stirring things up

[Qtip96]

I would counter that Medicine is also about saving lives (survival), not strictly "higher education". Wouldn't you want to be sure that the individual taking care of you is the best possible individual you can get?

In the other areas of higher education, I don't feel as strongly. Seldom does anyone die in a debate of who the true writer of all Shakespeare's work is.

hmmm... how would you select the "best individual"? GPA? Board scores? rank? at med school, residency, and fellowship, "ojective criteria" such as these were not very good predictors for the docs who ended up being the sharpest and most astute clinicians. program selection comittees, in addition to diversity, DO seek out qualified individuals. good docs are SHAPED by good training inasmuch as what they bring to the table.

although i love being a doc, i think you over-glorify our profession. sure, we have a significant impact on other people's health and quality of life, but i dare say that people who control vital resources, govern policy, wage war, make life worth living, etc, etc, have as great a share of impact on our lives. as for practicing docs, there are few professions with as rigorous credentialling as in medicine, and with as many safeguards for competency, redundancy, and regulation (with all of its pitfalls and inconveniences ). granted, more URMs fail certain exams, but they did FAIL (and thus either excluded from practice or motivated to study more). like i said before, i am not a big fan of AA as it stands, and it is an imperfect practice. i am curious also to see the data on these exams stratified to explore the demographics and performance in US med school educated and trained URMs.

i'll point out 2 episodes in the history of our life-saving profession:
1. San Antonio Contraception Study. Mexican-american women were recruited for a medical study to investigate the side effects of oral contraception. Unbeknownst to them, 1/2 of participants receiving OCP's were switched to placebo half-way through the study. Outcome: lots of unplanned pregnancies.
2. Public Health Service Sypilis Study. Study to investigate the natural history of syphilis in African-American men. even after penicillin was found to be a safe and effective treatment, the men were denied antibiotics. Result: lots of deaths, disabilities, and congenital syphilis.

you might think that our civil and social consciousness is currently way beyond these nightmares, but these events happened up to the early 1970's, which is WITHIN MY LIFETIME.

few professions have as great of an impact on the fabric of society as healthcare delivery. why should diversity in its practitioners not be a legitimate goal (in addition to moral and competent care)?

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[Qtip96]

It's hard not to show sarcasm when your opponent in the debate resorts to name calling when unable to give answers that support their point of view in an mature manner...

yeah, i can see where you're coming from.

 

[skypilot]

hmmm...
you might think that our civil and social consciousness is currently way beyond these nightmares, but these events happened up to the early 1970's, which is WITHIN MY LIFETIME.

few professions have as great of an impact on the fabric of society as healthcare delivery. why should diversity in its practitioners not be a legitimate goal (in addition to moral and competent care)?

Within my lifetime too. And I was even born before the voting rights act and desegregation laws.

As far as the article from 10 years ago quoted by Military MD, here is a quote:

The four-year graduation rate for blacks was 68 percent. Blacks graduated at a higher rate than do Asians (63 percent), but at a much lower rate as compared with whites (82 percent).

Makes me laugh, the writer obviously had a biased agenda and the data is so old that it is not relevant today.

Everyone in med school has to pass the boards and classes. The dropouts at my school have been the people who lacked motivation and drive, and they have not been the people you would expect based on racist views.

 

[deleted21609]

hmmm... how would you select the "best individual"? GPA? Board scores? rank? at med school, residency, and fellowship, "ojective criteria" such as these were not very good predictors for the docs who ended up being the sharpest and most astute clinicians. program selection comittees, in addition to diversity, DO seek out qualified individuals. i would dare say, that good docs are SHAPED by good training inasmuch as what they bring to the table.

There are two HUGE holes in your reasoning.
1) Dismissing GPA, board scores, and rank is a change of subject not an argument for AA. Are you suggesting that race is a better predictor of which docs will be the best clnicians? That's ridiculous. I'm sure admissions commitees will use any good indicator of clinical performance that you can come up with in their admissions decisions. The fact is that while imperfect, GPA and MCAT are the best available indicators of clinical aptitude.

2) Your mention of seeking out 'qualified individuals' is again just a change of subject. We aren't arguing against AA claiming that the AA-admits aren't 'qualified' to practice medicine. It's just that they are not the MOST QUALIFIED applicants available.

Why don't you try addressing the subject at hand instead of just shifting your thoughts away from the real issue. Race is in no way a valid criterion for admissions and ANY consideration of race is racist by definition.

 

[BlazerMed]

There are two HUGE holes in your reasoning.
1) Dismissing GPA, board scores, and rank is a change of subject not an argument for AA. Are you suggesting that race is a better predictor of which docs will be the best clnicians? That's ridiculous. I'm sure admissions commitees will use any good indicator of clinical performance that you can come up with in their admissions decisions. The fact is that while imperfect, GPA and MCAT are the best available indicators of clinical aptitude.

2) Your mention of seeking out 'qualified individuals' is again just a change of subject. We aren't arguing against AA claiming that the AA-admits aren't 'qualified' to practice medicine. It's just that they are not the MOST QUALIFIED applicants available.

Why don't you try addressing the subject at hand instead of just shifting your thoughts away from the real issue. Race is in no way a valid criterion for admissions and ANY consideration of race is racist by definition.

Did you miss this part?

like i said before, i am not a big fan of AA as it stands, and it is an imperfect practice

 

[seattledoc]

2. Public Health Service Sypilis Study. Study to investigate the natural history of syphilis in African-American men. even after penicillin was found to be a safe and effective treatment, the men were denied antibiotics. Result: lots of deaths, disabilities, and congenital syphilis.


There's a good book about this called "Bad Blood", by James Jones (a previous professor of mine). It's a pretty good read and is the single best account of this incident.

 

[Qtip96]

There are two HUGE holes in your reasoning.
1) Dismissing GPA, board scores, and rank is a change of subject not an argument for AA. Are you suggesting that race is a better predictor of which docs will be the best clnicians? That's ridiculous. I'm sure admissions commitees will use any good indicator of clinical performance that you can come up with in their admissions decisions. The fact is that while imperfect, GPA and MCAT are the best available indicators of clinical aptitude.

2) Your mention of seeking out 'qualified individuals' is again just a change of subject. We aren't arguing against AA claiming that the AA-admits aren't 'qualified' to practice medicine. It's just that they are not the MOST QUALIFIED applicants available.

i am not dismissing traditional measures of previous achievement. i am speaking from my experience, which includes exposure to training programs which are amongst the most competitive in my field. i disagree with you about GPA and MCAT being the "best available indicators of clinical aptitude". in my residency and fellowship programs, they could EASILY have populated its ranks with the HIGHEST MCAT and USMLE scores. instead, they took people who did overall well (to establish competency with standardized tests and basic knowlege base), and looked to OTHER PREDICTORS for clinical excellence: actual clinical performance, sense of motivation, personal presence, team-player, (publications if academics), etc.etc. a lot of these qualities are difficult to quantify by any conventional metric.

BTW, what stage are you in your career, and how much clinical experience do you have to judge indicators of clinical performance?

Why don't you try addressing the subject at hand instead of just shifting your thoughts away from the real issue. Race is in no way a valid criterion for admissions and ANY consideration of race is racist by definition.

a bit hostile aren't we?

i am not claiming to have ANY definitive answers, and i too do not like the status quo. but, i DO think that it we should be striving for diversity (ethnic and socioeonomic) in healthcare practitioners. in any case, Supreme Court precedent disagrees with you (Regent of Univ. Calif v. Bakke, and Grutter v. Bollinger), stating that seeking ethnic diversity in a student body IS constitutional (though quotas are not).

 

[nimbus]

i am not dismissing traditional measures of previous achievement. i am speaking from my experience, which includes exposure to training programs which are amongst the most competitive in my field. i disagree with you about GPA and MCAT being the "best available indicators of clinical aptitude". in my residency and fellowship programs, they could EASILY have populated its ranks with the HIGHEST MCAT and USMLE scores. instead, they took people who did overall well (to establish competency with standardized tests and basic knowlege base), and looked to OTHER PREDICTORS for clinical excellence: actual clinical performance, sense of motivation, personal presence, team-player, (publications if academics), etc.etc. a lot of these qualities are difficult to quantify by any conventional metric.

BTW, what stage are you in your career, and how much clinical experience do you have to judge indicators of clinical performance?



a bit hostile aren't we?

i am not claiming to have ANY definitive answers, and i too do not like the status quo. but, i DO think that it we should be striving for diversity (ethnic and socioeonomic) in healthcare practitioners. in any case, Supreme Court precedent disagrees with you (Regent of Univ. Calif v. Bakke, and Grutter v. Bollinger), stating that seeking ethnic diversity in a student body IS constitutional (though quotas are not).

An interesting side note on Allan Bakke. Although the court found UC Davis' AA program to be constitutional, the court also ordered him to be admitted to UC davis. He actually became an anesthesiologist practicing in Minnesota.

 

[militarymd]

hmmm... how would you select the "best individual"? GPA? Board scores? rank? at med school, residency, and fellowship, "ojective criteria" such as these were not very good predictors for the docs who ended up being the sharpest and most astute clinicians. program selection comittees, in addition to diversity, DO seek out qualified individuals. good docs are SHAPED by good training inasmuch as what they bring to the table.

Best criteria to use......What makes a great clinician.....These are all tough questions.

In order for someone to become a great physician, there needs to be the "basic" skills..mental, physical, and emotional sets of skills....which is than honed and trained through 4 years of medical school and then residency before that someone even has a chance of becoming a great physician.

How do we measure these mental, physical, and emotional skill sets???? Number 2 is easy....for now...but there was a law suit filed at my medical school in the 80's from a BLIND student who said he was physically qualified. So even the physical requirements is questioned.

Number 3....well, we have no "metric" to measure this...just the personal statement and interview.

Number 1 mental....is measured by all the test scores that we talk about....In AA policies, we lower this requirement to achieve "diversity"...because "diversity" is better?

Medicine has changed enormously in the last 10 years. There was soooo little known about medicine in the 60's and 70's that the practice of medicine was not mentally taxing.....it was more of a physical and emotional challenge.

With the explosion of "evidence" from rigorous trials that have been conducted in the last 10 years and which are continuing to be conducted, the practice of medicine is becoming more and more of a "mental" challenge.

The "mental" component of the basic skill sets are becoming more and more important with the greater breath of knowledge that a physician needs to grasp.

One of my interests is ARDS....Did you know that there have been 4 studies publsihed in the NEJM alone in the last few months? All prospective..and..3 randomized multicenter trials. Just following one disease process is a mentally challenging exercise.

So with the practice of medicine becoming more and more mentally taxing, we want to lower the bar on the measureable intellectual component of the admission process with AA policies?

That just doesn't make sense to me.

Keep the same standards, if 2 people had equal scores, then favor the URM....I would say that's fair, but favoring someone with lower scores in this modern day of medicine because of race is just not wise.

 

[dhb]

Is fair or wise probably not but all systems have their pros and cons (cf how do you get people to practice where no one else wants to go?)

What i'm sure (from personal experience) is that maybe 3 patients out of ten get the actual optimal treatment they should be receiving and I certainly do not trust a brown nosser feakin' nerd just because he 'got XYZ on whatever standardized test!

I routinely ask MD's i meet where they would go if they or a member of their family had a serious health problem... i've yet to receive a categorical answer!

 

[Qtip96]

An interesting side note on Allan Bakke. Although the court found UC Davis' AA program to be constitutional, the court also ordered him to be admitted to UC davis. He actually became an anesthesiologist practicing in Minnesota.

*gasp* i think i swallowed a bug.

don't i feel like a sh*thead for using that example!

 

[deleted21609]

i am not dismissing traditional measures of previous achievement. i am speaking from my experience, which includes exposure to training programs which are amongst the most competitive in my field. i disagree with you about GPA and MCAT being the "best available indicators of clinical aptitude". in my residency and fellowship programs, they could EASILY have populated its ranks with the HIGHEST MCAT and USMLE scores. instead, they took people who did overall well (to establish competency with standardized tests and basic knowlege base), and looked to OTHER PREDICTORS for clinical excellence: actual clinical performance, sense of motivation, personal presence, team-player, (publications if academics), etc.etc. a lot of these qualities are difficult to quantify by any conventional metric.
in any case, Supreme Court precedent disagrees with you (Regent of Univ. Calif v. Bakke, and Grutter v. Bollinger), stating that seeking ethnic diversity in a student body IS constitutional (though quotas are not).

I was talking about med school admissions with the GPA and MCAT stuff. You wouldn't have any clinical performance at that stage.

You continue to discuss everything but the racist discrimination known as AA. Use whatever components you want in admissions (grades, scores, clinical evals, etc.) just not race. Race is noticably absent from your list of predictors of clinical excellence by the way, so what's your point?

What do you mean the Supreme Court disagrees with me? I didn't say AA is unconstitutional, just racist. The courts have ruled against AA in other cases though. It usually rules against AA when it's identifiable. The schools don't change their discrimination after losing, they just have to hide it better using vague, difficult to quantify factors in admissions. The court is beside the point, the court can be wrong as it is any time it says discrimination is acceptable. At some point the court will realize that the 14th Amendment applies to whites and asians too.

Please, if you have an argument in favor of discrimination that is based on facts, lets hear them. The tangents and subject changes aren't really productive.

 

[Qtip96]

Best criteria to use......What makes a great clinician.....These are all tough questions...

...Keep the same standards, if 2 people had equal scores, then favor the URM....I would say that's fair, but favoring someone with lower scores in this modern day of medicine because of race is just not wise.

you raise a number of good points.

if you take caucasian students accepted to a any competitive med school/residency, you will find that they will have a Gaussian distribution in their standardized test scores and grades. there will be NUMEROUS rejected applicants with scores/grades higher than the lower half of this distribution (and even some with higher than the upper distribution), irrespective of ethnicity. is the process by virtue unfair? maybe, but it attests to the fact that we are accepting PEOPLE and not NUMBERS. the candidate with the highest scores by virtue may NOT be the most desirable candidate. some of this variation is attributable to individual attributes, specific talents, contribution of intellectual diversity, (and let's not forget political elbowgreasing, ugh), etc.

BUT, i strongly believe that all acceptable candidates need to be considered within the range of their peers as far as general intellect and measurable skills. and i do agree with you in that admitting students who are below the anticipated range of aptitude, is in the end a disservice to the profession and to the student him/herself.

 

[Qtip96]

I was talking about med school admissions with the GPA and MCAT stuff. You wouldn't have any clinical performance at that stage.

You continue to discuss everything but the racist discrimination known as AA. Use whatever components you want in admissions (grades, scores, clinical evals, etc.) just not race. Race is noticably absent from your list of predictors of clinical excellence by the way, so what's your point?

What do you mean the Supreme Court disagrees with me? I didn't say AA is unconstitutional, just racist. The courts have ruled against AA in other cases though. It usually rules against AA when it's identifiable. The schools don't change their discrimination after losing, they just have to hide it better using vague, difficult to quantify factors in admissions. The court is beside the point, the court can be wrong as it is any time it says discrimination is acceptable. At some point the court will realize that the 14th Amendment applies to whites and asians too.

Please, if you have an argument in favor of discrimination that is based on facts, lets hear them. The tangents and subject changes aren't really productive.

man, you are one angry dude...

if there were decisive evidence to support either way, we wouldn't be having this discussion, would we? as far as the disctinction between "diversity" and "discrimination" and outright "racism", this is nomenclature that is truly in the eyes of the beholder. in your case, your predetermined definition is a self-fulfilling argument, and your argument is in my perspective, unanswerable.

 

[deleted21609]

man, you are one angry dude...

if there were decisive evidence to support either way, we wouldn't be having this discussion, would we? as far as the disctinction between "diversity" and "discrimination" and outright "racism", this is nomenclature that is truly in the eyes of the beholder. in your case, your predetermined definition is a self-fulfilling argument, and your argument is in my perspective, unanswerable.

They aren't MY predetermined definitions. They are THE definitions.

Websters: http://www.m-w.com/
Discriminate: to make a difference in treatment or favor on a basis other than individual merit.
Racism: racial prejudice or discrimination

It's unanswerable because it's true. I'm angry because I am one of the overlooked people who has been hurt by AA. If you only think about helping URM, then it sounds ok. For every URM you help someone is hurt, and we're real people.

 

[Qtip96]

I know what it is like to be discriminated against because of race. I had to go to Ireland for medical school despite having a higher GPA and MCAT than 90% of "URMs" in my state schools...

so... er... you get sh*tfits thinking of this?

 

[deleted21609]

Ok Qtip96, don't make any arguments for AA.

At the University of Maryland Medical School in 2000, blacks with college g.p.a.’s of B or B+ and MCAT scores in the bottom half of all test-takers had a 70 percent chance of admission; for whites and Asians of similar credentials, the chance was 2 percent. I guess the black applicants were pretty extraordinary in 'actual clinical performance, sense of motivation, personal presence, team-player'.

Here's an interesting article about how blacks are harmed by AA in law school admissions. http://www.today.ucla.edu/2005/050223voices_preferences.html
Basically, they are admitted to more competitve schools than they should be which leads to poor performance, drop outs, etc. If they went to schools they actually deserved to be admitted to, they'd be competitive and more successful.

 

[militarymd]

Ok Qtip96, don't make any arguments for AA.

At the University of Maryland Medical School in 2000, blacks with college g.p.a.’s of B or B+ and MCAT scores in the bottom half of all test-takers had a 70 percent chance of admission; for whites and Asians of similar credentials, the chance was 2 percent. I guess the black applicants were pretty extraordinary in 'actual clinical performance, sense of motivation, personal presence, team-player'.

Here's an interesting article about how blacks are harmed by AA in law school admissions. http://www.today.ucla.edu/2005/050223voices_preferences.html
Basically, they are admitted to more competitve schools than they should be which leads to poor performance, drop outs, etc. If they went to schools they actually deserved to be admitted to, they'd be competitive and more successful.

Interesting essay......it discusses realities which I am familiar with, but also a reality that many are not willing to accept.

 

[Qtip96]

Ok Qtip96, don't make any arguments for AA.

At the University of Maryland Medical School in 2000, blacks with college g.p.a.’s of B or B+ and MCAT scores in the bottom half of all test-takers had a 70 percent chance of admission; for whites and Asians of similar credentials, the chance was 2 percent...

either you are dense or you don't know how to read...

like i said, i do not favor AA as it is practiced in many places. but i am a fan of ethnic diversity.

i am not a big fan of AA as it stands, and it is an imperfect practice...

i strongly believe that all acceptable candidates need to be considered within the range of their peers as far as general intellect and measurable skills. and i do agree with you in that admitting students who are below the anticipated range of aptitude, is in the end a disservice to the profession and to the student him/herself.

dude, if you choose to blame AA policies as the primary reason you didn't get into medical school in the US, it's not my problem. if it makes you sleep better at night, keep believing...

 

[r2b]

Lets be real there is no such thing as a level playing ground in America (even if AA was taken away)

So the original argument was about med school admissions. I will concede that there are lower GPA and MCAT standards for URMs but URMs have to excel in other areas, which have not been mentioned. For example, most URMs accepted to medical school have well-developed CVs in other areas (such as spending their summers doing research or taking time out to get another degree). As an URM when I talked to my URM classmates none of us back packed through Europe during the summer or just “painted houses and partied” during the summer. We worked hard, doing “extra” stuff just to get to into med school. Seriously no one studied two days and got in med school. The people that I know who made low scores studied as “hard” as my white colleagues. Standardized tests are biased plan and simple.

Let's be real boards scores do not indicate how good a clinician you are going to be. And, I say this as someone who scored very high on Step 1 and Step 2.

What bothers me is that we are spending time discussing whether AA should be allowed. To me this proves the point that we still need it. There are so many people out there who would prefer that URM esp. Blacks and now Hispanics not make progress and are feel they are innately inferior. So some URM get in with low scores? SO WHAT!!!! It is only about 5 spaces anyway and I am sure at least half of those URM people in those five spots earned their spot (meaning my packet was good enough to be a white guy’s packet that is the standard right?)…I know I did. So now we are talking about two spots. Seriously!!! Should we really be arguing about two spots?

And, to answer an earlier question about whether the URM cared he/she was stereotyped as inferior despite high board scores/grades just because “data indicates URMs score low “ and AA allows dumb (or should we said it pc under qualified) URMs into school. I don’t mind at all. So what…. I have to endure another stereotype so more of my people can get an opportunity. I am used to RACISM I have been African American my entire life. And I know regardless of whether we have AA some people will always feel URMs are inferior. I know this because I have been in such “free” situations. Any person who thinks the eradication of Affirmative Action is going to eradicate views like some of the ones expressed on the board is kidding himself.


Once again I want to point out we are only talking about a few spots. Man you people. I think it would be better if no URMs got into med school. I am trying to understand your goal....abolish AA, keep URM out? or just live in fantasy world where URM should have to meet the same standards on the test MCAT only, right, because if you dont pass the boards you dont become a doctor, despite not living the same standard life? Lets look at socioeconomic data too. Mil, Jet can you reference those numbers. Can we look at their affect on test performance. Or shall we continue discussing AA and equality in fantasy world where we all see no color and have equal opportunity.

 

[medstudent99]

you wanna be real, lets be real. i know ppl who have failed there step 1, took a kaplan course and got a 95th percentile while retaking it...i know a guy who got a 26 on his MCAT got into medical school (not an URM) was really motivated and got like a 240 on his step 1. i think less and less of it has to do with scores and more to do with motivation. if ur motivated to be a good doc ur gonna be good no matter what, ur gonna put forth that extra effort and learn what u need to learn. and as far as minorities and AA lets face the facts, the schools we go to are crap pure and simple, the teachers don't care and most of even the asian and white kids don't go to four year colleges from out schools. i was pushed by my teachers to go into military before going to college..that is very sad, but whatever i don't care anymore. Doctors have an awesome job and responsiblity but u really gotta question whether what u do could not be done by someone of normal intelligence and a ton of motivation. if ur motivated u can do anything regardless of your scores, boards, mcats, whatever. stop being elitest.

 

[jetproppilot]

Lets be real there is no such thing as a level playing ground in America (even if AA was taken away)

Standardized tests are biased plan and simple.


.

Biased? Towards whom?

I went to a public high school.

Non ivy league college.

So its harder for an URM to memorize the Bernoulli equation than a non-URM?

I didnt take an expensive MCAT prep course. Ordered the Flowers Manuals. Like many similar to me. Not every white person flies around in private planes (although I do now ) and takes expensive prep courses.

I guess you'll suggest that specialty-board-certification tests are biased as well.

 

[deleted21609]

I don't solely blame AA for my problems, but I think it hurt. I was waitlisted at three schools, so just a few spots made a big difference. It isn't important that you believe it affected me. It has nothing to with the argument over AA. I was just saying why I feel especially strongly about it.

There is not a level playing field. Most jobs are not given entirely on merit. People have personal connections, racial connections, religious connections, etc. that give them an unfair advantage. AA gives an unfair advantage to groups who had less of the other preferences. What you fail to consider is that many white people also don't have connections etc. either and we are totally screwed in this biased admissions process.

'URMs have to excel in other areas.' Everone has to do that. URMs spending summers doing research? I looked through hundreds of research programs' brochures and almost all of them only accepted minority applicants. I finally found about 3 programs that a white guy could even apply to, and I spent my summer at one of them. Virtually all applicants have developed CVs, so don't kid yourself. You get preference even when building you CV.

'Standardized tests are biased.' That's quite a statement. What about them is biased? Arguments for bias are that minorities don't do well, therefore they must be biased. Sorry, I think people on this board aren't quite brain-washed enough to buy that one. They say the same thing about the SAT math.

'There are so many people out there who would prefer that URM esp. Blacks and now Hispanics not make progress and are feel they are innately inferior.' I think URMs should earn their advancement. No one forces the social problems on you that are ultimately responsible for your lack of progress. Sure the past was tough, but you weren't there. Why can black people from Africa or the Carribean do so well? They have worse poverty and less education, but within one generation they do well in the US. It's not a racial problem, it's cultural.

'AA and equality in fantasy world where we all see no color and have equal opportunity.'
Socioeconomic data has been looked at. The fact is that black beneficiaries of AA are mostly middle class. Using economics instead of race would significantly decrease black enrollment while increasing hispanic and white enrollment. You people supporting AA don't care what's fair. You want the superficial appearance of equality through discrimination.

URMs aren't the only people without equal opportunity. You think it's all priviledged white rich kids who are hurt by AA? Read Hopwood vs Texas.

 

[Faebinder]

Biased? Towards whom?

I went to a public high school.

Non ivy league college.

So its harder for an URM to memorize the Bernoulli equation than a non-URM?

I didnt take an expensive MCAT prep course. Ordered the Flowers Manuals. Like many similar to me. Not every white person flies around in private planes (although I do now ) and takes expensive prep courses.

I guess you'll suggest that specialty-board-certification tests are biased as well.

http://www.ncbi.nlm.nih.gov/entrez/..._uids=16130540&query_hl=5&itool=pubmed_docsum

Pretty much repeating myself. Where you grow and who you grow around affects your verbal skills. (Critical for the information regurgitation process also known as a Standard Test). Also, how much money is involved in setting you up.... the link I provided shows a possibility of going even lower down to preschool with the economy argument....

 

[GasEmDee]

I agree with you.

I want to address another post first: Not all public high schools are equal. There are public high schools in affluent communities, and then there are public high schools in poor communities. I went to a public high school in a poor area with a large proportion of under-represented minorities (URMs). Despite the fact that I had a stellar SAT score, my high school counselor told me that I should do two years of community college before transfering to a university. He felt that the later might be overwhelming for me. Essentially, he expected nothing of me, just as he expected nothing of my entire high school. As a naive 15 year old, I might have taken his advice had it not been for the fact that my mother expected more of me.

This brings me to one my strongest personal beliefs: I think the single biggest advantage that a person can have is a family that encourages ambition and provides a sheltered environment that sets him up for success.

I think that admission committees should take into account those with economic and cultural disadvantages. I have had the privilige of attending some top-tier institutions, but I have never forgotten what it was like to grow up in poor schools were people expected nothing from me. When I went to college, it was if I went from bum to superstar. The differing expectations for success were like night and day. I have never forgotten this, and so when working on admissions committees, I always take this factor into account.

Now of course, economic and cultural disadvantage can occur in any race, URM or not, but I think that it is a circumstance more common to URMs. I do not agree with AA policies absolutely, but medicine is special in the sense that it needs to serve a diverse population in a culturally sensitive manner. Therefore, it needs practitioners that come from a variety of different backgrounds. I am generally pro-AA, but I dont think it should become the sole deciding factor for admisson. For example, given two relatively equal candidates, I would prefer an URM to balance out the class. However, I would not actually reserve a number of slots that must be filled by URMs.

We can talk about test scores all day long, but in the end, I feel test scores are useful in demonstrating a *minimum* level of intellectual competence, i.e., it is important to pass these tests. I dont think high scores are useful in stratifying top physicians -- and I say this despite achieving top percentiles on all of my standardized tests, SAT on up. After a certain point, your score is a reflection of the time that you spent studying and your test-taking skills.

I dont think that medicine is that intellectually demanding in practice. There is plenty of room for mediocrity in medicine. Your training teaches you to recognize specific scenarios and to respond to them in using a relatively standard intellectual framework. You learn it by rote, through repetition in medical school and residency. Medical training stamps out a lot creativity, in my opinion, but that is the way it should be. We want a standard, system-wide way of addressing known problems. Medicine at the frontiers of science is a different story altogether.

This is a tired discussion that has been hashed and re-hashed ever since I can remember. This thread might stretch on for pages, but the one thing that I have learned is that people generally do not budge from their stances. Like the middle-east situation, it tends to be an emotional issue, rather than an intellectual one, it is perpetuated by the same type of individuals, and it will go on, ad infinitum. C'est la vie, n'est pas?

you wanna be real, lets be real. i know ppl who have failed there step 1, took a kaplan course and got a 95th percentile while retaking it...i know a guy who got a 26 on his MCAT got into medical school (not an URM) was really motivated and got like a 240 on his step 1. i think less and less of it has to do with scores and more to do with motivation. if ur motivated to be a good doc ur gonna be good no matter what, ur gonna put forth that extra effort and learn what u need to learn. and as far as minorities and AA lets face the facts, the schools we go to are crap pure and simple, the teachers don't care and most of even the asian and white kids don't go to four year colleges from out schools. i was pushed by my teachers to go into military before going to college..that is very sad, but whatever i don't care anymore. Doctors have an awesome job and responsiblity but u really gotta question whether what u do could not be done by someone of normal intelligence and a ton of motivation. if ur motivated u can do anything regardless of your scores, boards, mcats, whatever. stop being elitest.

 

[GasEmDee]

Pretty much repeating myself. Where you grow and who you grow around affects your verbal skills. (Critical for the information regurgitation process also known as a Standard Test). Also, how much money is involved in setting you up.... the link I provided shows a possibility of going even lower down to preschool with the economy argument....

I agree with you 100%. You establish your own personal standards based on those of your peers, and the expectations of your family. Environment counts for a lot, and I think that there has been more than one study to suggest that the effects begin as early as pre-school. Thanks for posting the link.

 

[dhb]

C'est la vie, n'est-ce pas?

 

[GasEmDee]

I knew something was missing

 

[Qtip96]

Although, the title of the post is "stirring things up", I'm truly interested in open debate and education of all who are involved in the debate.

...discusses realities which I am familiar with, but also a reality that many are not willing to accept.

since i am not a regular here, i can't count myself as one of your cyberspace buddies, so i appreciate having had your attention for a little while. however, after observing the progression of this thread, i honestly doubt your sincerity in wanting to expand your perspective regarding this issue. you obviously appear set in your opinions, and this discussion is locked in a trajectory of pure argumentation.

as i have stated numerous times, i think AA, as it stands, is faulted in med school admissions (and law shool as well). this social experiment to try to reverse prior historic injustices is not succeeding on many fronts. what can we do to move forward in a reasonable fashion?

1. first, we have to determine whether diversity should be a goal in training our future doctors. some stalwarts (student.ie?) say no. i strongly think diversity is implicit in our educational mission and essential for providing health care integrated into our social fabric.

2. the hard part. how to implement diversity without sacrificing quality. now, i went to public school, but ended up going to a top ivy league college and med school, and trained in top competitive residencies and fellowships. All programs i attended had a certain percentage of URMs and not a single URM was ANY further behind than any of their peers. so, it CAN be done. i DO have beef with programs (usually in the lower tiers) that would dip below their usual threshold for excellence, and i feel this engenders problematic performance. in my book, this means fewer accepted URMs in total, but the ones who make it have no question of being at least as good as their non-URM peers. i understand this is much easier said than done.

i've said my peace. i'll quietly make my exit...

 

[Laryngospasm]

I agree with you.

I want to address another post first: Not all public high schools are equal. There are public high schools in affluent communities, and then there are public high schools in poor communities. I went to a public high school in a poor area with a large proportion of under-represented minorities (URMs). Despite the fact that I had a stellar SAT score, my high school counselor told me that I should do two years of community college before transfering to a university. He felt that the later might be overwhelming for me. Essentially, he expected nothing of me, just as he expected nothing of my entire high school. As a naive 15 year old, I might have taken his advice had it not been for the fact that my mother expected more of me.

This brings me to one my strongest personal beliefs: I think the single biggest advantage that a person can have is a family that encourages ambition and provides a sheltered environment that sets him up for success.

I think that admission committees should take into account those with economic and cultural disadvantages. I have had the privilige of attending some top-tier institutions, but I have never forgotten what it was like to grow up in poor schools were people expected nothing from me. When I went to college, it was if I went from bum to superstar. The differing expectations for success were like night and day. I have never forgotten this, and so when working on admissions committees, I always take this factor into account.

Now of course, economic and cultural disadvantage can occur in any race, URM or not, but I think that it is a circumstance more common to URMs. I do not agree with AA policies absolutely, but medicine is special in the sense that it needs to serve a diverse population in a culturally sensitive manner. Therefore, it needs practitioners that come from a variety of different backgrounds. I am generally pro-AA, but I dont think it should become the sole deciding factor for admisson. For example, given two relatively equal candidates, I would prefer an URM to balance out the class. However, I would not actually reserve a number of slots that must be filled by URMs.

We can talk about test scores all day long, but in the end, I feel test scores are useful in demonstrating a *minimum* level of intellectual competence, i.e., it is important to pass these tests. I dont think high scores are useful in stratifying top physicians -- and I say this despite achieving top percentiles on all of my standardized tests, SAT on up. After a certain point, your score is a reflection of the time that you spent studying and your test-taking skills.

I dont think that medicine is that intellectually demanding in practice. There is plenty of room for mediocrity in medicine. Your training teaches you to recognize specific scenarios and to respond to them in using a relatively standard intellectual framework. You learn it by rote, through repetition in medical school and residency. Medical training stamps out a lot creativity, in my opinion, but that is the way it should be. We want a standard, system-wide way of addressing known problems. Medicine at the frontiers of science is a different story altogether.

This is a tired discussion that has been hashed and re-hashed ever since I can remember. This thread might stretch on for pages, but the one thing that I have learned is that people generally do not budge from their stances. Like the middle-east situation, it tends to be an emotional issue, rather than an intellectual one, it is perpetuated by the same type of individuals, and it will go on, ad infinitum. C'est la vie, n'est pas?

Great post. I cant remember what city it was in but there was a wealthy businessman/company (I think the Kauffman foundation in Kansas City) that mentored and sponsored poor inner city kids through high school and college. The deal was that if they got accepted, then the foundation would pay for it. Many of these kids went on to graduate from very good institutions. Expectations and motivation are Huge with education I guess thats my point.

 

[johankriek]

I don't solely blame AA for my problems, but I think it hurt. I was waitlisted at three schools, so just a few spots made a big difference. It isn't important that you believe it affected me. It has nothing to with the argument over AA. I was just saying why I feel especially strongly about it.

sounds like you ARE blaming affirmative action for you NOT being accepted and thats ok.. Part of the grieving process.. You can continue to blame AA for your misfortunes and inabilty to achieve self actualization or you can study harder to achieve the grades that I DID to get into medical school; or go abroad where you dont have to deal with AA; or osteopathic schools where the bar is set lower.. but either way staying on this board blaming AA is not going to help you. You should be studying for your mcat to improve your application. You dont have time to bash policy now. You are too busy.

 

[medstudent99]

if u got below a 30 on ur mcat and didn't get in tough luck, retake the mcat and try again is my humble advice. if u got above a 30 and still didn't get in apply more broadly. i know urms who got like a 26 on their mcat and 4 years later still haven't got in anywhere so if u don't do well on ur mcat ur not likely to get in period. as far as that post about SAT math what don't u understand about pathetic public schools. i fortunately did will on my SAT despite the high school i went to. u ever had to repeat algebra 1 despite getting an A in the class because your teacher felt "your just not ready" with a bunch of inept seniors while ur a freshman, or having to be waived into Algebra 2 because ur the teacher thinks ur in danger of failing...and i ended up getting an A+ throughout the year in that class. this happens all the time to minority students. i don't know what you fail to see about poor public schooling. if you went to a public school in a low income area and did well afterwards i congratulate you because that is a great feat in and of itself.

 

[medstudent99]

and ur sadly mistaken if u think all schools are equal. down in Alabama all the black kids go to crappy public schools while all the white kids go to private schools. it's still jim crow down there. seperate but equal my ass...the south is STILL backwards.

 

[medstudent99]

i am not from alabama or anywhere in the south...thank God, california where things are a little more civilized

 

[deleted21609]

if u got below a 30 on ur mcat and didn't get in tough luck, retake the mcat and try again is my humble advice.

I got a 34 on my MCAT. I've already finished medical school. I'm justifiably angry because people with connections or who are minorities got into medical schools ahead of me with MCATs in the mid-20s.
I'm not trying to make this about me, so we can drop this line of discussion, ok? I just wanted to point out that there are individuals who are harmed by AA. It's not just numbers. Whether you think I'm one of the people hurt is irrelevant. If not me, then someone else loses every spot taken by an underqualified URM.
I think diversity will be nice when acheived by combating root causes, not through discrimination.
It isn't some rich connected guy who is hurt, and it isn't someone who is more or less equal to the URM applicant. It is an average person with a much stronger application than the competition who suffers at the hand of AA. There is no 'all else being equal' because the URM admits are nowhere near the people they replace.

 

[medstudent99]

ur making a big assumption there student.ie huge! not every urm who gets in gets an mcat in the mid 20s, there are plenty who score above 30, me included and in california that is the case as they don't even have AA so stop making broad generalizations like that

 

[deleted21609]

ur making a big assumption there student.ie huge! not every urm who gets in gets an mcat in the mid 20s, there are plenty who score above 30, me included and in california that is the case as they don't even have AA so stop making broad generalizations like that

I never said all. I've met black guys with 39 MCATs and 4.0 GPAs. They're the exception to the rule. What I wrote is generally true.
California has AA just like everyone else. It's hidden by giving URMs perfect scores in interviews, essays, extracurriculars, etc. to hide their AA policy, but AA is still practiced.

 

[cdql]

I never said all. I've met black guys with 39 MCATs and 4.0 GPAs. They're the exception to the rule. What I wrote is generally true.
California has AA just like everyone else. It's hidden by giving URMs perfect scores in interviews, essays, extracurriculars, etc. to hide their AA policy, but AA is still practiced.

eh....I don't know about the medical school system but I would say California has done well to eliminate (or at least mask) AA in their state college system.

I once took a campus tour of UC Berkeley and there's a very clear difference between that school and other state universities I've been to. It seems like merit goes a lot further in that state than others.

 

[johankriek]

I'm justifiably angry because people who are minorities got into medical schools .

Listen, just some advice.. DOnt be angry. Be happy. Being angry leads to heart disease, stress ulcers, affects judgement, affeects your relationship with your lover.. boyfriend or girlfriend whichever you like. go outside, take a walk, go see your favorite movie star perform in the latest movie. you finished medical school so why are you still angry. You are one of those people NOT affected because you became a physician. see.. it all works out in the end. I try not to get worked up over things i cant change. Channel that energy into something more important, and injustices that are actually injustices.. again, Just some advice.

 

[medstudent99]

one last comment, i won't ever comment on this subject again, i should be writing notes, i don't feel sorry because some privileged white or asian person didn't get into their top choice ivy-league medical school because some poor minority was given a shot, 2nd there are huge differences in the education we get up until college and i still support AA and lastly AA doesn't make a huge difference in the quality of doctors produced, i believe. all that said i have no animosity towards my white or asian colleuges i think they are all great. that's all i have to say about that. the end.

 

[militarymd]

however, after observing the progression of this thread, i honestly doubt your sincerity in wanting to expand your perspective regarding this issue. you obviously appear set in your opinions, and this discussion is locked in a trajectory of pure argumentation.

)

What did I say to make you thing that I am set in my opinion?

You have been fortunate to have worked with gifted URMs.....

 

[cdql]

one last comment, i won't ever comment on this subject again, i should be writing notes, i don't feel sorry because some privileged white or asian person didn't get into their top choice ivy-league medical school because some poor minority was given a shot, 2nd there are huge differences in the education we get up until college and i still support AA and lastly AA doesn't make a huge difference in the quality of doctors produced, i believe. all that said i have no animosity towards my white or asian colleuges i think they are all great. that's all i have to say about that. the end.

I find it interesting that Asians get lumped in with whites but every other ethnic group out there gets lumped in with URM. I guess they work too hard for their own good.

 

[Qtip96]

What did I say to make you thing that I am set in my opinion?

You have been fortunate to have worked with gifted URMs.....

well, i have been very fortunate to have trained in excellent programs/institutions. i only hope that my peers have learned as much from me as i have from them (okay, i'm being a bit too cheesy ). but there is the rub... desirable programs usually get to select the best qualified URMs, which is an increasingly shrinking pool. the tough question is whether less desirable/competitive programs should accept lesser qualified URMs in order to fulfill a need for diversity. and I have to admit i don't have a great solution.

if you are genuinely interested in reading some material with LOTS of data and references with regard to ethnic diversity and healthcare delivery, may i interest you to read this?:

http://www.aamc.org/diversity/amicusbrief.pdf

it is a brief written by the AAMC (along with 14 other medical organizations) to the Supreme Court, in reference to the Grutter v. Bollinger case. here are a few highlights (the references are in the pdf file. i'll exclude them to conserve space).

"The unfortunate but inescapable reality is that certain minority candidates for medical school — namely, African Americans, Native Americans, Mexican Americans and mainland Puerto Ricans — tend to have lower GPA’s and lower scores on the Medical College Admission Test (“MCAT”) than white candidates. It is likewise undeniable that, but for the race conscious admissions policies currently used by medical schools, the already low number of minority students admitted to medical school would fall precipitously. This would have an enormously damaging impact on the delivery of health care in America."

"OUR SOCIETY HAS A CRITICAL NEED TO GRADUATE COMPETENT MINORITY PHYSICIANS. It is well established that minority populations suffer greater health problems than non-minorities."

"Since 1978, numerous studies have demonstrated that minority physicians are more likely than their non-minority counterparts to serve minority populations... minority patients were over four times more likely to receive care from non-white physicians than were Caucasian patients... [African-American] physicians practiced in areas where the percentage of African-Americans was nearly five times as high, on average, as in areas where other physicians practiced and most Hispanic physicians practiced in areas where the percentage of Hispanic residents was twice as high as in areas where other physicians practiced... [A]lthough black physicians account for less than 5% of the total U.S. physician workforce, they served as regular health care providers for 23% of the black individuals"

"Minority physicians are also more likely to enter into primary care specialties, to practice in underserved areas, and to serve uninsured and Medicaid patients, regardless of the patients’ race or ethnicity. See, e.g., Keith, supra, at 1524; Moy & Bartman, supra, at 1517; Komaromy, supra, at 1308-09; Joel C. Cantor et al..."

"Candidate selection, conducted exclusively or predominantly by grades and test scores, [would] create an admission system with great potential for overlooking individuals who would, in fact, make superior physicians.” American Medical Ass’n Board of Trustees Report 15..."


so, ethnic minorities and rural poor are GROWING in number, and suffer from MORE medical problems. unless our healthcare system is prepared for expensive fulminant inpatient/ER care, i think it is of CRITICAL importance to train URM physicians. ugh... i feel like i just hurled...

 

[deleted21609]

one last comment, i won't ever comment on this subject again, i should be writing notes, i don't feel sorry because some privileged white or asian person didn't get into their top choice ivy-league medical school because some poor minority was given a shot, 2nd there are huge differences in the education we get up until college and i still support AA and lastly AA doesn't make a huge difference in the quality of doctors produced, i believe. all that said i have no animosity towards my white or asian colleuges i think they are all great. that's all i have to say about that. the end.

You choose to believe that it's a poor black person taking a spot from a priviledged white or asian person, but it still isn't true. Why can't you reference any data to support your lie?
To the black posters: What did your parents do for a living? What kind of neighborhood did you grow up in? What about most of the URMs you've met in med school, residency, etc? Most of you were priviledged. You can chose to support a racist program, but at least be honest about what you're supporting. Don't try to justify it with lies.

This is for college admissions, but it makes my point.
http://www.dean.usma.edu/english/pojman/PublishedWorks/AffirmativeAction.html
In 1990 black high school seniors from families with annual incomes of $70,000 or more scored an average of 855 on the SAT, compared with average scores of 855 and 879 respectively for Asian-American and white seniors whose families had incomes between $10,000 and 20,000 per year."… Affirmative Action simply shifts injustice… against young white males, especially ethnic and poor white males.

By the way, Statistics from the College Board indicate that the SAT actually predicts college performance for minorities more accurately than it predicts performance for whites.

 

[blocks]

Well they may not offically have AA, but one of my best friends in college in California had a 23 on the MCAT and was accepted at UCLA med...I had a *considerably* higher score and didn't even get an interview. C'est la vie...

ur making a big assumption there student.ie huge! not every urm who gets in gets an mcat in the mid 20s, there are plenty who score above 30, me included and in california that is the case as they don't even have AA so stop making broad generalizations like that

 

[Qtip96]

I had to go to Ireland for medical school despite having a higher GPA and MCAT than 90% of "URMs" in my state schools. That cost me an extra $120000...

nice to have money...

I'm angry because I am one of the overlooked people who has been hurt by AA. If you only think about helping URM, then it sounds ok. For every URM you help someone is hurt, and we're real people.

like i said, you can't blame AA for your mediocrity bub...

You choose to believe the lie that it's a poor black person taking a spot from a priviledged white or asian person, but it still isn't true. Why can't you reference any data to support your lie?

you sound pretty angry... you wouldn't by any chance look anthing like this?

 

[medstudent99]

as far as someone getting into ucla med with a 23 is amazing even to me, that's pretty narley..but as far as ppl who get 855 on their SAT i don't think apply to med school, i'm not talking about this anymore, i'm done.

 

[deleted21609]

nice to have money...


like i said, you can't blame AA for your mediocrity bub...


you sound pretty angry... you wouldn't by any chance look anthing like this?

Nice to have money? Who, the bank? Not nice to have debt.

You don't know anthing about me to lead you to any conclusion about my mediocrity. You can't defend your position so you attack me. Typical.

I am angry, but not at the black people around me. Sure they accept racism in their favor, but it's rich white people in school administration and politics who decided to sacrifice people like me. They're connected, so their family and friends won't be hurt by AA. People don't actually care about what's right, and that's just sad.

 

[medstudent99]

ur idea of right is really relative, a lot of things that aren't "right" have been done and part of our constitution

 

[medstudent99]

i'm really really done. no more. sorry.