One way that could justify racial discrimination is to make admissions unattainable for person X who was born under crappy circumstances, through no fault of his own. Then X, given his crappy birth circumstances is limited to a less-than high school education because highly qualified teachers don’t want to work where he lives. Additionally, X will need to face other challenges such as food insecurity because he lives in a food desert, high crime rate due to the low resource area that he lives in, and many peers with absent parents because of systemic let downs who make the class environment hardly compatible with academic success. Person X needs to work to help support the family and cannot afford to pay for SAT tutor. He gets a lower SAT score than other students across the state with private SAT tutors and a healthy diet of fruits and veggies. Kids with large supportive networks of people who have all managed to attain an education in relatively safe conditions. He does relatively well and maybe scores enough to get into a college with some aid, but not enough for a substantial merit based scholarship.
X maybe makes it out of his residential area to attend a college somewhere. He could very well be the only one that’s made it this far, many having fallen through the cracks for a multitude of reasons including poor social support structures, or even adverse health outcomes in the family. Statistically, person X has a very highly likelihood of being uninsured for some reasons stated above and many more that I won’t list, or just having poor health outcomes because of poor access to health related education, or other difficult circumstances.
In college, while other folks are drinking and partying and doing whatever with some idea of their options, X is in an entirely new domain. He has almost no one with reliable experience about what is and what isn’t available to him in college. He also has to work to support himself and maybe his family. If he decides that he wants to do medicine, well then he has to start checking off boxes. But he still has all the other stuff to deal with. He can not afford to lose his job, he has to find some way to get to and from his work / volunteering/ whatever else he needs for premed. He doesn’t have a reliable mentor or the social capital to just randomly shadow a physician. In fact, he’s likely never met a physician outside of the hospital, especially one that looks like him.
Now comes the MCAT. Given aforementioned social situation, he can not afford the time or money for the $$$ it takes to pay for tutoring services for the MCAT. He gets a 506. Not the best score, but one that technically meets the minimum score as set out by AAMC for success in med school.
He applies to a few schools. He describes his road travelled. An actual adcom reads his story and realizes that someone being able to score a 506, despite everything else he has going on, is probably going to bring a valuable experience to the class.
He is given a chance to go back and end the vicious cycle that he was born into. He now becomes the one doctor that Person Z will see and realize that they too can be something more than society has been led to believe. He goes back and works in that ****-hole neighborhood that other physicians won’t want to practice in. He makes an actual difference for his community.
And in turn, a little dent is made in the health care system for his community. Physician distrust is lessened for his smaller community. With other few success stories in different fields, maybe someone else can be the first grocery store in this food desert. Or a teacher who was given the opportunity comes back and inspires children the way she wasn’t inspired. And in that way, maybe preventative care in it’s messiness becomes more disseminated or at least better accessed. Less ERvisits for chronic preventable disease, etc.
