Why so little discussion of class?

[Mad Jack]

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I recognize that I will be in a crappy social situation no matter what lol. No matter which medical school I attend, there will be an elitist mentality prevalent. But, the alternative is to not attend a professional school or further my education, and I don't exactly fit in with the "bachelors and done" crowd, either. I think a nice balance is to attend medical school, but attend the best one I can that also minimizes its elitism as much as possible.

It'll be a little bit of a culture shock, but you get over it. Once you get past the superficialities, most people (rich, poor, and everything in between) are pretty much the same at their core. Sure, you may have never been shark fishing, set foot in a country club, seen all of Europe, or paid to hunt hobos from a helicopter, but you still want to make a difference in the world, probably have a family, make it through medical school, etc etc. People are more alike than they are different, regardless of class.

 

[Rogert]

Begin Rant:

How will things ever change if capable SES-disadvantaged applicants don't apply or refrain from attending elite schools to avoid a possible social misfit? This is precisely the type of diversity elite schools try to encourage. SES-disadvantaged applicants attending elite schools is the ideal of meritocracy embodied. And many, many SES-advantaged students welcome that diversity with open arms. Sure, they might make some bone-headed statements that reflect their sheltered upbringings -- but that's an opportunity to change minds and broaden horizons. There will be micro-aggressions - but many will be accidental. Again, an opportunity to educate. That's why the elite schools truly try to bring in a diverse student body.

Why stay in a 'lower tier' environment if you're capable of better? Because it's more 'comfortable' socially? Because it fits your inner monologue of 'not worthy'? Because you think you can't break some imaginary glass ceiling? Self-segregating attitudes like that perpetuate the class divide as much as micro-aggressions from the top-down.

The American ideal is of a pure meritocracy. To move closer to that ideal, both sides need to embrace it and act accordingly.

End Rant

Because the benefit to them isn't worth the cost to me. My energy would be better spent helping those who actually need help, like the child rachie once was; which does not require me to culturally isolate myself among my peers.

It's partially because I question the concept of "lower tier." What makes the "top tier" any better for me? What school you went to is irrelevant to physician performance. So yes, it is because it's more comfortable socially. Our time and energy is better spent basically anywhere than trying to educate our peers. If they want o diversify their outlook, let them do it on their own time and energy.

 

[mehc012]

Because the benefit to them isn't worth the cost to me. My energy would be better spent helping those who actually need help, like the child rachie once was; which does not require me to culturally isolate myself among my peers.

Our time and energy is better spent basically anywhere than trying to educate our peers. If they want o diversify their outlook, let them do it on their own time and energy.

It's not just a benefit for them...it benefits future people in your position.
Again, you are free to make your own assessment of what's worthwhile to you, I'm not trying to say you should make any choice other than the one you are making. I'm just trying to clarify what that choice is. It is not just beneficial to the advantaged students. It is beneficial to future disadvantaged ones, and to the future patients of your peers.

It'll be a little bit of a culture shock, but you get over it. Once you get past the superficialities, most people (rich, poor, and everything in between) are pretty much the same at their core. Sure, you may have never been shark fishing, set foot in a country club, seen all of Europe, or paid to hunt hobos from a helicopter, but you still want to make a difference in the world, probably have a family, make it through medical school, etc etc. People are more alike than they are different, regardless of class.

It's partially because I question the concept of "lower tier." What makes the "top tier" any better for me? What school you went to is irrelevant to physician performance. So yes, it is because it's more comfortable socially.

Having gone to the ridiculously extreme elitist for undergrad, I've got to agree with Mad Jack here...there's some whiplash up front, but things even out pretty quickly. To be honest, a more typical reaction for me was surprise and even feeling badly at how little people knew how to deal with. I never felt more capable than when surrounded by those who never had to do for themselves.
As for the 'what makes the top tier any better?' part...don't underestimate the power of a large, student-focused budget. It can make a world of difference to your personal experience. And, of course, connections. Choose to forgo them, sure, but don't make the mistake of dismissing them as trivial.

 

[Rogert]

It's not just a benefit for them...it benefits future people in your position.
Again, you are free to make your own assessment of what's worthwhile to you, I'm not trying to say you should make any choice other than the one you are making. I'm just trying to clarify what that choice is. It is not just beneficial to the advantaged students. It is beneficial to future disadvantaged ones, and to the future patients of your peers.



Having gone to the ridiculously extreme elitist for undergrad, I've got to agree with Mad Jack here...there's some whiplash up front, but things even out pretty quickly. To be honest, a more typical reaction for me was surprise and even feeling badly at how little people knew how to deal with. I never felt more capable than when surrounded by those who never had to do for themselves.
As for the 'what makes the top tier any better?' part...don't underestimate the power of a large, student-focused budget. It can make a world of difference to your personal experience. And, of course, connections. Choose to forgo them, sure, but don't make the mistake of dismissing them as trivial.

I'm not going to look down on anyone for not making the same choices as me. If rachie gets in to HMS, I'll support them in anyway I can. I just don't think it's effective because I disagree that it's that beneficial to future disadvantaged students. The effect we have would be like a drop of food coloring in a lake. You'll notice it and it'll stick around for a minute or two but it'll disappear. Now, if we flood the lake (10-15% seems like a reasonable arbitrary number), then something noticeable might happen but that's a situation decades in the future.

From what I've read on here, connections only matter for academic medicine and those trying to get into large organizations. If that's what you want, you should probably try to get into the biggest name you can. But that's not for everyone. And if you want to be involved in the community helping kids like those we once were, those places aren't going to give you the leash and free time to make it happen.

 

[Affiche]

We all just have different priorities here, that's all. I agree and disagree parts of just about every post here.

My undergraduate institution wasn't just temporary whiplash that eventually evened out, but was pervasive throughout all four years. In fact, during my senior year I was told that I could not review my exam (in a public health class, nonetheless!) because I was working during the office hours the professor designated as "review your exam" times. Had to work during those times? Too bad. It was similar for any review sessions that were held. This is just one example of many.

Personally, my focus will be on serving disadvantaged communities. I couldn't care less about academia. Because of that, I feel I would thrive in an environment that had a similar focus and perhaps even feel hindered in one that doesn't value this as much. I don't care how "top" a school is if its focus is on academia when mine is on the community. I want my personal mission to be understood and supported.

 

[mehc012]

I'm not going to look down on anyone for not making the same choices as me. If rachie gets in to HMS, I'll support them in anyway I can. I just don't think it's effective because I disagree that it's that beneficial to future disadvantaged students. The effect we have would be like a drop of food coloring in a lake. You'll notice it and it'll stick around for a minute or two but it'll disappear. Now, if we flood the lake (10-15% seems like a reasonable arbitrary number), then something noticeable might happen but that's a situation decades in the future.

From what I've read on here, connections only matter for academic medicine and those trying to get into large organizations. If that's what you want, you should probably try to get into the biggest name you can. But that's not for everyone. And if you want to be involved in the community helping kids like those we once were, those places aren't going to give you the leash and free time to make it happen.

Cool. Well, we're going to agree to disagree. I think you're making a lot of generalizations and assumptions, but I think the only real thing we're clashing on here is the framing. Your decisions may all work out for what you want, but you consistently fail to note the background goals inherent in your statements. For example, you say "top tier doesn't matter" rather than "I plan to go into xyz, so top tier doesn't matter in my situation". The latter is a solid statement. The former I would fight you on.
Similarly, you have decided that helping kids is the only viable route to change, so you deem other efforts as pointless. I disagree with the first point, so when I say I want to make a change, I don't necessarily mean "I want to work with community kids" (though I also disagree with your generalization about academic jobs having leash for community service work).


The bolded is the only part I think we could have a meaningful discussion on in here. I neither see the situation as bleakly as you do, nor do I think that progress 10yrs in the future is a waste of effort. If you want to keep up the discussion on that point, I'm all ears, but I think the rest of it is going to be fruitless.

 

[Mad Jack]

I'm not going to look down on anyone for not making the same choices as me. If rachie gets in to HMS, I'll support them in anyway I can. I just don't think it's effective because I disagree that it's that beneficial to future disadvantaged students. The effect we have would be like a drop of food coloring in a lake. You'll notice it and it'll stick around for a minute or two but it'll disappear. Now, if we flood the lake (10-15% seems like a reasonable arbitrary number), then something noticeable might happen but that's a situation decades in the future.

From what I've read on here, connections only matter for academic medicine and those trying to get into large organizations. If that's what you want, you should probably try to get into the biggest name you can. But that's not for everyone. And if you want to be involved in the community helping kids like those we once were, those places aren't going to give you the leash and free time to make it happen.

Many top-tier schools both actively recruit, and provide substantial scholarships for, disadvantaged students, specifically to provide diversity and hopefully some understanding of what things are like outside the high SES bubble. The other thing is, connections can help you with a lot more than just snagging an academic career- they can help you get better jobs, obtain the residency of your choosing, even get you access to people that can influence political or hospital policy in a way that benefits the subgroups you want to serve. Plus, and I hate to throw around this old trope, you never know what you want to do until you're sitting in the shoes of medic student that's trying to decide yiur own future. You might wabt to go into academics specifically to be a mentor and recruiter of students similar to yourself, or to have hours that are more compatible for your family life, or because the excellent benefits might help your children gain access to college resources that would otherwise be unavailable to them.

 

[mehc012]

We all just have different priorities here, that's all. I agree and disagree parts of just about every post here.

My undergraduate institution wasn't just temporary whiplash that eventually evened out, but was pervasive throughout all four years. In fact, during my senior year I was told that I could not review my exam (in a public health class, nonetheless!) because I was working during the office hours the professor designated as "review your exam" times. Had to work during those times? Too bad. It was similar for any review sessions that were held. This is just one example of many.

I guess those sorts of issues (the time constraints of having a job) are not something I see as elitism, but rather reality. That could just as easily be an issue at a large state school (perhaps moreso...larger schools tend to be less forgiving of personal circumstances, from what I've seen). If you're including those sorts of things, I'd argue that the wealthier, more elite schools are actually the ones best able to combat the problems.
For example, my school limited work study hours so you didn't see such schedule clashes. It also included travel expenses and personal expenses in the finaid budget and bought your textbooks for you if you were low SES. If your EFC was zero, these budgets actually came to you in the form of a check so you could pay for what you needed. It was not particularly diverse, but it was generous and attempted to alleviate disparities among students of different backgrounds. This sort of policy is only even possible at a wealthy, elite, school. In fact, I applied to such schools as a low SES high school student because such things were possible there.
There was 'cultural whiplash' when interacting with my peers, many of whom had no concept of a budget (fun when you are paired together on something that requires a small expenditure of personal funds), but that was an attitude/interaction/judgement thing, and that is what I'm referring to.

Personally, my focus will be on serving disadvantaged communities. I couldn't care less about academia. Because of that, I feel I would thrive in an environment that had a similar focus and perhaps even feel hindered in one that doesn't value this as much. I don't care how "top" a school is if its focus is on academia when mine is on the community. I want my personal mission to be understood and supported.

👍

 

[Rogert]

Cool. Well, we're going to agree to disagree. I think you're making a lot of generalizations and assumptions, but I think the only real thing we're clashing on here is the framing. Your decisions may all work out for what you want, but you consistently fail to note the background goals inherent in your statements. For example, you say "top tier doesn't matter" rather than "I plan to go into xyz, so top tier doesn't matter in my situation". The latter is a solid statement. The former I would fight you on.
Similarly, you have decided that helping kids is the only viable route to change, so you deem other efforts as pointless. I disagree with the first point, so when I say I want to make a change, I don't necessarily mean "I want to work with community kids" (though I also disagree with your generalization about academic jobs having leash for community service work).


The bolded is the only part I think we could have a meaningful discussion on in here. I neither see the situation as bleakly as you do, nor do I think that progress 10yrs in the future is a waste of effort. If you want to keep up the discussion on that point, I'm all ears, but I think the rest of it is going to be fruitless.

I apologize about the framing. My arguments do only make sense given that peer efforts are fruitless and that we, in general, have the goal of improving the lives of those who are disadvantaged in the future. You are correct.

I wasn't meaning to imply that progress in ten years wasn't worthwhile. It was an attempt to convey a means by which I thought peer efforts would be effective and that for us, in the here and now, it was irrelevant.

 

[altblue]

Begin Rant:

How will things ever change if capable SES-disadvantaged applicants don't apply or refrain from attending elite schools to avoid a possible social misfit? This is precisely the type of diversity elite schools try to encourage. SES-disadvantaged applicants attending elite med schools is the ideal of meritocracy embodied. And many, many SES-advantaged students welcome that diversity with open arms. Sure, they might make some bone-headed statements that reflect their sheltered upbringings -- but that's an opportunity to change minds and broaden horizons. There will be micro-aggressions - but many will be accidental. Again, an opportunity to educate. That's why the elite schools truly try to bring in a diverse student body.

Why stay in a 'lower tier' environment if you're capable of better? Because it's more 'comfortable' socially? Because it fits your inner monologue of 'not worthy'? Because you think you can't break some imaginary glass ceiling? Self-segregating attitudes like that perpetuate the class divide as much as micro-aggressions from the top-down.

The American ideal is of a pure meritocracy. To move closer to that ideal, both sides need to embrace it and act accordingly.

End Rant

I'm getting way ahead of myself (and am on this board way too much for someone finishing up his last prereq!), but I can see why for a number of reasons, but i'll base it on my undergraduate experience.

1. It's harder to do things with richer peers.
2. Money could be an issue too, so merit aid?
3. Bitterness. As an undergrad, it's difficult to acknowledge that I'm being compared, grade-wise, to those who have been trained their whole childhood to do the same I do. A good friend of mine would catch hell if he got a B+ in high school! My parents just wanted me to have a steady job someday. I'm doing this all on my own, but it is what it is. I can see why disadvantaged students would avoid elite medical schools, since the whole familial lineage thing is probably even stronger there, and to be honest, the idea of an "elite" school does come off as pretentious.
4. The ideal meritocracy doesn't happen in practice, unlike what the pundits insisting otherwise say. I suppose I'm getting into the semantics of it, but I don't think it's fair that talent, which is what I Think you're trying to say, can't come from low-tier or DO schools either.
5. Why would I want to adjust my peers' viewpoints? They can do the research if they want to. It's not like educating them would be of benefit to me.

 

[Rogert]

Many top-tier schools both actively recruit, and provide substantial scholarships for, disadvantaged students, specifically to provide diversity and hopefully some understanding of what things are like outside the high SES bubble. The other thing is, connections can help you with a lot more than just snagging an academic career- they can help you get better jobs, obtain the residency of your choosing, even get you access to people that can influence political or hospital policy in a way that benefits the subgroups you want to serve. Plus, and I hate to throw around this old trope, you never know what you want to do until you're sitting in the shoes of medic student that's trying to decide yiur own future. You might wabt to go into academics specifically to be a mentor and recruiter of students similar to yourself, or to have hours that are more compatible for your family life, or because the excellent benefits might help your children gain access to college resources that would otherwise be unavailable to them.

This is actually part of my argument. We're sought out as a benefit to those who already advantaged, not for our own. In more vitriolic terms, we're their zoo animal or trained monkey (Do the thing where you talk about the importance of a budget!). To me, the cost outweighs the rewards.

 

[Affiche]

I guess those sorts of issues (the time constraints of having a job) are not something I see as elitism, but rather reality. That could just as easily be an issue at a large state school (perhaps moreso...larger schools tend to be less forgiving of personal circumstances, from what I've seen). If you're including those sorts of things, I'd argue that the wealthier, more elite schools are actually the ones best able to combat the problems.
For example, my school limited work study hours so you didn't see such schedule clashes. It also included travel expenses and personal expenses in the finaid budget and bought your textbooks for you if you were low SES. If your EFC was zero, these budgets actually came to you in the form of a check so you could pay for what you needed. It was not particularly diverse, but it was generous and attempted to alleviate disparities among students of different backgrounds. This sort of policy is only even possible at a wealthy, elite, school. In fact, I applied to such schools as a low SES high school student because such things were possible there.

My school wasn't lacking in funds and had a similar policy for dispersing financial aid. My large, wealthy school was best able to combat these problems, but there was so much elitism here that it didn't translate into these problems actually being combated. It wasn't worthwhile for those that have never been disadvantaged. I was in a small school within the university as well, so I can't support the "large schools don't care about students" justification, either. My school is notorious for its elitism, both in its student body and its faculty. The inability to understand that some students have to work outside of classroom time and can't make a Sunday night review session is exactly the sort of thing I would include, because that short-sighted view led to disadvantage for low SES students. I also include things such as my professors pressuring me to do research instead of volunteering for habitat, and seeing the latter as "not as worthwhile". There are lots of things that I include and they have all painted me a pretty disturbing picture of what elitism looks like in education.

 

[altblue]

This is actually part of my argument. We're sought out as a benefit to those who already advantaged, not for our own. In more vitriolic terms, we're their zoo animal or trained monkey (Do the thing where you talk about the importance of a budget!). To me, the cost outweighs the rewards.

I had the most unremarkable application for an Ivy League school and got in anyway. I guess poor people were rare and those upper-middle class students had to get a better perspective.

 

[Mad Jack]

This is actually part of my argument. We're sought out as a benefit to those who already advantaged, not for our own. In more vitriolic terms, we're their zoo animal or trained monkey (Do the thing where you talk about the importance of a budget!). To me, the cost outweighs the rewards.

So you'd rather everyone of lower SES just pass and let the elites be the elites? It's not just an advantage to them, it provides low SES and URM students with the highest quality education and most resources possible so that they can do the most for their communities. It's basically winning all around.

 

[altblue]

My school wasn't lacking in funds and had a similar policy for dispersing financial aid. My large, wealthy school was best able to combat these problems, but there was so much elitism here that it didn't translate into these problems actually being combated. It wasn't worthwhile for those that have never been disadvantaged. I was in a small school within the university as well, so I can't support the "large schools don't care about students" justification, either. My school is notorious for its elitism, both in its student body and its faculty. The inability to understand that some students have to work outside of classroom time and can't make a Sunday night review session is exactly the sort of thing I would include, because that short-sighted view led to disadvantage for low SES students. I also include things such as my professors pressuring me to do research instead of volunteering for habitat, and seeing the latter as "not as worthwhile". There are lots of things that I include and they have all painted me a pretty disturbing picture of what elitism looks like in education.

Yes, I don't have to worry about the basic funding of it, but I still have other issues as well.

My school is very Greek, dues for which are too expensive, and dorms were expensive to live in (tuition was covered, but I'd have to go into to debt to stay in a dorm), so I felt horribly shut out for my first semester. Clubs are very uninvolved socially and kind of resume-building exercises unless you're lucky to find one of more the involved ones.

 

[mehc012]

Yes, I don't have to worry about the basic funding of it, but I still have other issues as well.

My school is very Greek, dues for which are too expensive, and dorms were expensive to live in (tuition was covered, but I'd have to go into to debt to stay in a dorm), so I felt horribly shut out for my first semester. Clubs are very uninvolved socially and kind of resume-building exercises unless you're lucky to find one of more the involved ones.

That is having to worry about the funding of it. If finaid doesn't cover dorms, or they expect a large number of work study hours, that's not a very SES-friendly policy. Whether or not the school can afford an SES-friendly policy is another issue

 

[Rogert]

So you'd rather everyone of lower SES just pass and let the elites be the elites? It's not just an advantage to them, it provides low SES and URM students with the highest quality education and most resources possible so that they can do the most for their communities. It's basically winning all around.

Do a little dance for us and we'll give you a shiny coin (probably)! Someone capable of working for their community is able to do it whether they go to an "elite" school or not. To a lesser degree perhaps, but how much is that extra degree worth? Clearly, I don't think it's worth enough but I wouldn't fault someone for disagreeing. The elites will continue to be the elites until a major demographic change, like the flood I mentioned in my earlier analogy, happens.

 

[Affiche]

So you'd rather everyone of lower SES just pass and let the elites be the elites? It's not just an advantage to them, it provides low SES and URM students with the highest quality education and most resources possible so that they can do the most for their communities. It's basically winning all around.

Not everyone wants to sacrifice their own comfort to be an activist, and that's okay.

 

[Affiche]

That's a SHRUG?! For the longest time, I've thought that little guy was holding up dumbbells!

 

[Rogert]

That's a SHRUG?! For the longest time, I've thought that little guy was holding up barbells!

🤣

 

[mehc012]

That's a SHRUG?! For the longest time, I've thought that little guy was holding up dumbbells!

Oh lord...I use that smiley ALL the time. If we've ever been in the same thread before, you must've thought I was just obsessed with lifting or some ish

 

[Cytokine2014]

It's not America's fault -- (though many other countries do have significantly more class mobility)
And I certainly don't advocate self-victimization. That helps no one.

But for 'The Haves' to denigrate the 'Have Nots' for not being able to just pull themselves up by the bootstraps and dismiss those who don't as less able or less deserving (We all admire those who do/can.) -- well, it's short-sighted, and doesn't acknowledge the very real impacts of what it's like to grow up disadvantaged.

You can't pull yourself up by your bootstraps if you have not boots.

 

[Affiche]

@Cytokine2014 that's the point she was making.

 

[altblue]

That is having to worry about the funding of it. If finaid doesn't cover dorms, or they expect a large number of work study hours, that's not a very SES-friendly policy. Whether or not the school can afford an SES-friendly policy is another issue

Lol, I can still live 30 minutes away in a different part of the city without taking out loans...

 

[hurryskurry]

Real life is probably a lot better, but much more difficult.

There seems to be persistent issues with our social psychology when thinking about class, and the disparity between classes and their ability to maximize their potential. So finding people to talk about it might be hard in the same way that finding people who can admit they are wrong or easily apologize is hard.

 

[pageantry]

Real life is probably a lot better, but much more difficult.

There seems to be persistent issues with our social psychology when thinking about class, and the disparity between classes and their ability to maximize their potential. So finding people to talk about it might be hard in the same way that finding people who can admit they are wrong or easily apologize is hard.

One thing that makes it hard to talk about class is the condescending nonsense people spout when they get a chance.

For some reason this discussion of class has focused on individual economics and genetics (!) but touched very little on systemic racism, sexism, and institutions of power. The current state of medicine owes a lot to powers that systematically excluded women, black people, and poor white men. It continues to exclude those who speak openly about their experiences of rape, molestation, and mental illness--often passed down via an (until recently) intensely racist and sexist psychiatric system. These are also class issues. Not because poor people are inherently stupid or bad, but because of the many amazing ways the rich have discredited and devalued the struggle of the poor to improve their lot.

Seriously, guys, it's great to go to an "elite" institution if you can hack it and get the chance, but let's not pretend fighting over who deserves the chance to dine at the master's table changes what's really going on here.

 

[Cytokine2014]

@Cytokine2014 that's the point she was making.

Yep! Understood. It was a great point. Perhaps I should have said "in other words, X."

🙂