers to serve the broadest population possible in a fiscally responsible manner. The objective is not to serve other ill-defined social missions.
URM’s are given an edge due to empirical evidence that upon completion of their education they will go on to serve under-served populations. Hence accomplishing an overarching objective of the system. Providing a seat to a white SES who likely in most circumstances can hardly wait to finish school, move to the suburb, join the country club and take care of the "wealthy" does not serve the overarching goals. Will there be the occasional SES that has the desire to serve the poor after graduation, of course there will, is it worth lowering the standards of the system for the few, of course not.
I also find OP’s use of “egalitarian” in the medical school admission process quite amusing. In the event “egalitarianism” where to be applied in the context of medical school admissions there would be no consideration of sex, race, URM, SES etc., etc.. Egalitarianism would require the best applicants based on demonstrated achievement be given the seats regardless of any other factor. That my friend is egalitarian, everyone is equal in the eyes of the Adcom and the most qualified get the spot. What OP is advocating is social engineering.
On to other points. “Wealth” is only a small factor in the demographic class that OP seems to believe is oppressing him. Let’s agree that the “wealthy class” being referred is the working wealthy not the inherited wealthy. Let’s face it if you were going to inherit real wealth there are a lot better things you could do with your time than toil through medical school. Let’s diagnose the working wealthy. Generally speaking they are college educated (perhaps grad school), hardworking, value education, more likely to provide a stable home environment, encourage achievement and intelligent. Is it a surprise to anyone that most (including URM) medical school students come from this background? Of course it is not surprising. The only meaningful way to change this fact is to change the unfortunate shift away from family values and the responsibility of raising a family in a caring and nurturing fashion. Wealth has very little to do with that.
Finally OP’s assertion “But the majority of applicants are neither extremely hard-working nor extremely intelligent” shows a level of ignorance that is truly astounding. Given the difficulty of achieving admittance to medical school today and the scrutiny of the Adcoms this is an astonishing statement that can only be attributed to some deep seated emotional distress experience be OP at some point in his life. I hope you reconcile your emotions with respect to these issues or I fear you will have a very unhappy life. It is truly discomforting to know that there are individuals who may actually practice medicine someday who are so self-possessed that they and they alone are the arbiters of who does and does not “deserve” admittance to medical school.

TESTIFY!

 

[badgerbimmer]

Egalitarians recognize the existence of inequalities and advocate for the removal of them by leveling the playing filed. In other words egalitarianism advocates for distributing the public good by prioritizing the interests of the least advantaged in society. Unless you're living on Mars, you should know that SES and URMs are least advantaged in our society. Therefore leveling out the playing field by prioritizing their interests is justified.

You of course are referencing societal egalitarianism. The discussion here relates to a specific activity, admission to medical school. This would be contextual egalitarianism, the concept is quite simple. Societal egalitarianism is an admirable goal. Unfortunately history tells us that the concept is not very successful with respect to the human species. The millions slaughtered by Stalin and Mao would, if they could, be able to attest to that. How about the millions that live in abject poverty in Cuba? The Cubans are certainly enjoying an "egalitarian system". Egalitarianism in this life can not be coerced by "the system", human nature does not allow it.

You can choose to live in a fantasy world, I will live in the real world. The best you can hope for is to provide the opportunity to people to better themselves, what they do with that opportunity is their choice. Should they use that opportunity in a wise fashion and prepare themselves adequately for admission to college, medical school, law school, tech school etc fantastic, well done. The world is a competitive place, always has been always will. This is how species evolve.

 

[histidine]

I dont know if this is relevant but I think making social status a factor(even separate from income) might have some benefit. My dad is a carpenter, I know a lot of working class/skilled trade people. Some of them make a lot of money, some dont but the one thing they all have in common is a massive distrust for professionals, especially lawyers and doctors. A physician who has experience with their concerns(or outright paranoia in some cases) might be at an advantage. And a lot of these people are the type who fall for the "natural remedy" crap. Maybe if we had more doctors who come from a working class background this will be less of an issue, maybe not.

Honestly I've never found any group of people to have a "common massive distrust for doctors". Carpenters and other skilled tradesmen especially. Hand surgeons reattach sawed off fingers, reconstruct hands mangled in machinery, and perform carpal tunnel releases. In fact, many surgeons have hobbies like carpentry, as surgery itself is somewhat of a skilled trade.

Although I think having doctors that were born into working class backgrounds is a good thing, I don't think it will lessen the massive distrust that you have seen. I think those types of people will see doctors from working class backgrounds as sellouts. Better education and more transparency in medicine might help. Maybe a class in middle school about "medicine vs natural remedy crap."

 

[badgerbimmer]

That is extremely ignorant. Not all white people live in country clubs and play golf. Not all URMs live in a shack in Compton. How do you know people's intentions and goals in life?

You obviously miss the point. Human nature generally ascribes to the goal of bettering your living conditions. Hence when given the choice the majority of people will choose to take the path that leads to higher compensation and will live accordingly. Thus given the choice of being poorly paid and serving an under served population or being higher paid and serving those that are better off most will choose the latter. There are certainly the altruistic among us who will choose the former. That was my point, not a difficult concept to understand.

 

[badgerbimmer]

Change what fact? I am unable to decipher what you mean with this at all




A GPA of 3.6 and a 31 MCAT is hardly "extremely intellengent and hard working," but these are just opinions. How does that difference in opinion suddenly jump to deep seated emotional distress? Your entire post is based on nothing really

If you are incapable of comprehending this statement I can't help you, it really is quite simple.

Given that in 2012 the average MCAT for all applicants was 28.3 and the average GPA was 3.54 while the averages for the matriculants was 31.2/3.68 I will stand by extremely intelligent and hard working.

 

[mactnc]

I am typically a lurker on this forum. I am a parent trying to learn more about the current med school process. My spouse is a physician and my child is a medical school applicant. I just read this thread and the one on doctor parents. This post could go on either thread.

There have been many excellent posts by many different people. There is also a lot of generalizing and stereotyping going on that I find unsettling, starting with the original poster, Distinct, who made this statement - "Why is it that the bulk of America's future doctors are rich, spoiled, disconnected people? How can this generation of people be taught to empathize with and care for those who have nothing when they themselves have unfairly snatched admission by flashing their store-bought resumes to the admissions staff?" That is really a horrible and insulting statement. Distinct, I know you tried to soften this insult with later posts, but is this really what you think of your peers?

I think we all have to be careful about categorizing people. It's hard to know someone's life story by their outside appearance and the size of their parents' wallet.

My children have advantages due to their wealth. No doubt about it. We have been able to provide them with a very nice life. We worked hard to be where we are today. Sure, there was some luck involved, but there was also a lot of hard work, sacrifice, and debt. Our monthly school loan payment was greater than our first mortgage. We didn't have a nanny, a housekeeper, or any fancy cars. We were always a two working parent family. We did send our kids to a private school. It was a great school and they got a great education...a definite advantage. We are choosing to spend our money on our children's educations. The economy is tough, and after living with our own school debt for many, many years, we want our children to be debt free, or at least debt low, once they start out on their own. That is definitely another big advantage for them. Exercisemed, you may be happy to learn that we always put family first. It can be done. In fact, our close physician friends are all great and involved parents. My husband coached both of our children's sports teams when they were little and that is not an unusual occurrence in our community. You pick your priorities and learn to make the time you have work.

We are a country built by immigrants. Every American has an immigrant story in their family history, and many of those stories start with poverty and prejudice. I am not one to say "life is hard, suck it up" to a child who is being raised in a bad situation that is out of their control. I believe real change has to start with education and I agree with LizzyM that we need to "change the culture that denigrates academic achievement". Our country loves to throw band-aids over problems, instead of attacking the root. The "American Dream" should be available to everyone. My children have lived a very different lifestyle than I lived as a child. Are they spoiled? Probably. Are they spoiled brats? I hope not. We have tried to raise them to be humble and appreciative of their good fortune, and to give back to the community when and how they can. Think about what you want for your children in the future and please don't throw "rich kid" stereotypes at people you don't know.

 

[sourdoughllama]

If you are incapable of comprehending this statement I can't help you, it really is quite simple.

.

 

[SunsFun]

You of course are referencing societal egalitarianism. The discussion here relates to a specific activity, admission to medical school. This would be contextual egalitarianism, the concept is quite simple. Societal egalitarianism is an admirable goal. Unfortunately history tells us that the concept is not very successful with respect to the human species. The millions slaughtered by Stalin and Mao would, if they could, be able to attest to that. How about the millions that live in abject poverty in Cuba? The Cubans are certainly enjoying an "egalitarian system". Egalitarianism in this life can not be coerced by "the system", human nature does not allow it.

You can choose to live in a fantasy world, I will live in the real world. The best you can hope for is to provide the opportunity to people to better themselves, what they do with that opportunity is their choice. Should they use that opportunity in a wise fashion and prepare themselves adequately for admission to college, medical school, law school, tech school etc fantastic, well done. The world is a competitive place, always has been always will. This is how species evolve.

You're right I am referring to overall societal justice theory. I personally believe that choices we make about each public good distribution including the distribution of seats in schools should be in line with my overall philosophy.

It is easy to fall into a trap and assume that the logical end game for my philosophy is communism. This had already been brought up in this thread. However, I am not suggesting pure forceful wealth redistribution. Egalitarian goals can (and should IMO) be achieved through socialism. I believe in redistribution of access and opportunity. Creating social nets as well as setting up educational, participatory, environmental policies that promote "American Dream" for every child regardless of circumstances should be of key importance. I am willing to prioritize this goal over efficiency, convenience, tradition, and even rewarding economic success in some instances.

I have thought quite a bit about a point BlueLabel brought up that I thought was legitimate. Once I am a parent, wouldn't I want my kid to enjoy the fruits of my current labor? Yes, I would. But thinking about it little more made me realize that supporting a policy that prioritizes what is best for my offspring, IMO, will backfire and make his/her life worth. Unless we ensure equal access to opportunity and stop the decline of the middle class, my child will find itself living in the world of lavish mansions surrounded by giant fences with their own private armies protecting the people within from the rest of the outsiders. This type of future as unlikely as it sounds was a common occurrence in many Latin American countries in the twenties century. And I know we can blame corruption and bunch of other factors but that would be splitting hairs since in my opinion shark economic inequities and poor majority create many of those problems.

 

[BlueLabel]

I am typically a lurker on this forum. I am a parent trying to learn more about the current med school process. My spouse is a physician and my child is a medical school applicant. I just read this thread and the one on doctor parents. This post could go on either thread.
There have been many excellent posts by many different people. There is also a lot of generalizing and stereotyping going on that I find unsettling, starting with the original poster, Distinct, who made this statement - "Why is it that the bulk of America's future doctors are rich, spoiled, disconnected people? How can this generation of people be taught to empathize with and care for those who have nothing when they themselves have unfairly snatched admission by flashing their store-bought resumes to the admissions staff?" That is really a horrible and insulting statement. Distinct, I know you tried to soften this insult with later posts, but is this really what you think of your peers?

I think we all have to be careful about categorizing people. It's hard to know someone's life story by their outside appearance and the size of their parents' wallet.

My children have advantages due to their wealth. No doubt about it. We have been able to provide them with a very nice life. We worked hard to be where we are today. Sure, there was some luck involved, but there was also a lot of hard work, sacrifice, and debt. Our monthly school loan payment was greater than our first mortgage. We didn't have a nanny, a housekeeper, or any fancy cars. We were always a two working parent family. We did send our kids to a private school. It was a great school and they got a great education...a definite advantage. We are choosing to spend our money on our children's educations. The economy is tough, and after living with our own school debt for many, many years, we want our children to be debt free, or at least debt low, once they start out on their own. That is definitely another big advantage for them. Exercisemed, you may be happy to learn that we always put family first. It can be done. In fact, our close physician friends are all great and involved parents. My husband coached both of our children's sports teams when they were little and that is not an unusual occurrence in our community. You pick your priorities and learn to make the time you have work.

We are a country built by immigrants. Every American has an immigrant story in their family history, and many of those stories start with poverty and prejudice. I am not one to say "life is hard, suck it up" to a child who is being raised in a bad situation that is out of their control. I believe real change has to start with education and I agree with LizzyM that we need to "change the culture that denigrates academic achievement". Our country loves to throw band-aids over problems, instead of attacking the root. The "American Dream" should be available to everyone. My children have lived a very different lifestyle than I lived as a child. Are they spoiled? Probably. Are they spoiled brats? I hope not. We have tried to raise them to be humble and appreciative of their good fortune, and to give back to the community when and how they can. Think about what you want for your children in the future and please don't throw "rich kid" stereotypes at people you don't know.

5 star post, thanks for sharing!

I have thought quite a bit about a point BlueLabel brought up that I thought was legitimate. Once I am a parent, wouldn't I want my kid to enjoy the fruits of my current labor? Yes, I would. But thinking about it little more made me realize that supporting a policy that prioritizes what is best for my offspring, IMO, will backfire and make his/her life worth. Unless we ensure equal access to opportunity and stop the decline of the middle class, my child will find itself living in the world of lavish mansions surrounded by giant fences with their own private armies protecting the people within from the rest of the outsiders. This type of future as unlikely as it sounds was a common occurrence in many Latin American countries in the twenties century. And I know we can blame corruption and bunch of other factors but that would be splitting hairs since in my opinion shark economic inequities and poor majority create many of those problems.

I can't understand what you're trying to say in the bolded, could you explain it differently?

 

[DokterMom]

I suspect what SunsFun is saying is that extreme economic inequality harms the wealthy in addition to the poor, and that a large, healthy and vital middle class is important to the national well-being.

 

[SunsFun]

I suspect what SunsFun is saying is that extreme economic inequality harms the wealthy in addition to the poor, and that a large, healthy and vital middle class is important to the national well-being.

This! Thank you. Sounds much better than what I would be able to come up with.

Apologies for being vague in my initial reply.

 

[badgerbimmer]

You're right I am referring to overall societal justice theory. I personally believe that choices we make about each public good distribution including the distribution of seats in schools should be in line with my overall philosophy.

It is easy to fall into a trap and assume that the logical end game for my philosophy is communism. This had already been brought up in this thread. However, I am not suggesting pure forceful wealth redistribution. Egalitarian goals can (and should IMO) be achieved through socialism. I believe in redistribution of access and opportunity. Creating social nets as well as setting up educational, participatory, environmental policies that promote "American Dream" for every child regardless of circumstances should be of key importance. I am willing to prioritize this goal over efficiency, convenience, tradition, and even rewarding economic success in some instances.

I have thought quite a bit about a point BlueLabel brought up that I thought was legitimate. Once I am a parent, wouldn't I want my kid to enjoy the fruits of my current labor? Yes, I would. But thinking about it little more made me realize that supporting a policy that prioritizes what is best for my offspring, IMO, will backfire and make his/her life worth. Unless we ensure equal access to opportunity and stop the decline of the middle class, my child will find itself living in the world of lavish mansions surrounded by giant fences with their own private armies protecting the people within from the rest of the outsiders. This type of future as unlikely as it sounds was a common occurrence in many Latin American countries in the twenties century. And I know we can blame corruption and bunch of other factors but that would be splitting hairs since in my opinion shark economic inequities and poor majority create many of those problems.

There is no point to continue this debate as you will not sway me nor I you. History has shown that your point of view does not work. Perhaps at a point in the enlightened future it will. I think we all agree that is the desired end state. For now, being a pragmatist, a reasonable approach is to provide the opportunity for education and allowing people the choice to try and better themselves. Unfortunately our public education system is not an effective delivery model for the required education and the decline of the family in certain population groups counter the opportunity currently being provided. The public education model is simple to reform. Provide school vouchers to every child and instill competition into the eduction system. The necessary change will happen quickly. Improving the family support system however will prove very difficult to correct and goes well beyond this debate.

 

[Mad Jack]

You're right I am referring to overall societal justice theory. I personally believe that choices we make about each public good distribution including the distribution of seats in schools should be in line with my overall philosophy.

It is easy to fall into a trap and assume that the logical end game for my philosophy is communism. This had already been brought up in this thread. However, I am not suggesting pure forceful wealth redistribution. Egalitarian goals can (and should IMO) be achieved through socialism. I believe in redistribution of access and opportunity. Creating social nets as well as setting up educational, participatory, environmental policies that promote "American Dream" for every child regardless of circumstances should be of key importance. I am willing to prioritize this goal over efficiency, convenience, tradition, and even rewarding economic success in some instances.

I have thought quite a bit about a point BlueLabel brought up that I thought was legitimate. Once I am a parent, wouldn't I want my kid to enjoy the fruits of my current labor? Yes, I would. But thinking about it little more made me realize that supporting a policy that prioritizes what is best for my offspring, IMO, will backfire and make his/her life worth. Unless we ensure equal access to opportunity and stop the decline of the middle class, my child will find itself living in the world of lavish mansions surrounded by giant fences with their own private armies protecting the people within from the rest of the outsiders. This type of future as unlikely as it sounds was a common occurrence in many Latin American countries in the twenties century. And I know we can blame corruption and bunch of other factors but that would be splitting hairs since in my opinion shark economic inequities and poor majority create many of those problems.

So you're basically saying, rather than having the most intelligent and capable physicians, we should distribute seats based on socioeconomic and racial factors?

You would essentially be denying many very hardworking and intelligent people seats in medical school based on their parent's income, as many of the best applicants come from well off households. Denying someone something they are well qualified for due to a factor they have no control over... I could swear there's a word for that...

 

[mcloaf]

So you're basically saying, rather than having the most intelligent and capable physicians, we should distribute seats based on socioeconomic and racial factors?

Implicit in this post is the assumption that the current admissions system selects only the most capable and intelligent, and that SES and race factors have no modifying effects on these outcomes. Without equality of opportunity as a starting point I don't see how anyone could contend that admissions is truly selecting only the most capable or intelligent rather than students with a combination of favorable factors including both innate abilities and enabling environmental factors like supportive and affluent families, good schools, etc.

 

[BlueLabel]

Implicit in this post is the assumption that the current admissions system selects only the most capable and intelligent, and that SES and race factors have no modifying effects on these outcomes. Without equality of opportunity as a starting point I don't see how anyone could contend that admissions is truly selecting only the most capable or intelligent rather than students with a combination of favorable factors including both innate abilities and enabling environmental factors like supportive and affluent families, good schools, etc.

Well first of all, we know the current admissions system already does take race and to a lesser extent SES into account, so you have to include them in your list of "favorable factors".

Also, LizzyM posted earlier in this thread that studies have shown that low SES matriculants tend to struggle more and require more resources on the part of the school to be successful, and then agreed with the notion that low SES tends to result in objectively lower-quality applicants. There is a connection between SES and outcome, this shouldn't be a surprise. But medical admissions is neither the time nor the place to address issues such as wealth inequality and limited social mobility. These issues need to be addressed at their roots, without jeopardizing the quality of our medical students/physicians.

 

[Mad Jack]

Implicit in this post is the assumption that the current admissions system selects only the most capable and intelligent, and that SES and race factors have no modifying effects on these outcomes. Without equality of opportunity as a starting point I don't see how anyone could contend that admissions is truly selecting only the most capable or intelligent rather than students with a combination of favorable factors including both innate abilities and enabling environmental factors like supportive and affluent families, good schools, etc.

They are largely the most well prepared and capable of success at the time of admission. This is not to say that there are many students of lower SES that would have been just as capable if they had spent years in private schools, spent their spare time doing extracurricular activities that foster leadership and decision making, etc, but at the time of admission, many students of lower SES do not have this preparation and are thus often not as well prepared to do well in, and successfully complete, medical school. As was noted by LizzyM (and BlueLabel above), there is research that bears this out. Is there a lot of unharvested potential at the lower end of the SES scale? Certainly. But cultivating such potential requires efforts outside of the medical school admissions process.

And I'm saying all this from the point of view of someone that was fairly disadvantaged. Being advantaged provides educational and developmental advantages, leading to a large group of well-educated, well-rounded upper class students. We can't just go about denying them admission because they had advantages in getting to their current level of capability. They are still, quite often, the best candidates for admission. Is it socially just or fair? Not really. But the job of a medical school is not to produce social justice. It is to produce the best physicians to provide care to the citizens of this country. To produce lower quality physicians in the name of socioeconomic justice is doing a disservice both to medicine and to the country as a whole.