The Social Mission of Medical Education: Ranking the Schools

[KUNRD07]

Ann Intern Med. 2010 Jun 15;152(12):804-11.
The social mission of medical education: ranking the schools.
Mullan F, Chen C, Petterson S, Kolsky G, Spagnola M.
Department of Health Policy, George Washington University, 2121 K Street NW, Washington, DC 20037, USA.

http://www.annals.org/content/152/12/804.full

http://www.annals.org/content/152/12/804/T1.expansion.html

Background: The basic purpose of medical schools is to educate physicians to care for the national population. Fulfilling this goal requires an adequate number of primary care physicians, adequate distribution of physicians to underserved areas, and a sufficient number of minority physicians in the workforce.

Objective: To develop a metric called the social mission score to evaluate medical school output in these 3 dimensions.

Design: Secondary analysis of data from the American Medical Association (AMA) Physician Masterfile and of data on race and ethnicity in medical schools from the Association of American Medical Colleges and the Association of American Colleges of Osteopathic Medicine.

Setting: U.S. medical schools.

Participants: 60,043 physicians in active practice who graduated from medical school between 1999 and 2001.

Measurements: The percentage of graduates who practice primary care, work in health professional shortage areas, and are underrepresented minorities, combined into a composite social mission score.

Results: The contribution of medical schools to the social mission of medical education varied substantially. Three historically black colleges had the highest social mission rankings. Public and community-based medical schools had higher social mission scores than private and non–community-based schools. National Institutes of Health funding was inversely associated with social mission scores. Medical schools in the northeastern United States and in more urban areas were less likely to produce primary care physicians and physicians who practice in underserved areas.

Limitations: The AMA Physician Masterfile has limitations, including specialty self-designation by physicians, inconsistencies in reporting work addresses, and delays in information updates. The public good provided by medical schools may include contributions not reflected in the social mission score. The study was not designed to evaluate quality of care provided by medical school graduates.

Conclusion: Medical schools vary substantially in their contribution to the social mission of medical education. School rankings based on the social mission score differ from those that use research funding and subjective assessments of school reputation. These findings suggest that initiatives at the medical school level could increase the proportion of physicians who practice primary care, work in underserved areas, and are underrepresented minorities.

Top 20:
1. Morehouse College
2. Meharry Medical College
3. Howard University
4. Wright State University Boonshoft School of Medicine
5. University of Kansas
6. Michigan State University
7. East Carolina University Brody School of Medicine
8. University of South Alabama
9. Universidad de Puerto Rico en Ponce
10. University of Iowa Carver College of Medicine
11. Oregon Health & Science Center
12. East Tennessee State University Quillen College of Medicine
13. University of Mississippi
14. University of Kentucky
15. Southern Illinois University
16. Marshall University Joan C. Edwards University
17. University of Massachusetts Medical School
18. University of Illinois
19. University of New Mexico
20. University of Wisconsin

Bottom 20:
1. Vanderbilt University
2. University of Texas Southwestern Medical Center
3. Northwestern University Feinberg School of Medicine
4. University of California, Irvine
5. New York University
6. University of Medicine and Dentistry of New Jersey
7. Uniformed Services University of the Health Sciences
8. Thomas Jefferson University
9. Stony Brook University
10. Albert Einstein College of Medicine of Yeshiva University
11. Boston University
12. Loyola University Chicago Stritch School of Medicine
13. University of Pennsylvania
14. Medical College of Wisconsin
15. University at Albany, State University of New York
16. Columbia University
17. Texas A&M University
18. Duke University
19. Stanford University
20. Johns Hopkins University

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[Ilvcurst]

http://www.annals.org/content/152/12/804/T1.expansion.html

Interesting, I like how US News just ranked the best hospitals and Johns Hopkins was #1.

Seems like the HBCU were all ranked in the top Great article!

 

[schrizto]

Looks like they tried to make another US News primary care ranking which no one cares about in the first place. Not trying to belittle any of these schools, just saying it's kinda pointless to make such a ranking.

 

[schrizto]

And where are the DO schools? Looks like none made either list despite the study saying that data from the AACOM was included. You would have thought with osteopathy's emphasis on primary care there would be some high on the social mission ranking.

And come on, look at this:

Measurements: The percentage of graduates who practice primary care, work in health professional shortage areas, and are underrepresented minorities, combined into a composite social mission score.

Unless I'm reading this wrong, only grads who were all three really counted for this study. What hurt the osteopathic schools in this ranking was "[c]ompared with allopathic schools, osteopathic schools produced relatively more primary care physicians but trained fewer underrepresented minorities." So grads who are not URM but practice primary care in underserved areas are just not "social mission" enough for this ranking, eh?

 

[RogueUnicorn]

thank you for this brilliant piece of news that hasn't been discussed at all on SDN before.

 

[KUNRD07]

delete

 

[Ilvcurst]

And where are the DO schools? Looks like none made either list despite the study saying that data from the AACOM was included. You would have thought with osteopathy's emphasis on primary care there would be some high on the social mission ranking.

And come on, look at this:



Unless I'm reading this wrong, only grads who were all three really counted for this study. What hurt the osteopathic schools in this ranking was "[c]ompared with allopathic schools, osteopathic schools produced relatively more primary care physicians but trained fewer underrepresented minorities." So grads who are not URM but practice primary care in underserved areas are just not "social mission" enough for this ranking, eh?

It's a composite score where I think all three factors are looked at.

It can't be soley based on URMS because Kansas ranked higher then a school in Puerto Rico. I highly doubt that Kansas has more URMs than Peurto Rico.

There are lot of allopathoc school that didn't make the list. How do u know that some DO schools would?

 

[LizzyM]

If you look at the entire article, you'll see that there were separate rankings for each of the 3 measures. In primary care the DO schools in the top 20 were: #7. North Texas COM 47.3% primary care, #11 Des Moine COM 46.7%, #12 Western COM 46.4%, New England COM 44.2%.

The schools with the greatest number of alumni practicing in health shortage areas were: Mississippi (62.5%), South Alabama (52.7%), and U. South Florida (48.1%).

The med schools in Puerto Rico ranked 10, 12 adn 13 on URM. This was expressed as a ratio of the number of URM in the school (%) and the underreprented minorities in the population of the state, or in the case of schools that recruit more broadly, based on the URM population of the area from which their graduates originated (X% from NY, x% from VA, etc)

The overall ranking was created by combining the 3 rankings using a rank-sum (two different methods gave similar results).

I won't go into the details but I do think that this did give a pat on the back to some schools that are doing good work despite being "unranked" by US News. However, the missions of some of the school at the bottom of the list are not congruent with the values expressed by the "social mission" construct and I think that they should not be ashamed of doing what they do (research and production of sub-specialists and academic physicians).

 

[schrizto]

It's a composite score where I think all three factors are looked at.

It can't be soley based on URMS because Kansas ranked higher then a school in Puerto Rico. I highly doubt that Kansas has more URMs than Peurto Rico.

There are lot of allopathoc school that didn't make the list. How do u know that some DO schools would?

Of course the % of URMs aren't the only factor for their ranking, what I said is that I don't think it should be considered as heavily as they applied it in the ranking.

 

[seelee]

Bull****. Is it more socially responsible to accept students who are less qualified for no other reason than their race?

 

[Espadaleader]

Bull****. Is it more socially responsible to accept students who are less qualified for no other reason than their race?

No it is not. What is qualified for you? Okay, so we have a student applying to John Hopkins. He has lived in Inner-City Baltimore his entire life, seen it all...shootings, stabbing, violence, "trauma". The kid has a 30 MCAT and 3.4 GPA. We have another student that has a 3.9 and 38 MCAT. Both have elite extracurriculars. Okay so who is more qualified? It depends on the school's mission. Its not about numbers all the time. The kid from Baltimore would make an excellent physician...he "lives" trauma it everyday...even though his grades is not as sharp as the other student. Its the total package.

 

[LizzyM]

Bull****. Is it more socially responsible to accept students who are less qualified for no other reason than their race?

What are the required qualifications? Many people meet the minimum qualifications that a school might set for itself with the understanding that anyone that falls below that cut point may have difficulty completing the academic program of study.

Let's take a look at Morehouse. Given the 10th to 90th percentile of matriculants, it appears that Morehouse will rarely take a chance on someone with a sciene gpa of < 2.8, a overall gpa < 3.2, or a MCAT < 24. So that's their floor. (The average overall gpa is 3.5, science gpa 3.3, and average MCAT 27. )


What else are they looking for? Its mission is to improve the health and wellbeing of individuals and communities; increase the diversity of the health professional and scientific workforce; and address primary health care needs through programs in education, research and service, with an emphasis on people of color and the underserved urban and rural populations of Georgia and the nation.In addition to gpa & MCAT the school is looking for academic improvement, balance & depth of the academic program, difficulty of courses taken, extracurriculars, hobbies, need to work, research projects and experience, and evidence of activities that indicate concurrence withthe school's mission.

69% of its matriculants have had some community service or volunteer work, 79% report engaging in medically related work and 73% have done research, 23% have graduate degrees.

Some schools may have different minimum standards and other factors that they consider important but no one deliberately admits an unqualified applicant. I do not believe in more qualified or less qualified. It is yes or no; admissable or inadmissable. Within the pool of admissable applicants there are those who are stronger or a better fit with the mission but to be admissable one must meet the minumum as defined by that school.

 

[schrizto]

This thread is taking a wrong turn... it's not about AA, it's just a simple ranking that is pretty flawed in itself.

No it is not. What is qualified for you? Okay, so we have a student applying to John Hopkins. He has lived in Inner-City Baltimore his entire life, seen it all...shootings, stabbing, violence, "trauma". The kid has a 30 MCAT and 3.4 GPA. We have another student that has a 3.9 and 38 MCAT. Both have elite extracurriculars. Okay so who is more qualified? It depends on the school's mission. Its not about numbers all the time. The kid from Baltimore would make an excellent physician...he "lives" trauma it everyday...even though his grades is not as sharp as the other student. Its the total package.

Just having been around trauma and violence alone does not mean someone will become an excellent physician. The guy with lower stats would need to demonstrate that he had some sort of hardship that resulted in his lower numbers and show that personal growth resulted from his experiences.

 

[Brigade4Radiant]

Bull****. Is it more socially responsible to accept students who are less qualified for no other reason than their race?

Race plays a big factor since URMs under perform on exams and are underrepresented in the healthcare population. Also the scores are the same for D.O. So how are they under qualified? You can say they get in with lower scores but that doesn't make them under qualified.

 

[pennstate4life]

If you want house officers to be extra nice to you, go to a social mission hospital. If you want to live, go to Hopkins.

 

[basupran]

Does this really really surprise anyone?

 

[schrizto]

Does this really really surprise anyone?

The rankings or the responses?

 

[Charles_Carmichael]

These rankings are just as worthless as the US News rankings are. Pretty useless "study," IMO.

 

[KTownGT]

"Worst: 17. Texas A&M University"

No argument there.

 

[NickNaylor]

This exact paper has already been discussed. I believe the consensus was that this survey is really indicative of nothing and useless.

 

[Espadaleader]

If you want house officers to be extra nice to you, go to a social mission hospital. If you want to live, go to Hopkins.

You're a fool. You're already on probation and you still say such things? Lame. That comment was just wrong.

 

[seelee]

No it is not. What is qualified for you? Okay, so we have a student applying to John Hopkins. He has lived in Inner-City Baltimore his entire life, seen it all...shootings, stabbing, violence, "trauma". The kid has a 30 MCAT and 3.4 GPA. We have another student that has a 3.9 and 38 MCAT. Both have elite extracurriculars. Okay so who is more qualified? It depends on the school's mission. Its not about numbers all the time. The kid from Baltimore would make an excellent physician...he "lives" trauma it everyday...even though his grades is not as sharp as the other student. Its the total package.

This thread is taking a wrong turn... it's not about AA, it's just a simple ranking that is pretty flawed in itself.



Just having been around trauma and violence alone does not mean someone will become an excellent physician. The guy with lower stats would need to demonstrate that he had some sort of hardship that resulted in his lower numbers and show that personal growth resulted from his experiences.

Race plays a big factor since URMs under perform on exams and are underrepresented in the healthcare population. Also the scores are the same for D.O. So how are they under qualified? You can say they get in with lower scores but that doesn't make them under qualified.

Show me one single study that indicates that students who have "seen it all" yet have lower scores make better doctors overall. That is something that is constantly stated as fact, without any evidence backing it up. If am a black person raised in the inner city, do I have a higher success rate? Do I have higher test scores? Can I correctly diagnose an uncommon disease better than the suburban white doctor? My bet is that your answer is that none of those things can be measured, that being a "good" doctor is more than just test scores, and numbers, that it is some thing that is intangible. So my response then is if being a "good" doctor is immeasurable, then why do we blatantly assume that someone from a more "diverse" background will make a better physician than someone who did not?

When the cutoff for a white or Asian kid is higher than the cutoff for URM, what does that tell you? When a large number of lower performing students are accepted to programs, and then subsequently wash out because they couldn't cut it, or when academic exceptions are made for URMs that are not made for whites and Asians. When there is a plethora of statistics on how many URMs matriculate each year, yet a deafening silence with regards to statistics as to how many URMs graduate, then that is indiciative of accepting lower qualified students in the name of "diversity".

 

[RogueUnicorn]

If you want house officers to be extra nice to you, go to a social mission hospital. If you want to live, go to Hopkins.

i say this out of great concern for you as a person - is this just an internet thing or are you this obtuse in real life?

Show me one single study that indicates that students who have "seen it all" yet have lower scores make better doctors overall. That is something that is constantly stated as fact, without any evidence backing it up. If am a black person raised in the inner city, do I have a higher success rate? Do I have higher test scores? Can I correctly diagnose an uncommon disease better than the suburban white doctor? My bet is that your answer is that none of those things can be measured, that being a "good" doctor is more than just test scores, and numbers, that it is some thing that is intangible. So my response then is if being a "good" doctor is immeasurable, then why do we blatantly assume that someone from a more "diverse" background will make a better physician than someone who did not?

When the cutoff for a white or Asian kid is higher than the cutoff for URM, what does that tell you? When a large number of lower performing students are accepted to programs, and then subsequently wash out because they couldn't cut it, or when academic exceptions are made for URMs that are not made for whites and Asians. When there is a plethora of statistics on how many URMs matriculate each year, yet a deafening silence with regards to statistics as to how many URMs graduate, then that is indiciative of accepting lower qualified students in the name of "diversity".

nobody of consequence argues this, the whole point of medical school affirmative action is to bridge the physician gap for URMs while the rest of society catches up. nobody thinks that URMs make better physicians based solely on their minority status. simmer down.

 

[seelee]

i say this out of great concern for you as a person - is this just an internet thing or are you this obtuse in real life?


nobody of consequence argues this, the whole point of medical school affirmative action is to bridge the physician gap for URMs while the rest of society catches up. nobody thinks that URMs make better physicians based solely on their minority status. simmer down.

So if this is in fact the case, why is there even a need to "bridge the gap", and does affirmative action achieve that goal? When a URM student is accepted to a school for which he is under prepared academically, that student will struggle more, than if he had gone to a school that better suited his ability. I don't care how many shootings or stabbings you have witnessed, it won't help you deal with the academic rigors of medical school.

From what I have seen and read, AA does little more than displace URMs from institutions where they could be successful, to institutions where that success is much less likely. Diversity is not achieved, and the notion of having a diverse student body acomplishes little more than a high score on the "social mission ranking".

 

[RogueUnicorn]

So if this is in fact the case, why is there even a need to "bridge the gap", and does affirmative action achieve that goal? When a URM student is accepted to a school for which he is under prepared academically, that student will struggle more, than if he had gone to a school that better suited his ability. I don't care how many shootings or stabbings you have witnessed, it won't help you deal with the academic rigors of medical school.

From what I have seen and read, AA does little more than displace URMs from institutions where they could be successful, to institutions where that success is much less likely. Diversity is not achieved, and the notion of having a diverse student body acomplishes little more than a high score on the "social mission ranking".

first of all, i'd like to see why you're so sure URMs struggle so mightly to graduate as you keep implying

second, the student body diversity is completely secondary to the lack of physicians of the URM groups (hence the name) which is the gap that needs to be bridged.

i'm rather disconcerted that a medical student fails to see this.

 

[FaLoRe]

When the cutoff for a white or Asian kid is higher than the cutoff for URM, what does that tell you? When a large number of lower performing students are accepted to programs, and then subsequently wash out because they couldn't cut it, or when academic exceptions are made for URMs that are not made for whites and Asians. When there is a plethora of statistics on how many URMs matriculate each year, yet a deafening silence with regards to statistics as to how many URMs graduate, then that is indiciative of accepting lower qualified students in the name of "diversity".

http://www.aamc.org/data/facts/enrollmentgraduate/table30-gradsschlraceeth09-web.pdf

I usually lurk here but I'm so fed up with all this permeating ignorance that I have to say something...

Why are you so passionate about this topic? Did a URM almost try to sabotage your chances of getting into medical school? Chances are you're probably not going to practice in an underserved community anyway and could care less about the URM population, so why do you want to deprive that opportunity to someone who will? Why are you so quick to undermine our potential of becoming effective doctors? Stop putting the blame on blacks, hispanics, and native americans and start putting the blame on the system.

It's scary to think that if I met you in real life I would probably judge you as a non-threatening guy who'd be smiling in my face & shaking hands but behind closed doors or on a forum like this your true colors come out & you start making trash statements and baseless assumptions (you've probably already done that to your fellow urm classmates). By reading your comments & from past experience I'm seriously wary of the kind of doctors that exist & will exist in the future.

 

[seelee]

first of all, i'd like to see why you're so sure URMs struggle so mightly to graduate as you keep implying

second, the student body diversity is completely secondary to the lack of physicians of the URM groups (hence the name) which is the gap that needs to be bridged.

i'm rather disconcerted that a medical student fails to see this.

http://www.eric.ed.gov:80/ERICWebPo...&ERICExtSearch_SearchType_0=no&accno=ED319343

I don't have a problem with URMs getting admitted to medical school. I do have a problem with a clear double standard based on an unproven and untestable claim.

So you say that we have to have URM doctors, and the only way to get URM doctors is to lower admission standards? This begs two questions. 1) Why do we have to have a proportionate number of URM doctors? In other words, why should a doctor's race matter if we want to live in a post-racial society. 2) What evidence is there that lowered standards is more effective at achieving that diversity than some other means.

 

[venacontracta]

http://www.eric.ed.gov:80/ERICWebPo...&ERICExtSearch_SearchType_0=no&accno=ED319343

I don't have a problem with URMs getting admitted to medical school. I do have a problem with a clear double standard based on an unproven and untestable claim.

So you say that we have to have URM doctors, and the only way to get URM doctors is to lower admission standards? This begs two questions. 1) Why do we have to have a proportionate number of URM doctors? In other words, why should a doctor's race matter if we want to live in a post-racial society. 2) What evidence is there that lowered standards is more effective at achieving that diversity than some other means.

Better yet... if our goal is a fair, merit-based post-racial society with the same opportunities available for all, which is going to do more damage to our efforts to achieve that goal? a) having disproportionately few minorities become doctors until another generation or two has passed and the achievement gap (which I will admit exists as a result of past societal injustices) closes, or b) having blatant double-standards and a systematic disregard for the importance objective, merit-based admissions

I would argue b is worse. The way to get past racism is not by focusing on race.

 

[wanderer]

15. University at Albany, State University of New York

 

[Simplify]

Why are you so quick to undermine our potential of becoming effective doctors? Stop putting the blame on blacks, hispanics, and native americans and start putting the blame on the system.

If you're really capable of riding a bicycle then you don't need training wheels.

 

[schrizto]

seelee is arguing racism with racism... the article is racist because they believe that the number of URM doctors practicing primary care in underserved areas is the definitive measure of a school's "social mission," seelee is being racist because he thinks URMs admitted with lower numbers will be less competent doctors than non-URM peers.

 

[LizzyM]

When the cutoff for a white or Asian kid is higher than the cutoff for URM, what does that tell you? When a large number of lower performing students are accepted to programs, and then subsequently wash out because they couldn't cut it, or when academic exceptions are made for URMs that are not made for whites and Asians. When there is a plethora of statistics on how many URMs matriculate each year, yet a deafening silence with regards to statistics as to how many URMs graduate, then that is indiciative of accepting lower qualified students in the name of "diversity".

What proportion of med school matriculants fail to graduate or go on to be unsuccessful at obtaining licensure? The proportion is exceedingly small. Please read: http://www.unmc.edu/Community/ruralmeded/history_of_the_mcat.htm

Data from AAMC shows that successful completion of medical school in 4 years is correlated with MCAT but the curve flattens out at an MCAT of 26! It actually dips in the high 30s (I suspect that the dip is due to the ambitious who take a year off to do research & buff their residency application).

The link above has links at the bottom of the page to a number of other essays about selection criteria and they are well worth your time.

 

[NickNaylor]

http://www.aamc.org/data/facts/enrollmentgraduate/table30-gradsschlraceeth09-web.pdf

I usually lurk here but I'm so fed up with all this permeating ignorance that I have to say something...

Why are you so passionate about this topic? Did a URM almost try to sabotage your chances of getting into medical school? Chances are you're probably not going to practice in an underserved community anyway and could care less about the URM population, so why do you want to deprive that opportunity to someone who will? Why are you so quick to undermine our potential of becoming effective doctors? Stop putting the blame on blacks, hispanics, and native americans and start putting the blame on the system.

It's scary to think that if I met you in real life I would probably judge you as a non-threatening guy who'd be smiling in my face & shaking hands but behind closed doors or on a forum like this your true colors come out & you start making trash statements and baseless assumptions (you've probably already done that to your fellow urm classmates). By reading your comments & from past experience I'm seriously wary of the kind of doctors that exist & will exist in the future.

I don't think anyone here is making that argument. In fact, I would argue that most people who are against the whole URM system believes that absolute equality is what they want; people should be admitted to medical school based solely on their "potential of becoming effective doctors," REGARDLESS of their race. Unfortunately, this is what's preferred in a perfect world, and obviously our world isn't perfect. I don't think that the whole URM system is the best solution, though.

Also, your implication that only URMs practice in underserved areas is hogwash.

 

[seelee]

seelee is arguing racism with racism... the article is racist because they believe that the number of URM doctors practicing primary care in underserved areas is the definitive measure of a school's "social mission," seelee is being racist because he thinks URMs admitted with lower numbers will be less competent doctors than non-URM peers.

Really? Call me racist if you want. I really don't give two pieces of dog **** about that word because it is tossed around so carelessly in the face of ideological disagreement that it has become all but meaningless, but I digress.

Before I respond, why do you think that schools have an academic requirement if not to ensure that the students will be able to handle the rigor of medical school? So which is a more unreasonable claim, that a student (any student) who has lower stats is more likely to struggle in medical school, and more likely to score lower on boards, or that being exposed to poverty, violence, etc. will make up for academic shortcomings?

I would also like to point out that Asians and Jews, 50-60 years ago were underrepresented as well, and now make up a significant, if not dominate proportion of the professional make up, all without preferential admission or URM status.

Furthermore, I take issue with the notion that I have something against URM students. I don't. I take issue with a system that keeps certain ethnicities dependent on a administrative crutch until the inevitable time that they are forced to perform without some affirmative action program (which if the AA proponents had their way, would never happen). What does it communicate when we essentially say that the only way a black student can achieve success is if we lower acceptance and grading standards from cradle to grave? How is that supposed to enhance the ability of future generations? AA programs serve no other role than to allow the institution to proclaim that it is sufficiently "diverse", without having serious concern for the future of its students.

Oh, and I got into medical school on the first try, so Falore's ad hominem is completely baseless.

 

[FaLoRe]

I don't think anyone here is making that argument. In fact, I would argue that most people who are against the whole URM system believes that absolute equality is what they want; people should be admitted to medical school based solely on their "potential of becoming effective doctors," REGARDLESS of their race. Unfortunately, this is what's preferred in a perfect world, and obviously our world isn't perfect. I don't think that the whole URM system is the best solution, though.

Also, your implication that only URMs practice in underserved areas is hogwash.

Where did I imply that only URMs practice in underserved areas? I'm not stupid...I understand that there are gray areas to the issue, so stop making it seem like its all or nothing. And If only URMs practiced in the underserved then we wouldn't be having this discussion anyway because the gap will have already been "bridged." (if that's what you meant)

seelee is arguing racism with racism... the article is racist because they believe that the number of URM doctors practicing primary care in underserved areas is the definitive measure of a school's "social mission," seelee is being racist because he thinks URMs admitted with lower numbers will be less competent doctors than non-URM peers.

So far in this thread I've only seen one positive review of this study, and the rest have just been negative, just critiquing the study. I have a feeling that this wouldn't be the case if the rankings were reversed. Why is that? Maybe those that are against this article didn't like the way "social mission" was defined. But URM wasn't the only measurement in this study they also focused on physicians practicing in primary care and HPSAs (health professional shortage areas) too, which involves everyone not just urm. So why the heavy focus on the URM measurement? I see nothing racist about this article and I'm glad they did this study.

 

[jzrull]

If you want house officers to be extra nice to you, go to a social mission hospital. If you want to live, go to Hopkins.

This is what is wrong with our health care system.

 

[FaLoRe]

I would also like to point out that Asians and Jews, 50-60 years ago were underrepresented as well, and now make up a significant, if not dominate proportion of the professional make up, all without preferential admission or URM status.

Furthermore, I take issue with the notion that I have something against URM students. I don't. I take issue with a system that keeps certain ethnicities dependent on a administrative crutch until the inevitable time that they are forced to perform without some affirmative action program (which if the AA proponents had their way, would never happen). What does it communicate when we essentially say that the only way a black student can achieve success is if we lower acceptance and grading standards from cradle to grave? How is that supposed to enhance the ability of future generations? AA programs serve no other role than to allow the institution to proclaim that it is sufficiently "diverse", without having serious concern for the future of its students.

Oh, and I got into medical school on the first try, so Falore's ad hominem is completely baseless.

I'm genuinely sorry if I offended you, it was my attempt at making a jab & I senselessly missed & hit below the belt. I don't know you, so I was clearly wrong to make those baseless claims. I agree with the bolded parts & much of what you said in that paragraph. I really think a level playing field should be established, instead of lowering standards.

 

[seelee]

No worries. I do have to say though that this is a rarity on SDN.

Cheers.

 

[schrizto]

Really? Call me racist if you want. I really don't give two pieces of dog **** about that word because it is tossed around so carelessly in the face of ideological disagreement that it has become all but meaningless, but I digress.

Before I respond, why do you think that schools have an academic requirement if not to ensure that the students will be able to handle the rigor of medical school? So which is a more unreasonable claim, that a student (any student) who has lower stats is more likely to struggle in medical school, and more likely to score lower on boards, or that being exposed to poverty, violence, etc. will make up for academic shortcomings?

I would also like to point out that Asians and Jews, 50-60 years ago were underrepresented as well, and now make up a significant, if not dominate proportion of the professional make up, all without preferential admission or URM status.

Furthermore, I take issue with the notion that I have something against URM students. I don't. I take issue with a system that keeps certain ethnicities dependent on a administrative crutch until the inevitable time that they are forced to perform without some affirmative action program (which if the AA proponents had their way, would never happen). What does it communicate when we essentially say that the only way a black student can achieve success is if we lower acceptance and grading standards from cradle to grave? How is that supposed to enhance the ability of future generations? AA programs serve no other role than to allow the institution to proclaim that it is sufficiently "diverse", without having serious concern for the future of its students.

Oh, and I got into medical school on the first try, so Falore's ad hominem is completely baseless.

I'm not trying to disagree with you. If you look back, I did say that being exposed to violence alone doesn't mean it will result in someone becoming a good doctor (before you quoted me and said the same thing).

But to say that being exposed to poverty won't make up for academic shortcomings... now come on, if you think about it in some cases it should. Studying and taking the MCAT, attending school, it all costs money. Now take someone whose family is low income and doesn't emphasize education so the student has to find their own way around, work extra jobs to pay their own tuition, and self study for the MCAT because a prep course isn't even an option... don't you think their numbers might end up being lower than someone with similar intelligence but had parents who were willing to shell out lots of money for an education?

Besides, we are not taking about URMs being admitted with absolutely horrible stats here. There is still a standard, albeit lower than that of the general pool, but that standard is still high enough that these URM admits end up being competent doctors.

Btw, you said Asians and Jews were underrepresented in medicine 50-60 years ago. Well, this was due to discrimination on the part of the institutions, not because of a quality of the Asian and Jewish applicants themselves. The cultures of Asian and Jewish families tend to heavily emphasize and invest in education (even back then) while in many URM families it is not.

 

[Charles_Carmichael]

So far in this thread I've only seen one positive review of this study, and the rest have just been negative, just critiquing the study. I have a feeling that this wouldn't be the case if the rankings were reversed. Why is that? Maybe those that are against this article didn't like the way "social mission" was defined. But URM wasn't the only measurement in this study they also focused on physicians practicing in primary care and HPSAs (health professional shortage areas) too, which involves everyone not just urm. So why the heavy focus on the URM measurement? I see nothing racist about this article and I'm glad they did this study.

Um what? You do realize that the rankings are essentially reversed in the USNews rankings right? And most people on SDN seem to realize how worthless those rankings are too. Reread several of the posts in this thread and the previous thread discussing this topic where users (including myself) have mentioned that the social mission ranking is just as useless as the US News ranking.

Also, who is to say that focusing more on research is of a lower "social value" than being a PCP? If they called this a primary care ranking, it would make more sense. But by calling it a social mission ranking, they essentially make the suggestion that research/academics are of a lower social value than being a PCP. A little funny because all those clinical guidelines PCPs follow are a result of extensive research.

 

[seelee]

I'm not trying to disagree with you. If you look back, I did say that being exposed to violence alone doesn't mean it will result in someone becoming a good doctor (before you quoted me and said the same thing).

But to say that being exposed to poverty won't make up for academic shortcomings... now come on, if you think about it in some cases it should. Studying and taking the MCAT, attending school, it all costs money. Now take someone whose family is low income and doesn't emphasize education so the student has to find their own way around, work extra jobs to pay their own tuition, and self study for the MCAT because a prep course isn't even an option... don't you think their numbers might end up being lower than someone with similar intelligence but had parents who were willing to shell out lots of money for an education?

Besides, we are not taking about URMs being admitted with absolutely horrible stats here. There is still a standard, albeit lower than that of the general pool, but that standard is still high enough that these URM admits end up being competent doctors.

Btw, you said Asians and Jews were underrepresented in medicine 50-60 years ago. Well, this was due to discrimination on the part of the institutions, not because of a quality of the Asian and Jewish applicants themselves. The cultures of Asian and Jewish families tend to heavily emphasize and invest in education (even back then) while in many URM families it is not.

If you compare two students, one who has developed the ability to study long hours, absorb large quantities of information, and then apply that information in the correct setting; and another who has not achieved any of those things but has come from a "rough" background. That second student will still struggle academically. Yes he may have a similar innate intelligence (if there is such a thing) and a similar potential, but what matters is if he is at the level he needs to be in order to succeed in medical school, and despite all the wishful thinking in the world, coming from a rough neighborhood does not change that level. The student either can or can't handle the material, the only way to determine that is if he has been able to do it in the past.

And regarding Jews and Asians verses URMs. Perhaps you are right, but what is the best way to influence those cultures to place a higher value on education? Is it to continue to accept a lower standard, or to expect the same standard from everyone and allow the culture to rise and meet it? Claiming the former is like expecting a person to spend their life in a power chair, and then be able to run a marathon.

 

[schrizto]

If you compare two students, one who has developed the ability to study long hours, absorb large quantities of information, and then apply that information in the correct setting; and another who has not achieved any of those things but has come from a "rough" background. That second student will still struggle academically. Yes he may have a similar innate intelligence (if there is such a thing) and a similar potential, but what matters is if he is at the level he needs to be in order to succeed in medical school, and despite all the wishful thinking in the world, coming from a rough neighborhood does not change that level. The student either can or can't handle the material, the only way to determine that is if he has been able to do it in the past.

And regarding Jews and Asians verses URMs. Perhaps you are right, but what is the best way to influence those cultures to place a higher value on education? Is it to continue to accept a lower standard, or to expect the same standard from everyone and allow the culture to rise and meet it? Claiming the former is like expecting a person to spend their life in a power chair, and then be able to run a marathon.

Who said that the student who comes from a "rough" background won't have developed these skills as well as the student without that rough background? Numbers don't always tell the full story. Say both students developed the skill to study long hours and absorb information, but the more disadvantaged one can't study as often because he has to work an extra job.

And a good way to bring up the emphasis on education is to provide well-educated mentors and other bastions of the community into said cultures. An educated parent is much more likely to urge for an education in their children. That is why we need to accept a lower standard for now to narrowen that gap, so more URMs can become educated and influence the next generation to aim for an education as well. If institutions were to set all applicants to the same standard as you suggest, many URMs would just continue to be shut out. Making a culture rise and meet to an accepted standard is a very gradual process.

 

[eablackwell]

If you want house officers to be extra nice to you, go to a social mission hospital. If you want to live, go to Hopkins.

My MCAT is not high enough for Hopkins, but I'm somewhat attached to life. Please advise.

 

[Brigade4Radiant]

The lowered standard is only for admittance not passing through medschool also for URMs to be accepted their stats have to be close enough to the avg. Also nearly all URMs pass medschool when given admittance. Urms also only make 11% of most medschool classes and have stats equal to the avg D.O. Also about 8% of Medstudents are ORMs with stats equal and lower than the avg URM stats.

 

[seelee]

Who said that the student who comes from a "rough" background won't have developed these skills as well as the student without that rough background? Numbers don't always tell the full story. Say both students developed the skill to study long hours and absorb information, but the more disadvantaged one can't study as often because he has to work an extra job.

And a good way to bring up the emphasis on education is to provide well-educated mentors and other bastions of the community into said cultures. An educated parent is much more likely to urge for an education in their children. That is why we need to accept a lower standard for now to narrowen that gap, so more URMs can become educated and influence the next generation to aim for an education as well. If institutions were to set all applicants to the same standard as you suggest, many URMs would just continue to be shut out. Making a culture rise and meet to an accepted standard is a very gradual process.

I'll give you that numbers don't always tell the whole story. But what about the white student who has to work an extra job? He doesn't get the URM status. What about the black students who come from more affluent neighborhoods. It is a pretty raw generalization to say that all black students are in need of additional consideration. What if the black student didn't work an extra job? How do you distinguish "lack of ability" from "lack of opportunity"? How do you know that the applicant isn't just flat out lying about his "tough" time. It isn't hard to put together a sob story to explain your bad performance. And what does that say to all the people, URM or not, who had just as bad, if not worse, a time and managed to get the grades?

No, numbers do not tell the whole story, but it is the best way of objectively measuring how well a student can perform.

And yet you are still clinging to the notion that the Black and Hispanic communities cannot increase their presence without a crutch. Never mind that it highlights racial difference, never mind that it fosters resentment by other races. Never mind that it has never been shown to have any effect on the cultures view of education, the dogma that you are spouting has been repeated so often that it must be true right?

 

[schrizto]

I'll give you that numbers don't always tell the whole story. But what about the white student who has to work an extra job? He doesn't get the URM status. What about the black students who come from more affluent neighborhoods. It is a pretty raw generalization to say that all black students are in need of additional consideration. What if the black student didn't work an extra job? How do you distinguish "lack of ability" from "lack of opportunity"? How do you know that the applicant isn't just flat out lying about his "tough" time. It isn't hard to put together a sob story to explain your bad performance. And what does that say to all the people, URM or not, who had just as bad, if not worse, a time and managed to get the grades?

No, numbers do not tell the whole story, but it is the best way of objectively measuring how well a student can perform.

And yet you are still clinging to the notion that the Black and Hispanic communities cannot increase their presence without a crutch. Never mind that it highlights racial difference, never mind that it fosters resentment by other races. Never mind that it has never been shown to have any effect on the cultures view of education, the dogma that you are spouting has been repeated so often that it must be true right?

You seem to see things in only black and white. That white student who has to work an extra job may not get URM status, but his circumstances are still considered. Yes, it's an enormous generalization to say that all URMs are in need of additional consideration, but for the most part it's true. Overall, the distribution of the GPAs and MCATs of URMs applying to medical school does not match the distribution of white or Asian applicants. AA is an imperfect system, but it's still needed to diversify medicine. And before you get on with the whole sacrificing competency for diversity rant, unless you have solid evidence that AA has resulted in subpar medical students and doctors you really don't have much of an argument.

How do you suggest Black and Hispanic communities increase their presence in medicine without some form of AA? Thus far, it looks like you want all applicants held to the same numerical standards. And you know what? Doing so would also "highlight racial differences" and "foster resentment by other races" (quoting what you say is a result of AA) but in this case the other way around because there would be fewer URMs in medical school.

Never mind that it has never been shown to have any effect on the cultures view of education

I'm really, really surprised that you would say this and wonder if you have actual evidence to back this up.

 

[pennstate4life]

Ok kids let's stop blaming everything on race. Barrack Obama is president now. Yah Yuayy

 

[Simplify]

Why don't we make a URM category to help increase the number of white people in professional sports? Sounds ridiculous, right? The problem here is the notion that the color of a doctor's skin matters. It doesn't and anyone here arguing that it does is a racist. A patient that won't talk to a doctor with a different skin color is a racist. If a white patient refused to see a black doctor it'd be called racism. The reverse holds true. The whole prospect is utterly ridiculous. The most qualified candidate should always get the job and their skin color shouldn't mean jack.

 

[Simplify]

...accomodating a racially insecure society does nothing to change the problem. All it does is legitimize and promote separatism when we should all be learning to live together.

 

[schrizto]

Why don't we make a URM category to help increase the number of white people in professional sports? Sounds ridiculous, right? The problem here is the notion that the color of a doctor's skin matters. It doesn't and anyone here arguing that it does is a racist. A patient that won't talk to a doctor with a different skin color is a racist. If a white patient refused to see a black doctor it'd be called racism. The reverse holds true. The whole prospect is utterly ridiculous. The most qualified candidate should always get the job and their skin color shouldn't mean jack.

...accomodating a racially insecure society does nothing to change the problem. All it does is legitimize and promote separatism when we should all be learning to live together.

I think people wish it were that easy.