Question for URMs, how could the process improve?

[mistafab]

1. I think the process is doing good.

2. I think that just bringing us into schools is not doing enough. Underrepresented groups are doing well in being included, but many of the “my parents are doctors” types don’t understand what struggles people face due to 1. race, 2. socioeconomic status, or 3. sexual preference. EDIT::: Then, when the people who don’t understand DO become doctors, they will become doctors who won’t understand why patients are having health problems exacerbated by 1. Race 2. Socioeconomic status or 3. Sexual preference.

3. No

4. No

EDIT: To add to the discussion, I think that the SDN “URM stereotype” is less applicable to the real world than the problems with representation that med schools have. I mean the stereotype is that some kid who underperforms is included based on race/SES/gender preference alone. Meanwhile, in actual med schools the problem is that many people don’t understand race/SES/Gender which is why there is a push to include diversity. But just adding us in the pool doesn’t fix it, so that is why schools are also adding humanities type work to help people become better future doctors.

P.S. I am URM who was included into school with high stats, and now that i’m in med school I am top quartile in school and hopefully soon I’ll be top quartile on my step 1 exam (so top quartile nationwide as well). Not saying this to gloat, but jk yes I am gloating - because I am over here winning and being one of the smartest of a pool of already some of the smartest.

Not a troll thread, not trying to start any flame wars. I genuinely would like only those who belong to groups who are under represented in medicine to answer these questions to avoid any SDN drama. I just want a point of view from those who truly knows what its like to be a minority in the US who is URM.

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Do you think this process of recognizing groups who are under represented in medicine is doing good or harm?

How do you think this process could improve?

Is this process inherently reinforcing racial stereotypes?

Do you feel this is leveling the playing field?



P.S. I know this is a sensitive issue, just remember to be nice to people even if they disagree

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[Microbug]

Just find the step score by race breakdown and end the competency issue once and for all

 

[Osminog]

People should be judged on the basis of their merits, not on the basis of race or socioeconomic status. Racial discrimination should have no place in the modern medical school admissions process -- or any academic admissions process for that matter.

Also, it's not inherently a problem that blacks and Hispanics are underrepresented relative to whites in medical school, for the same reason that it's not a problem that whites are underrepresented relative to Asians in medical school. This is merely a reflection of the merits of individuals within each group. Are Asians (East Asians in particular) overrepresented in medicine because they're "racist" against other groups? Did they achieve their success solely at others' expense? No and no. They're just more bright and hardworking, on average, so they achieve better outcomes.

 

[Microbug]

I think you'll have a hard time convincing the SDN members who are now in clinical practice that their Step 1 score is reflective of their overall competency as a physician.

I’m not saying step1 score is predictive of competency of physician but just academic competency. People argue that URM shouldn’t get advantages and be accepted with lower stats/bar. Step1 would end the question whether URM have lower stats bc step1 is a better predictor of academic merit than GPA or MCAT that can be influenced by many additional factors. unless we all accepted the premise that URM do in fact get accepted regardless of lower academic merits.

 

[Microbug]

I've never really understood SDN's obsession with URM when you can usually count the number of black med students in a class of 100 on one hand,MAYBE two and theres a spectrum of stats represented in those 10 students. We have already come to the realization that stats aren't the only things necessary to get into medical school as we see multiple posts on SDN of students with 518, 3.8 sGPA, and 10 clinical hours wondering why they weren't accepted. A glance at the URM threads show a spectrum of Lizzy schoools, multiple acceptances, multiple waitlists and multiple rejections in an already smaller pool of students.

When things are this competitive, every little advantage matters to some people. Like what if there’s just one seat left at your dream school and it comes down to two ppl with the same stats and similar extracurricular and the other applicant has URM status and you don’t. This scenario is probably unlikely and highly theoretical. It probably hardly matters in the grand scheme of your career but at the moment, it seems huge to people.

 

[Piglet2020]

From an n=1 Asian American perspective:

American society has created the Model Minority Myth: that Asians are inherently smarter and hard working than their peers. This misconception, propagated by media, basically treats all Asians the same, regardless of the fact that many are from low SES backgrounds (Filipinos, Vietnamese, etc). Somehow, we Americans have been conditioned to see Asians as this collective group of geniuses. It’s become expected that an Asian kid gets straight A’s, excels in tennis, does programming and robotics for fun, etc while simultaneously ignoring the distinctions between subgroups of this weird conglommeration termed “Asian”.

1) My parents are both immigrants and have worked their butts off since coming here while facing discrimination left and right. Even now, my mom gets called names/racial slurs by customers who prefer to see a white clerk

2) My parents often go see a Chinese doctor, not a Korean or Japanese doctor because of language barriers. Also for more trust due to similar values. So I kind of understand where the argument that patients may feel more comfortable with seeing X race doctor.
However is it totally appropritate to make Asians a whole monolithic category, deeming that they are overrepresented? Many Asian subgroups wont even go to a diff Asian subgroup doctor and then they are stuck with the 1-2 choices they have in their area.

3) Back to the Model Minority Myth, this stereotype has caused some tensions between the AA and Asian community. (AA being compared to Asians & blamed for playing the victim card by mass media.) Basically saying: Oh Asians got this far and never complained, why should you?
But this ignores many fundamental issues:
*”Making a flawed comparison between Asian Americans and other groups, particularly Black Americans, to argue that racism, including more than two centuries of black enslavement, can be overcome by hard work and strong family values."
'Model Minority' Myth Again Used As A Racial Wedge Between Asians And Blacks

 

[Osminog]

I've never really understood SDN's obsession with URM when you can usually count the number of black med students in a class of 100 on one hand,MAYBE two and theres a spectrum of stats represented in those 10 students. We have already come to the realization that stats aren't the only things necessary to get into medical school as we see multiple posts on SDN of students with 518, 3.8 sGPA, and 10 clinical hours wondering why they weren't accepted. A glance at the URM threads show a spectrum of Lizzy schoools, multiple acceptances, multiple waitlists and multiple rejections in an already smaller pool of students.

SDN doesn't have an "obsession with URM," and I'm not sure what led you to that conclusion. In reality, being even remotely critical of racial discrimination in the context of medical school admissions is considered to be in poor taste on here. (If you don't believe me, look through this thread and note which viewpoint is most strongly represented.)

The data shows that URM applicants, on average, are held to significantly lower academic standards than white and Asian applicants. There are plenty of individual outliers, but the overall trend of the data is remarkably clear.

 

[Osminog]

From an n=1 Asian American perspective:

American society has created the Model Minority Myth: that Asians are inherently smarter and hard working than their peers. This misconception, propagated by media, basically treats all Asians the same, regardless of the fact that many are from low SES backgrounds (Filipinos, Vietnamese, etc). Somehow, we Americans have been conditioned to see Asians as this collective group of geniuses. It’s become expected that an Asian kid gets straight A’s, excels in tennis, does programming and robotics for fun, etc while simultaneously ignoring the distinctions between subgroups of this weird conglommeration termed “Asian”.

1) My parents are both immigrants and have worked their butts off since coming here while facing discrimination left and right. Even now, my mom gets called names/racial slurs by customers who prefer to see a white clerk

2) My parents often go see a Chinese doctor, not a Korean or Japanese doctor because of language barriers. Also for more trust due to similar values. So I kind of understand where the argument that patients may feel more comfortable with seeing X race doctor.
However is it totally appropritate to make Asians a whole category and say they are overrepresented? Many Asian subgroups wont even go to a diff Asian subgroup doctor and are stuck with the 1-2 choices they have in their area.

3) Back to the Model Minority Myth, this stereotype has caused some tensions between the AA and Asian community. AA being compared to Asians & blamed for playing the victim card by mass media. Basically saying: Oh Asians got this far and never complained, why should you?
But this ignores many fundamental issues:
making a flawed comparison between Asian Americans and other groups, particularly Black Americans, to argue that racism, including more than two centuries of black enslavement, can be overcome by hard work and strong family values."
'Model Minority' Myth Again Used As A Racial Wedge Between Asians And Blacks

Thank you for your "n=1 Asian American perspective."

From the perspective of empirical data, East Asians vastly outperform other groups in America. Look at the composition of US-based tech companies, crime data, economic mobility data, representation in elite undergraduate institutions, SAT/ACT scores, science/math competition finalists/winners, etc. All of the data points to the exact same conclusion.

Regarding point #1: I think that people can sometimes exaggerate the adversity that they face in order to gain respect and sympathy, as well as to build solidarity with those in their in-group. That being said, I acknowledge that isolated acts of racism do take place in America (albeit infrequently).

Point #2: Fair enough. I think East Asian performance pushes the entire Asian category up. There may very well be a shortage of doctors in Vietnamese, Hmong, Thai, etc., communities.

Point #3: The Chinese went through communism under Mao, which led to intense poverty and killed 85-100 million people. Many Chinese immigrants came to the US with nothing but memories of starvation and death. You seem to be underestimating your group's struggles. But I agree that Asians shouldn't be viewed as a "model minority"; people should try to be the best that they can be, not aspire to become like someone else.

 

[BestoFriedo-Todo]

People should be judged on the basis of their merits, not on the basis of race or socioeconomic status. Racial discrimination should have no place in the modern medical school admissions process -- or any academic admissions process for that matter.

SES plays a role in merits.
- When your parents are well off or you're a 3rd generation college graduate from a prestigious school and get a better education you have an advantage over someone who comes from the ghetto or whose parents are non English speaking immigrants.

- When your parents can afford healthcare, and you get access to medications that help you focus in college, you have an advantage over those who can't.

- When you can just take 2-3 months off of work and move in with mom and dad to do nothing but study for the mcat.

That is just a few examples of how SES starts to play a role in the merits of the student. You don't have to agree or acknowledge it, but it is reality. Medical School Admissions are aware of this. That is why the they don't ignore race or SES and that is why they are adopting the "holistic" review process to include such things.

 

[Osminog]

I want to know how many ORMs with lower stats are in a medical school class, because I feel as though it would be the same number or relatively close to the small amount of minorities in the class. But you don't see as many people complain about that on the internet. Why is that?

Using 2017-2018 data (and assuming a normal distribution): 2.5% of Asian matriculants had a 500 or lower on the MCAT. 25% of African-American matriculants had a 500 or lower on the MCAT.

AA matriculants are ten times more likely to have below a 500 MCAT than Asian matriculants.

(If you're looking for raw numbers, that's 112 out of 4,481 Asian matriculants vs. 376 out of 1,505 African-American matriculants.)

 

[byunprime2]

Great discussion, happy to my see fellow students of color approaching this topic constructively. Keep it civil or I will have to close this thread.

I have a couple of things to add, speaking as Lucca now and not as a mod (or for SDN):

1. Racism exists, and the US is a racist country. Racism is not a pathology of individuals but a structural fact, like a hologram, that emerges from the relations and power transactions that occur between individuals, groups, institutions.

2. To answer the OP I think that “AA” (Med schools don’t use the same AA practiced in UG, but it’s a good enough shorthand) is a bandaid solution to a much deeper and complex problem that they have no way of directly tackling.

To answer the second question in the Op: I used to feel that benefiting from AA somehow devalued me in the eyes of my peers or gave me something further to prove to show that I “deserved” to be where I was or the accolades I won. I don’t feel this way anymore for 2 reasons:

A) if people think less of me just because I benefited from affirmative action without knowing anything else about me then that’s racist pure and simple and the goal of affirmative action (or diversity in education period) is not to make racist people less racist. I’ve had this occur sooo many times, from people saying I got a scholarship just because of my last name (and not, say, 99th percentile SAT and ACTs) to a teacher not recommending me for an advanced course in mathematics because “while I was good at math for an Hispanic” she did not feel I was “a hard enough worker” to succeed in that course. I went over her head, took it, and got an A. I see this kind of thing all the time on SDN, in this very thread even: the assumption that people of color don’t work hard even if they are able to achieve at the same level as anybody else, or without having any concrete knowledge of their achievements to begin with.

I also think it’s really weird and kind of sinister that people will say “aren’t you afraid people will think less of your achievements for being a student of color?” right after they automatically assume less of your achievements for being a student of color. You can’t control what people think nor should your or anyone really care because what others think of you has very little to do with education or your livelihood or anything. The work is the thing.

B) everyone deserves access to education and it should be universal. Humans are creative beings and education gives us the tool to make the most of our labor or change what we do with our lives. Nobody “deserves” to be anywhere more than anyone else. The scarcity of educational resources that drives competition is artificial and should not exist. There should not be a single concentrated period of time to be educated, but education should be free and liberal and either focused and academic or deeply technical and practical, or both, but everyone should have the opportunity to pursue it whenever they want. Utopian, I know, but at the heart of it is a simple idea: there is no deserve, there is only can you succeed at what you set out to do or not and while educational resources are artificially scarce and racism and segregation persist in the US, then efforts should be made to ensure people of color are well represented (and are they? Texas is 20% Black but my undergrad was less than 10% Black in spite of AA). In medical school, the vast majority of URMs are able to graduate and become physicians. That’s the goal of med school, not to exclusicely accept people so wickedly academic that they don’t even need lectures or guidance or anything other than coffee and access to a library to learn material.

3. SES: AAMC issues guidelines on how to use SES in admissions. It’s definitely already a factor, regardless of the applicant’s race. I’m sure that when Paul Farmer applied to Duke and Harvard Med the fact that he grew up in an abandoned bus had a lot to do with how closely his application was read. Same goes for Dr. Q going from undocumented immigrant to med student vs. any other Hispanic applicant who came from privilege; there are definitely degrees and being a URM is not in and of itself a golden key to academia. I know plenty of URMs with lower stars who have had to take postbaccs and reapply or go for different careers. Also, AAMC also has released data on SES breakdowns by ethnicity and race. I can look for it later but I’ll tell you that in spite of lower SES whites being a numerically larger group that minorities are more likely to come from lower SES.

4. I think that Asians are being unfairly discriminated against in many cases because there are very large communities of Filipino, Vietnamese and other non SE Asian minority groups that need docs, healthcare workers but at many schools all Asians are lumped together into one big category. Always seemed like a really weird thing to do for a continent that has nearly half the worlds population. Also, I think that Asians are often used as scapegoats by actual white supremacists and well-meaning but confused white people to say that higher education is racist. The existence of, say, something like quotas for Asians is 100%, definitely discriminatory, but the destruction of these quotas does not necessarily mean ending AA altogether. That option is of course never considered because the ultimate pervading fear, in my opinion, driving political efforts to undermine AA is a fear of whites being pushed out of a well regarded, stable, upwardly mobile, lucrative profession because they have a racist impression of Asians as robotic hyperacjievers they could never possibly compete with. Maybe this is an American complex leftover from losing to rice farmers in Vietnam or slowly ceding the world economy to China, who knows. I’ve lived across the pond for half a year now and I’ve never heard someone talk about Asians in higher education the way they do in the US.

I agree wholeheartedly with every line written here. Lucca, I don't know who you are but your post gives me hope. People are often so blind to their own racism in the real world and on this very site. People here also tend to forget that the purpose of medical school is to train doctors who will best serve the health of the public -- not to guarantee a high-paying, high-prestige job for the college students with the best grades.

Your last paragraph also touches on ideas that I rarely see expressed on this site. Asians are too often disowned by other PoC even though we suffer similarly at the hands of a somewhat subtler kind of racism. The fact that affirmative action is often framed as a white/Asian vs black/Latino issue is just another example in a long line of instances in which those in power have succeeded in pitting disadvantaged groups against one another. And as a member of one of those Southeast Asian groups, it pains me when people (mods of this site, even!) disregard our struggles or make the false claim that we are somehow overrepresented in medicine.

 

[Osminog]

SES plays a role in merits.
- When your parents are well off or you're a 3rd generation college graduate from a prestigious school and get a better education you have an advantage over someone who comes from the ghetto or whose parents are non English speaking immigrants.

- When your parents can afford healthcare, and you get access to medications that help you focus in college, you have an advantage over those who can't.

- When you can just take 2-3 months off of work and move in with mom and dad to do nothing but study for the mcat.

That is just a few examples of how SES starts to play a role in the merits of the student. You don't have to agree or acknowledge it, but it is reality. Medical School Admissions are aware of this. That is why the they don't ignore race or SES and that is why they are adopting the "holistic" review process to include such things.

If I'm receiving medical care from a physician, I don't care whether he grew up wealthy or poor. I just want him to have brains and talent.

Why is it so popular to think that medical school admissions decisions are meant to be recompensatory? Racking up victim points doesn't help you when you're standing at the operation table with someone's life in your hands.

 

[altblue]

Should take SES into account before race imo. Being poor stops you dead in your tracks regardless of race. Private tutors? Nah. Prep courses? Nah. Luxury of not working in undergrad? Nah. One quick call to daddy’s buddy for shadowing/letter? Nah.

Taking SES into account would benefit the majority of URM’s as is, but wouldn’t simultaneously hurt the poor ORM’s.

Poverty doesn’t discriminate based on the color of your skin and should most definitely be taken into account more than it is. (Of course with valid proof aka FAFSA).

That said, I truly do see the importance of having physicians from all backgrounds and happy it’s in place.
But at the same time it’s lame when a rich URM has significantly better chances than a poor ORM based solely on the color of their skin.

Yup, as a low-income white I had no paid tutoring for pre-reqs, no MCAT prep classes, worked in undergrad, cold-called departments I wasn't interested in for shadowing because they were the shadowing-friendly ones. I don't have the polished, samey upper-middle class accent nearly everyone in my undergrad does (think Brooklyn, southern, skater instead etc.), which I strongly suspect has hurt me on research presentation grades from even though I'm often told I'm a clear and engaging speaker. It's not all bad though. I'm very proud of the work I've done in undergrad with the few financial and cultural resources I'd been given. As much as I'd like it, I don't need a top 25 med school acceptance to feel good about myself.

At the same time, even as a low-income white there's things I haven't had to deal with. I don't have to walk down the street worried whenever I see a cop. Groups of women don't go out of their way to avoid me on the street. I can wear what I want and generally not be afraid of looking "dangerous" or "foreign." I don't have people question my success by virtue of my skin color (and can keep my SES private). Even if you're a wealthy black applicant, you still have to deal with many of these things, and as a wealthy black applicant, you still have the potential to make those from your background more comfortable in medicine.

I mean to say that it's hard to quantify extents of disadvantage, from race and SES. I think it's beside the point, and boosting enrollment from low-SES and URM is something I'd be in favor of.

 

[BestoFriedo-Todo]

Also, it's not inherently a problem that blacks and Hispanics are underrepresented relative to whites in medical school, for the same reason that it's not a problem that whites are underrepresented relative to Asians in medical school.

Diversity matters in health care. Physicians are here to serve the public. America's population is diverse and therefore the providers should be as well. If you're coming from a group that is well represented you cannot understand, cause you simply do not experience it and probably never will. If you're white, you will always be able to find a white doctor to take care of you. If you're Asian, the same thing applies, as they are over represented in medicine. If it came down to them picking a white doctor or a doctor from their homeland who speaks their language, who do you think they will go to and be more open with?

To bring it into perspective, say a women comes in for a UTI and her provider is a male. She may not feel comfortable disclosing all her symptoms to a male. However, when the female nurse comes in she may start to reveal that she is concerned about discharge, abnormal periods and other feminine issues. The female is more relatable, and the pt feels more comfortable disclosing that information to a female vs a male. That is why some women seek out female providers.

Same thing with African Americans. There is numerous cases of them being treated unfairly in the past by white physicians. Take the Tuskegee Airmen experience. There are still people alive who LIVED through that event and remember it well. So a lot of them avoid hospitals unless they have to go, because they lack representation there. Put physicians who they can relate to more and feel comfortable with and they will start to come in more to be treated.

Medical Admission boards are considering the needs of the community and the population that the providers they produce will be serving. Medical Admissions boards aren't obligated to cater to you. They are obligated to produce physicians who can take care of our diverse population.

 

[Skiiiiiing]

Great discussion, happy to my see fellow students of color approaching this topic constructively. Keep it civil or I will have to close this thread.

I have a couple of things to add, speaking as Lucca now and not as a mod (or for SDN):

1. Racism exists, and the US is a racist country. Racism is not a pathology of individuals but a structural fact, like a hologram, that emerges from the relations and power transactions that occur between individuals, groups, institutions.

2. To answer the OP I think that “AA” (Med schools don’t use the same AA practiced in UG, but it’s a good enough shorthand) is a bandaid solution to a much deeper and complex problem that they have no way of directly tackling.

To answer the second question in the Op: I used to feel that benefiting from AA somehow devalued me in the eyes of my peers or gave me something further to prove to show that I “deserved” to be where I was or the accolades I won. I don’t feel this way anymore for 2 reasons:

A) if people think less of me just because I benefited from affirmative action without knowing anything else about me then that’s racist pure and simple and the goal of affirmative action (or diversity in education period) is not to make racist people less racist. I’ve had this occur sooo many times, from people saying I got a scholarship just because of my last name (and not, say, 99th percentile SAT and ACTs) to a teacher not recommending me for an advanced course in mathematics because “while I was good at math for an Hispanic” she did not feel I was “a hard enough worker” to succeed in that course. I went over her head, took it, and got an A. I see this kind of thing all the time on SDN, in this very thread even: the assumption that people of color don’t work hard even if they are able to achieve at the same level as anybody else, or without having any concrete knowledge of their achievements to begin with.

I also think it’s really weird and kind of sinister that people will say “aren’t you afraid people will think less of your achievements for being a student of color?” right after they automatically assume less of your achievements for being a student of color. You can’t control what people think nor should your or anyone really care because what others think of you has very little to do with education or your livelihood or anything. The work is the thing.

B) everyone deserves access to education and it should be universal. Humans are creative beings and education gives us the tool to make the most of our labor or change what we do with our lives. Nobody “deserves” to be anywhere more than anyone else. The scarcity of educational resources that drives competition is artificial and should not exist. There should not be a single concentrated period of time to be educated, but education should be free and liberal and either focused and academic or deeply technical and practical, or both, but everyone should have the opportunity to pursue it whenever they want. Utopian, I know, but at the heart of it is a simple idea: there is no deserve, there is only can you succeed at what you set out to do or not and while educational resources are artificially scarce and racism and segregation persist in the US, then efforts should be made to ensure people of color are well represented (and are they? Texas is 20% Black but my undergrad was less than 10% Black in spite of AA). In medical school, the vast majority of URMs are able to graduate and become physicians. That’s the goal of med school, not to exclusicely accept people so wickedly academic that they don’t even need lectures or guidance or anything other than coffee and access to a library to learn material.

3. SES: AAMC issues guidelines on how to use SES in admissions. It’s definitely already a factor, regardless of the applicant’s race. I’m sure that when Paul Farmer applied to Duke and Harvard Med the fact that he grew up in an abandoned bus had a lot to do with how closely his application was read. Same goes for Dr. Q going from undocumented immigrant to med student vs. any other Hispanic applicant who came from privilege; there are definitely degrees and being a URM is not in and of itself a golden key to academia. I know plenty of URMs with lower stars who have had to take postbaccs and reapply or go for different careers. Also, AAMC also has released data on SES breakdowns by ethnicity and race. I can look for it later but I’ll tell you that in spite of lower SES whites being a numerically larger group that minorities are more likely to come from lower SES.

4. I think that Asians are being unfairly discriminated against in many cases because there are very large communities of Filipino, Vietnamese and other non SE Asian minority groups that need docs, healthcare workers but at many schools all Asians are lumped together into one big category. Always seemed like a really weird thing to do for a continent that has nearly half the worlds population. Also, I think that Asians are often used as scapegoats by actual white supremacists and well-meaning but confused white people to say that higher education is racist. The existence of, say, something like quotas for Asians is 100%, definitely discriminatory, but the destruction of these quotas does not necessarily mean ending AA altogether. That option is of course never considered because the ultimate pervading fear, in my opinion, driving political efforts to undermine AA is a fear of whites being pushed out of a well regarded, stable, upwardly mobile, lucrative profession because they have a racist impression of Asians as robotic hyperacjievers they could never possibly compete with. Maybe this is an American complex leftover from losing to rice farmers in Vietnam or slowly ceding the world economy to China, who knows. I’ve lived across the pond for half a year now and I’ve never heard someone talk about Asians in higher education the way they do in the US.

Asians have higher incomes, higher rates of family formation, higher educational attainment, lower rates of crime and victimization of crime, longer life expectancy, higher rates of home and business ownership, lower rates of suicide than whites as a group.

How exactly does this get squared with notions of pervasive white supremacy?

 

[Osminog]

Diversity matters in health care. Physicians are here to serve the public. America's population is diverse and therefore the providers should be as well. If you're coming from a group that is well represented you cannot understand, cause you simply do not experience it and probably never will. If you're white, you will always be able to find a white doctor to take care of you. If you're Asian, the same thing applies, as they are over represented in medicine. If it came down to them picking a white doctor or a doctor from their homeland who speaks their language, who do you think they will go to and be more open with?

To bring it into perspective, say a women comes in for a UTI and her provider is a male. She may not feel comfortable disclosing all her symptoms to a male. However, when the female nurse comes in she may start to reveal that she is concerned about discharge, abnormal periods and other feminine issues. The female is more relatable, and the pt feels more comfortable disclosing that information to a female vs a male. That is why some women seek out female providers.

Same thing with African Americans. There is numerous cases of them being treated unfairly in the past by white physicians. Take the Tuskegee Airmen experience. There are still people alive who LIVED through that event and remember it well. So a lot of them avoid hospitals unless they have to go, because they lack representation there. Put physicians who they can relate to more and feel comfortable with and they will start to come in more to be treated.

Medical Admission boards are considering the needs of the community and the population that the providers they produce will be serving. Medical Admissions boards aren't obligated to cater to you. They are obligated to produce physicians who can take care of our diverse population.

I'm white, and my long-time allergist is black. I go to him because he's knowledgeable, efficient, and does a good job. If non-black patients refuse to go to my allergist's practice because he's black, then that's not a problem with the healthcare system; that's a problem with the mentality of the non-black patients.

Likewise, if black or Asian or Native American patients are more interested in going to a doctor who looks like them than going to a doctor who is successful and skilled, then that's a serious problem with the patients' priorities; they are prioritizing racial preferences over their own health. The healthcare system shouldn't be pumping out sub-par doctors just to accommodate certain patients' bigotry and shallowness.

 

[BestoFriedo-Todo]

If I'm receiving medical care from a physician, I don't care whether he grew up wealthy or poor. I just want him to have brains and talent.

That is nice to know. However, that is how YOU FEEL! The rest of the population does not feel the same way. Being competent isn't the only requirement for physicians. Otherwise, we would have a bunch of House, MD clones running around. Patients don't care about your mcat score or your gpa. So long as you passed med school. And if someone who was incompetent got into a program they didn't belong in, rest easy knowing that they will fail out. Otherwise, the admission committee made the right choice. Med school drop out rates are low. So they seem to know what they're doing. Patients want competent and understanding doctors.

Physicians are there to serve the community. Having a diverse group of physicians who can serve a diverse population benefits medicine. Its that simple. Med Schools understand this, and that is why it exist. You don't have to agree, but it is reality.

 

[Lucca]

Remember to keep it civil. This thread started out as URMs reflecting on their experience. If you want to argue and debate then take it to PMs or SPF, but not here. If you want a URM debate feel free to read through the thousands of iterations that have come through SDN in the past.

 

[Skiiiiiing]

From an n=1 Asian American perspective:

American society has created the Model Minority Myth: that Asians are inherently smarter and hard working than their peers. This misconception, propagated by media, basically treats all Asians the same, regardless of the fact that many are from low SES backgrounds (Filipinos, Vietnamese, etc). Somehow, we Americans have been conditioned to see Asians as this collective group of geniuses. It’s become expected that an Asian kid gets straight A’s, excels in tennis, does programming and robotics for fun, etc while simultaneously ignoring the distinctions between subgroups of this weird conglommeration termed “Asian”.

1) My parents are both immigrants and have worked their butts off since coming here while facing discrimination left and right. Even now, my mom gets called names/racial slurs by customers who prefer to see a white clerk

2) My parents often go see a Chinese doctor, not a Korean or Japanese doctor because of language barriers. Also for more trust due to similar values. So I kind of understand where the argument that patients may feel more comfortable with seeing X race doctor.
However is it totally appropritate to make Asians a whole monolithic category, deeming that they are overrepresented? Many Asian subgroups wont even go to a diff Asian subgroup doctor and then they are stuck with the 1-2 choices they have in their area.

3) Back to the Model Minority Myth, this stereotype has caused some tensions between the AA and Asian community. (AA being compared to Asians & blamed for playing the victim card by mass media.) Basically saying: Oh Asians got this far and never complained, why should you?
But this ignores many fundamental issues:
*”Making a flawed comparison between Asian Americans and other groups, particularly Black Americans, to argue that racism, including more than two centuries of black enslavement, can be overcome by hard work and strong family values."
'Model Minority' Myth Again Used As A Racial Wedge Between Asians And Blacks

There is racism against Asians, just as there is racism against whites. One such form of this is being called a white supremacist when there is no evidence for it and strong evidence against it.

I don't think the Asian experience is all that relevant to the Black experience. The legacy of slavery is complex.

 

[dr_kateb]

Unfair? Unfair to who exactly? You? Hate to break it to you but life gets a lot more unfair the older you get. Medical schools don't exist to be fair to you. Welcome to the real world.


No it isn't the metric they are using, its simply part of a much larger application. Those test scores have extensive data behind them to show that someone with a 500 is equally as likely to pass boards and graduate medical school as someone with a 520.



True, but race has a big difference on how certain patient populations react to their doctors. If you think the doctor only treats the bodies of patients then you have a fundamental misunderstanding of the field of medicine.



Yes and for good reason, this country needs URM's as physicians a hell of a lot more than it needs you as one. These lower stat applicants still meet the metrics that research show are just as capable as those with higher stats.

1. To who? Everyone that’s not URM? I could just tell every URM to deal with it but no that’s oppression and racism.

2. Just a part? GPA and MCAT are the two most important parts of the applying process? Am I missing something here? If they are not indicative of how good of a physician is they are at least very important in the most important step of becoming one.

3. Sure. You need good bedside manner and “connect” with the patient. But wait, in order to understand someone’s life and experiences, all you need to be is the exact same skin color as the patient. Ain’t that something?

4. Struck a nerve? Also that’s debatable. See 2.

 

[calivianya]

I'm white, and my long-time allergist is black. I go to him because he's knowledgeable, efficient, and does a good job. If non-black patients refuse to go to my allergist's practice because he's black, then that's not a problem with the healthcare system; that's a problem with the mentality of the non-black patients.

Likewise, if black or Asian or Native American patients are more interested in going to a doctor who looks like them than going to a doctor who is successful and skilled, then that's a serious problem with the patients' priorities; they are prioritizing racial preferences over their own health. The healthcare system shouldn't be pumping out sub-par doctors just to accommodate certain patients' bigotry and shallowness.

I couldn't disagree more... because who's paying for US citizens' care when they can't afford it? I am.

If the biased AA patient won't take his/her prescribed meds because a white doctor prescribed them and he/she doesn't trust white doctors, and then ends up in the hospital, and then doesn't have sufficient health insurance/monetary reserves to pay that bill, you and I are both paying for it. We're paying either with our tax money now when the patient uses Medicaid/Medicare, or the hospital cutting our quarterly bonuses as physicians down the road because of decreased profit margins from providing free care.

It's about way more than fairness and how stupid bigotry is. Nobody's going to change a bigoted person's mind. EMTALA says we have to stabilize/treat everyone who presents with a medical problem; it does not make an exception for bigots who refused to comply with the instructions of someone from a different race. So, unfortunately, the shallow, uneducated bigots are who we have to cater to - we have to do whatever we can to get them to listen and follow instructions, so they can stay the hell out of the hospital. If that involves pumping out docs who look like them, it is what it is.

 

[Microbug]

But why does that matter beyond a certain point? Obviously you should be competent and knowledgeable enough to provide effective and efficient healthcare, but that's already guaranteed because if you're not competent you won't pass step 1, step 2, step 3, medical school in general, & your specialty boards anyway. Once you're in practice, if you've met the standards to jump those hurdles, I don't think "academic competency" is that relevant. The peds residents I've worked with probably have lower step scores on average than the urology ones, but the peds residents and attendings somehow still manage to provide excellent patient care even to very sick and complicated patients.

you're making the assumption that someone with high step score isn't capable of being compassionate or meet the other qualities of being a good physician. why can they be capable of the humanistic side of medicine AND do well on standardized exams? There is a reason why step1 scores is one of the most important factor in residency matching.

 

[Microbug]

I couldn't disagree more... because who's paying for US citizens' care when they can't afford it? I am.

If the biased AA patient won't take his/her prescribed meds because a white doctor prescribed them and he/she doesn't trust white doctors, and then ends up in the hospital, and then doesn't have sufficient health insurance/monetary reserves to pay that bill, you and I are both paying for it. We're paying either with our tax money now when the patient uses Medicaid/Medicare, or the hospital cutting our quarterly bonuses as physicians down the road because of decreased profit margins from providing free care.

It's about way more than fairness and how stupid bigotry is. Nobody's going to change a bigoted person's mind. EMTALA says we have to stabilize/treat everyone who presents with a medical problem; it does not make an exception for bigots who refused to comply with the instructions of someone from a different race. So, unfortunately, the shallow, uneducated bigots are who we have to cater to - we have to do whatever we can to get them to listen and follow instructions, so they can stay the hell out of the hospital. If that involves pumping out docs who look like them, it is what it is.

so you're saying URM patients can be racist against non-URM physicians? And we as a society has a job to select physicians based on their racism even if it is unfair.

 

[AnatomyGrey12]

1. To who? Everyone that’s not URM? I could just tell every URM to deal with it but no that’s oppression and racism.

2. Just a part? GPA and MCAT are the two most important parts of the applying process? Am I missing something here? If they are not indicative of how good of a physician is they are at least very important in the most important step of becoming one.

3. Sure. You need good bedside manner and “connect” with the patient. But wait, in order to understand someone’s life and experiences, all you need to be is the exact same skin color as the patient. Ain’t that something?

4. Struck a nerve? Also that’s debatable. See 2.

I’m struggling to see how it’s unfair to the whole cohort of people who aren’t URM when they are easily the most accepted demographic. If you didn’t get accepted then it’s because you simply weren’t good enough when compared to similar applicants.

With the bolded you honestly sound like a teenager who has finally realized that simply by getting your drivers license doesn’t mean that someone has to give you a car to drive. Your arrogance that this country needs you as a doctor simply because you scored well on a test is astounding and the world of medicine won’t even skip a beat because someone with a lower MCAT score than you became a doctor.

Likewise, if black or Asian or Native American patients are more interested in going to a doctor who looks like them than going to a doctor who is successful and skilled, then that's a serious problem with the patients' priorities; they are prioritizing racial preferences over their own health. The healthcare system shouldn't be pumping out sub-par doctors just to accommodate certain patients' bigotry and shallowness.

You act as if there is a separation between a successful and skilled doctor and one that isn’t ORM. You know what makes a skilled and successful doctor? Medical school, passing the Step exams, graduating an accredited residency program. Now where in there is anything about undergrad or MCAT performance. If someone has done those things then they are a successful and skilled doctor. UG GPA and MCAT have literally zero prediction power of how skilled of a physician someone will be. None. They simply predict one’s ability to successfully make it through all of the check points in medical training.

I have said this a few times recently and will say it again. This applies to all of you in this thread using terms like “sub par physicians” or who think that your academics somehow make you special and that you are somehow entitled to become a doctor: medical schools don’t owe you a thing, especially not for simply getting a good MCAT and GPA.

 

[OneTwoThreeFour]

so you're saying URM patients can be racist against non-URM physicians? And we as a society has a job to select physicians based on their racism even if it is unfair.

Do you consider fear/mistrust based on historical abuses of power to be racism?

 

[Microbug]

Do you consider fear/mistrust based on historical abuses of power to be racism?

yes, because it is not like the non-URM physicians were the ones who exercised the abuse of power. Their judgement/assumptions/fear/mistrust is because of the physician's skin color, which is the definition of racism...

 

[BestoFriedo-Todo]

so you're saying URM patients can be racist against non-URM physicians? And we as a society has a job to select physicians based on their racism even if it is unfair.

You say they're being racist for wanting a doctor that looks like them, but you ignore the fact that they spent most of their life being mistreated by people who didn't. Are you aware of what happened to them to make them think that way? Did you forget how these people were treated the 1900s? Up until 1960s /1970s, they were still killing people for dating outside their race. It was completely acceptable to give people of color harasser judicial punishments for minor incidents. Did you forget that white doctors were performing sterilization procedures on people of color without the patient's permission. Did you forget the Tuskegee Airmen experiment? Did you miss those history lesson of people in the streets being sprayed by fire hydrants, attacked by dogs and discriminated against for the majority of the 1900s for asking to be treated fairly?

The end of racism and discrimination is RECENT event. The people who lived through it are still alive. Some of them were children when this occurred are just now hitting their 30s or 40s. The injuries inflicted on those people for centuries do not disappear after 1 generation.

 

[dr_kateb]

I’m struggling to see how it’s unfair to the whole cohort of people who aren’t URM when they are easily the most accepted demographic. If you didn’t get accepted then it’s because you simply weren’t good enough when compared to similar applicants.

With the bolded you honestly sound like a teenager who has finally realized that simply by getting your drivers license doesn’t mean that someone has to give you a car to drive. Your arrogance that this country needs you as a doctor simply because you scored well on a test is astounding and the world of medicine won’t even skip a beat because someone with a lower MCAT score than you became a doctor.



You act as if there is a separation between a successful and skilled doctor and one that isn’t ORM. You know what makes a skilled and successful doctor? Medical school, passing the Step exams, graduating an accredited residency program. Now where in there is anything about undergrad or MCAT performance. If someone has done those things then they are a successful and skilled doctor. UG GPA and MCAT have literally zero prediction power of how skilled of a physician someone will be. None. They simply predict one’s ability to successfully make it through all of the check points in medical training.

I have said this a few times recently and will say it again. This applies to all of you in this thread using terms like “sub par physicians” or who think that your academics somehow make you special and that you are somehow entitled to become a doctor: medical schools don’t owe you a thing, especially not for simply getting a good MCAT and GPA.

Hahahhahahahah. Are you joking? Tell me you’re joking. URMs are generally accepted with much lower stats but on paper they’re better?

Where have I ever said that the country needs me as a doctor? Where? I want quotes.

And in bold. I agree. But you should also know that life doesn’t owe you anything either. Who says affirmative action is necessary in the first place? Who says the playing field needs leveling? You? URMs?

 

[Microbug]

You say they're being racist for wanting a doctor that looks like them, but you ignore the fact that they spent most of their life being mistreated by people who didn't. Are you aware of what happened to them to make them think that way? Did you forget how these people were treated the 1900s? Up until 1960s /1970s, they were still killing people for dating outside their race. It was completely acceptable to give people of color harasser judicial punishments for minor incidents. Did you forget that white doctors were performing sterilization procedures on people of color without the patient's permission. Did you forget the Tuskegee Airmen experiment? Did you miss those history lesson of people in the streets being sprayed by fire hydrants, attacked by dogs and discriminated against for the majority of the 1900s for asking to be treated fairly?

The end of racism and discrimination is RECENT event. The people who lived through it are still alive. Some of them were children when this occurred are just now hitting their 30s or 40s. The injuries inflicted on those people for centuries do not disappear after 1 generation.

So by your definition, jewish people should get the same advantages in admission process as AA URM do? Let's also not forget the Japanese internment camps during WWII. I think you're the one who is forgetting the mistreatment other race of people have endured.

 

[Osminog]

Do you consider fear/mistrust based on historical abuses of power to be racism?

Forming negative generalizations about entire groups of people on the basis of racial identity is racist.

If my grandmother got mugged by a individual of Asian descent, it would obviously be racist for me to hold that against every single Asian individual I meet in my day-to-day life.

 

[BestoFriedo-Todo]

So by your definition, jewish people should get the same advantages in admission process as AA URM do?

Jewish people suffered in Germany, but they benefited from being white in America in the 1900s.
Which one do you think the Jewish were using?

 

[Osminog]

So by your definition, jewish people should get the same advantages in admission process as AA URM do?

Jews don't get advantages because they outperform other groups and are highly overrepresented in medicine.

In practice, affirmative action has little, if anything, to do with reparations; it's about artificially equalizing outcomes for groups that perform at different levels.

 

[CUatthefinishline]

Not a troll thread, not trying to start any flame wars. I genuinely would like only those who belong to groups who are under represented in medicine to answer these questions to avoid any SDN drama. I just want a point of view from those who truly knows what its like to be a minority in the US who is URM.

------------------------------------------------------------------------------------------------------------------------------
Do you think this process of recognizing groups who are under represented in medicine is doing good or harm?

How do you think this process could improve?

Is this process inherently reinforcing racial stereotypes?

Do you feel this is leveling the playing field?



P.S. I know this is a sensitive issue, just remember to be nice to people even if they disagree

1) I think it's doing both, but definitely more good. Actually, I'm not sure it's doing any harm when I think about it. Those things need to be addressed so we can improve. How we use that data, or biases we form based on it, is up to us (or the individual med schools). But it definitely needs to be recognized. Racism, prejudice, and discrimination aren't dead so it will continue to be an issue that requires addressing.

2) I agree with calls to also focus on SES to address that role in an applicant's application. However, I interviewed at a few schools that already do this, so I'm not sure how it would be focused on more. I also don't think that you have to focus on one or the other. Things are not just Black and white (.... or is it? - jk), and there are issues of intersectionality. We can address race, while also addressing disparities in SES, gender, etc.

3) Not inherently, no. I think it's just bringing to light the bias, privilege, and prejudice of others. In order to reinforce something, it has to be initially established already. If you had issues with URMs before (subconsciously or otherwise) then something like this might deeply rile you. Any addressing of differences, especially race or gender, is going to ruffle feathers and cause the majority or individuals with the most power/privilege to question themselves and their place in the world. That's not bad, and how progress is made. But we can't stop addressing things, further silencing the minority or disadvantaged, because people don't like thinking about it.

4) Somewhat. I think there is more that could be done, but that could be said of any initiative or movement. We have to start somewhere, and we can always improve (& we should strive to). There are still existing disparities that are being influenced by our country's past and present so there is still much work to do, but it's a large step in the right direction.

 

[OneTwoThreeFour]

Forming negative generalizations about entire groups of people on the basis of racial identity is racist.

If my grandmother got mugged by a individual of Asian descent, it would obviously be racist for me to hold that against every single Asian individual I meet in my day-to-day life.

And yet situations like these happen every day. People let personal or historical events dictate how they interact with others that look a certain way or speak a certain language or come from a certain country. The only way to break down some of these stereotypes is to interact with people of these groups in different scenarios/situations.

I am not saying it is "right" that patients prefer doctors that look like them, rather that it is a statistical fact. And I'd argue that an African American mistrusting a white doctor can lead to just as bad an outcome as a Chinese speaking patient seeing a doc who doesn't know their language.

These two things may seem like opposite viewpoints: "you're saying we should be exposed to different races in different settings yet saying black people should only see black doctors" but I don't think it should be seen as such. By normalizing/equalizing representation we are enhancing the perception of the medical profession by marginalized groups as well as working on racial barriers in society as a whole.

 

[BestoFriedo-Todo]

Forming negative generalizations about entire groups of people on the basis of racial identity is racist.

If my grandmother got mugged by a individual of Asian descent, it would obviously be racist for me to hold that against every single Asian individual I meet in my day-to-day life.

The example of a grandmother represents an event in which ONE PERSON mistreats another individual. We are talking about MAJORITY OF A ENTIRE NATION, mistreating individuals.

 

[Microbug]

Jewish people suffered in Germany, but they benefited from being white in America in the 1900s.
Which one do you think the Jewish were using?

So now we’re going to measure the level of suffering and mistreatment various group of people went through and whoever suffered more gets more advantages? Do you SEE how crazy this idea is?

 

[Osminog]

Jewish people suffered in Germany, but they benefited from being white in America 1900s.
Which one do you think the Jewish were using?

Educate yourself: History of antisemitism in the United States - Wikipedia

Also, note that many Jews in the US are the descendants of people who were targeted for systematic extermination. It's one thing to be told that you can't use the same water fountain as everybody else; it's another to be subjected to starvation, torture, and medical experimentation during an attempted genocide.

 

[Osminog]

The example of a grandmother represents an event in which ONE PERSON mistreats another individual. We are talking about MAJORITY OF A ENTIRE NATION, mistreating individuals.

The vast majority of white people didn't own slaves in America when slavery was legal, and not one white American alive today has legally owned a slave. Why are you trying to excuse bigotry?

 

[dr_kateb]

The example of a grandmother represents an event in which ONE PERSON mistreats another individual. We are talking about MAJORITY OF A ENTIRE NATION, mistreating individuals.

Are you saying only URMs go through racism? And that ORMs or minorities in general do not?

 

[AnatomyGrey12]

Hahahhahahahah. Are you joking? Tell me you’re joking. URMs are generally accepted with much lower stats but on paper they’re better?

Did you actually read the comment you bolded?

Once again you sound like a spoiled teenager who’s parents said they wouldn’t give him a car after he got his license. You want a medical school spot? Prove to an adcom they should take you over someone from the same applicant pool. If you don’t get a seat you weren’t better, plain and simple.

 

[Osminog]

Once again you sound like a spoiled teenager who’s parents said they wouldn’t give him a car after he got his license. You want a medical school spot? Prove to an adcom they should take you over someone from the same applicant pool. If you don’t get a seat you weren’t better, plain and simple.

Using an appeal to authority in order to try to justify racial discrimination. Nice.

"You want to sit in the front of the bus with the white folks? Prove to the bus driver that you deserve it."

 

[dr_kateb]

Did you actually read the comment you bolded?

Once again you sound like a spoiled teenager who’s parents said they wouldn’t give him a car after he got his license. You want a medical school spot? Prove to an adcom they should take you over someone from the same applicant pool. If you don’t get a seat you weren’t better, plain and simple.

Why are URMs admitted with generally much lower GPAs and MCATs?

 

[BestoFriedo-Todo]

The vast majority of white people didn't own slaves in America when slavery was legal, and not one white American alive today has legally owned a slave. Why are you trying to excuse bigotry?

You think racism stopped at slavery? Did you forget the Black codes? Jim Crow? Segregation? Redlining? Gentrification? Eugenics? Any white person over the age of 40 or 50 has been alive long enough to have benefited from or participated in at least one of those events. Any black person over the age of 40 or 50 has lived long enough to have been hurt by one of those events. And you just want to tell them and their children to "get over it".

 

[OneTwoThreeFour]

Why are URMs admitted with generally much lower GPAs and MCATs?

Because "value added to a class" extends beyond how well each person did in school.

 

[CUatthefinishline]

I see we've begun the Oppression Olympics.....

 

[Microbug]

You think racism stopped at slavery? Did you forget the Black codes? Jim Crow? Segregation? Redlining? Gentrification? Eugenics? Any white person over the age of 40 or 50 has been alive long enough to have benefited from or participated in at least one of those events. Any black person over the age of 40 or 50 has lived long enough to have been hurt by one of those events. And you just want to tell them and their children to "get over it".

Okay then respond to what I said before:

So now we’re going to measure the level of suffering and mistreatment various group of people went through and whoever suffered more gets more advantages? Do you SEE how crazy this idea is?

 

[dr_kateb]

Because "value added to a class" extends beyond how well each person did in school.

Soooo... their race?

 

[CUatthefinishline]

Soooo... their race?

I don't think that's a fair assumption. Statistically, URMs or minority students travel a more diverse/non-traditional (or just "gap year") route to medicine and may have a higher chance of being diverse in their SES background from the majority of other applicants. (Someone feel free to correct me stat-wise). So their "value added to a class" could come from multiple places or parts of their life story/application. They could even tick multiple boxes, increasing their "value" (along with the school's mission, vision, & "fit") to the school even more.

 

[OneTwoThreeFour]

Soooo... their race?

I feel like you're purposely being inflammatory when it isn't called for. A person's lived experience is certainly a factor and race plays into that strongly. I have yet to meet a black person-regardless of class-who has not reported being a victim of direct hate speech and oftentimes worse. Sometimes by representatives of the very community structures that are supposed to support them. As someone else mentioned, it is a "distance traveled" evaluation. ORM applicants with difficult upbringings similarly get "points" for having overcome adversity but their baseline is significantly lower.

 

[RNthenDoc]

Did you actually read the comment you bolded?

Once again you sound like a spoiled teenager who’s parents said they wouldn’t give him a car after he got his license. You want a medical school spot? Prove to an adcom they should take you over someone from the same applicant pool. If you don’t get a seat you weren’t better, plain and simple.

Actually had someone at a huge, well-known school tell me I’d be a shoo-in if I was [urm race].

As in, my stats and experience were great, but not great enough without that. I didn’t even get an II despite my connections there.


Also,
Saying someone inherently adds more value to a class because of their race is absolutely racist.

I’m not saying we don’t need URM or to give a fair shake, but I think it’s hugely offensive to assume a student of a certain race needs training wheels when in fact they are brilliant and can be just as competent a physician without training wheels.