Moved Medical school admissions and race - was: VP pick

[JohnG]

But how does discriminating by race in medical school admissions help alleviate that?

Hi Derec - I want to interject a point here - before you argue against DEI, It's important to know that hiring based on gender and race was already happening before these ideas came into place.

Two wrongs don't make a right.

DEI is an effort to course correct.

No, it is not. It is the same course, just with different groups being discriminated against.

Here lies your impasse to this discussion

 

[Derec]

Every time that this chart is brought up, I mention that there is a different distribution of medical schools that different groups go to. For example, African Americans in significant numbers go to Historically Black universities.

How many of those are there? There's Morehouse, Meharry, any others?

The medical schools there have missions regarding serving in urban, underserved, and/or minority areas and their criteria for admission are less than some other medical schools so far as test scores.

Would they extend those same low admissions standards to, say, an Asian applicant? If not, they are still discriminating by race.

So you can't really take two means, one for African Americans, say for example, and one for Whites, and expect them to be equal for admissions nationally.

If there was no racial discrimination, I would most certainly expect them to be equal. The few black med schools are not enough to throw off the nationwide means that much, which means Emory, MCG etc. are also practicing discrimination. That said, it would be interesting to see school by school stats.

That isn't to say there is nothing at all to the claim being made by the op post so far as some kind of other bias but without eliminating this significant, confounding impact to means of different groups in entrance, the chart isn't any kind of proof.

It is evidence of racial discrimination nationwide. Your contention is that it is only due to a handful of black med schools discriminating against non-blacks, but where is your evidence for that? And even so, Morehouse or Meharry discriminating by race is still wrong.

 

[Derec]

It has a corollary to the utter fear that many racists have when they think about equality. This is not speculation, they say it out loud, so it’s their words, not mine. They fear - truly fear - what it will be like to be victims of the discrimination.

Being victims of discrimination is not "equality" and you also do not have to be "racist" to fear that.

But the truth - clear and demonstrated - is that minorities do not want retribution. They only want equality of opportunity.

Bullshit! They demand racial preferences in admissions as well as in hiring. That is antithetical to "equality of opportunity".

Or, as Ruth Bader Ginsburg said, “I do not ask for special privileges, I only ask that you take your boots off my neck”

And yet she kept voting to keep racial preferences legal. She was obviously lying.

History has shown us that every time minorities have gained equality and inclusion, they have delivered equality and inclusion.

Equality and inclusion are good things. Discriminating against certain people in order to achieve parity (or even hyperparity) is not.

In other words, we’ve never seen anyone “try to decrease numbers” for the sake of decreasing numbers. There’s no rebound, no overcorrection, no vengeance, no retribution. We can see it in example after example after example of when women and minorities finally get to have the occasional member in a position of power, they do not tend to abuse it.

In general female quotas are written as "at least half of positions shall be female". I.e. these policies are written to achieve parity or hyperparity, not equality of opportunities.

No it does not need to maintain intertia. This is where “unless a force is applied to it” has a legislative analog. Create a program, pass a law, fund an avenue. All of these can dispense with the excuse that inertia is the only force we can weild against a problem.

But this "force" is discrimination in the opposite direction. It is not making anything more fair.

 

[Derec]

The otther factors are easily measured. Look at the doctors in underserved communities who stay and put down roots and serve these places long term. Get more people like them. They aren’t high MCAT, high GPA, Type-A ambitious academic wonders, perhaps.

There are whites and Asians who are not "MCAT wonders" either. They could be admitted with the same probability as lower MCAT blacks. But that is not the case. Low MCAT Asians have a very low chance of admissions, while blacks with the same low MCAT have a much higher chance.
This is an older chart that still uses the old MCAT scale, but it still illustrates my point.

As you can see, blacks with 3.2-3.39 GPA and 499-502 MCAT (using this conversion chart) have a similar chance of admission as Asian students with 3.6-3.79 GPA and 510-513 MCAT. Is that just?

The goal is getting health care to more people, not giving degrees to people who won’t work there.

How do you know who will work there? Assuming that blacks and Hispanics "will work there" but Asians and whites will not is just racist prejudice.

 

[Derec]

Here lies your impasse to this discussion

Exactly. I view people as individuals, not mere ciphers for a racial or ethnic identity.
Discriminating in favor of blacks today is not fixing injustices of yesteryear. It is compounding one injustice by adding another, it is not fixing any injustice.

 

[Derec]

You seem to lack some knowledge about medical schools and their applications.

How so?

I’m kind of immersed in this right now as one of my children (White/Appalachian (by some definitions)) is currently applying to medical schools. So we are examining actual entrance requirements for actual real world medical schools in great detail. Including how to write essays that will help you.

I think academic ability is a better predictor of success in medicine than writing essays whose evaluation, beyond basics of proper grammar and spelling, is inherently subjective.

Medical schools *DO* have programs in the first four years of medical school that target and focus on things like primary care. It is explicit in the application process. There are seats in the medical school essentially reserved for people who will enter GP - and classes to target them.

Do you have a link to some such program? In particular, does the medical school somehow prohibit one from applying to non-primary residencies later? I know many medical schools emphasize primary care, but I know that aspiring medical students know how to play that up in essays regardless of their future plans.

You are mis-informed or using out of date information. See above.

I think you are misinformed. Specialties are a function of what residency one matches into.
See The Match.

Many of these programs look for people who match the communities they are trying to serve,
Some explicitly say that if you must be a member of the community or have family ties to the area.

State, not "community" or "area". At least when you talk about med schools. And it is mostly public med schools that restrict eligibility to in state applicants.

So they do not call out race, but the accepted applicants will likely have a different racial make-up than the general applicant pool.

It would average out over all states though.

Both of the white people and that one Asian guy who live in rural mississippi will have a chance, of course.

Are you trying to say that there are few whites in rural Mississippi or what is your point here? Because that's not even true.

If Mr. 4.0/220 White Guy or Asian Guy answers his essay with an obvious lack of understanding of underserved communities, and an obvious lack of compelling backstory on whether they have any intention to serve those communities or capability of being comfortable in those comunities, they will lose out to someone who, perhaps with a lower GAP or MCAT, shows a willingness to serve there and compelling backstory showing they are capable of it.

When you make race part of the "backstory" then obviously you end up discriminating by race.

Here you are again conflating “URM points” with people who are admitted. The percentage of hispanic people admitted will be high, because they are more likely to know spanish. The White Appalachian who speaks spanish (such as my child - also speaks Japanese and ASL) may also get in, but she won’t be in a crowd of hundreds of Appalachian white applicants who can speak spanish, relative to the much larger number of spanish-speaking hispanic applicants.

You are missing my point. It is URM status itself that gives Hispanics and blacks points. Blacks are not likely to know Spanish either, and yet their scores and grades are even worse than for Hispanics.
Your daughter's language skills would give her a small boost over other ORMs, but it will not make up for URM status even for those who don't speak other languages.

Here’s a reason they are less likely, based on my knowledge of my Asian friends and their families: those families value education and status at a much different degree than White or Black families do. They will push their children into the most prestigious position they can. Some of my friends lament this as a real stressor in their upbringing. One friend lamented how dissappointed his parents were that he was not a cardiac surgeon but “only a thoracic surgeon”. For real.

That is wild, if true, but thoracic surgery is still a highly competitive specialty.

This is - of course - not universal of all Americans with Asian ancestry. But it is far more likely than white families, such that an Asian medical school applicant may indeed be less likely to accept long term emplyment as a GP in an underserved neighborhood.

If they match into family medicine there isn't much choice than to work as a GP. Where they work is just like for any job; it depends where you get hired. Unsurprisingly, more people regardless of race want to live in desirable cities rather than Bumfuck, Mississippi.

Yes, I meant 520. Sorry.
Pauses to laugh really hard and mutter, “220, 221, whatever it takes”.

528 or bust!

Already told you.
Asian ancestry people are a lower percent of the rural population than they are of the suburban population.
White people are less likely to have experience in diverse neighborhoods than diverse people are.

What do you mean by "diverse people"?
Why should somebody be penalized based on whether they live in a suburban or rural county? Especially when the definitions of those are fluid.

So when a medical school is selecting for people who will stick it out in those working environments for the long term, and not leave the nano-second that their residency is done, they will pick people who can demonstrate reasons that they are more likely to put down roots and stay.

Stick it out where? Close to the medical school? And why do you think blacks or Hispanics are more likely to do that?

Indeed there is certainly data about what type of people put down roots and stay in those areas. And they are not, typically, people with suburban backgrounds - who are overwhelmingly White and Asian.

Do you have those data? Because it seems to me made up to justify racial discrimination.

You assume it was done “in order to reduce the number of Asians getting accepted,” but the intent behind the measure is speculation on your part.

The Harvard "personality score" scandal was certainly done in order to adjust racial mix of admitted students toward fewer Asians being admitted.

Equally likely is to react to other goals such as who tends to make it through residency with favorable job reviews from their advisors. And if that does not include certain socio-economic backgrounds, that may have significantly different representations in diversity, then the “diversity” numbers will look different.

The personality score thing was for Harvard undergrad. I offered it as an example of similar shenanigans taking part outside of medical school admissions racket.

You have no reason to think you know this in order to do things racially. Maybe in some cases it is. Maybe in some cases they think, “shit, we have been discriminating against these groups for, like, ever. We have to show that we have changed, or the diverse applicants will never consider us. We have to be the change we want to see.”

Do you use "diverse" to mean "non-white"? Because that's not what the word "diverse" means.
Also, present discrimination by race is not justified by past discrimination by race. It's just perpetuating injustice.

And then they acknowledge that they will have to listen to whiners who can’t abide that they want to change fast. Wanh! No! It should be a slow curve! Only natural changes to fix artificial problems!!

Since any solution to the achievement gap starts in early childhood, it will be a slow process. Applying lower standards to certain applicants based on race and ethnicity may mask the problem, but it is not fixing it.

And again, one does not commit to a particular specialty upon application.

You are wrong, see above.

No, it happens during residency match.

You are wrong, see above.

No, you see above, where I linked to a video about the Residency Match.

Also, in another post you proposed that medical schools should change the residencies if they want more GPs,

Residencies and med schools are separate. And residencies are mostly funded by Medicare, so Congress could expand GP residency slots by increasing funding for them.

but this will obviously not solve the problem as people are not required to stay in the area of their residency after completion, and so the underserved areas will continue to have to replace their healthcare force regularly and at great cost, unless they can select in medical school for applicants who have a passion and a reason to commit to serving these areas.

I do not see how medical schools can control where somebody will work say a decade after graduation.
More GP residency slots would mean more GPs. Yes, residencies do not control where one will work. That can only happen by funding rural medical centers and hospitals and make those positions more attractive.

And you will once again claim that medical schools don’t target specialties upon application and that there’s no reason white or Asian applicants will eschew underserved care at a different rate, as if you had never read an explanation of why that is demonstrably so.

They may target certain specialties. That does not change the fact that specialties are locked in at The Match, not when somebody applies for med school.
And it does not justify discriminating against Asians and whites merely because you think they are less likely to work in underserved areas.

 

[Derec]

First - may I remind you that they are not “girls”. They are women. They are adult, post-pubescent humans. It’s time to stop infantilizing women by calling them children.

"Girl" is commonly used in the English language for young adult women.

 

[Derec]

Medical students typically choose their specialty (s) in their 3rd year of a 4 year degree before moving onto residencies.

They typically chose which specialty they would like to pursue by then, and often even earlier.
But they are not guaranteed to match into that specialty until match day in March of their 4th year. The Match is between them and the residency program, not the med school.

 

[Derec]

But white and Asian students do NOT need higher scores to get into any medical school.

AAMC data contradicts that claim.

 

[Derec]

It’s been explained to you more than once in this thread that it is not discrimination to use more criteria than GPA and MCAT scores to admit students

Nobody is arguing against that. But race and ethnicity, nor gender, should be among those criteria.

and that the differences in scores are small and not predictive of who will make a good physician.

The differences are not small and they are predictive of med school performance.
The Validity of MCAT Scores in Predicting Students' Performance and Progress in Medical School: Results From a Multisite Study
Take this paper. I do not have access to the full text, only the abstract.

Researchers reported medium to large correlations between MCAT total scores and medical student outcomes. Correlations between total UGPAs and medical student outcomes were similar but slightly lower. When MCAT scores and UGPAs were used together, they predicted student performance and progress better than either alone. Despite differences in average MCAT scores and UGPAs between students who self-identified as White or Asian and those from underrepresented racial and ethnic groups, predictive validity results were comparable. The same was true for students from different socioeconomic backgrounds, and for males and females.

Not every prospective medical student is willing to pursue the less high paying positions in general practice, pediatrics, internal medicine or ob/gyn care.

What data do you have that suggest that this willingness is higher for URMs over ORMs?

But no one can understand these things for you.

Ditto.

 

[Derec]

No, not racist or sexist. This is all based on scientific observation and statistical analysis.

[citation needed]

 

[laughing dog]

Medical students typically choose their specialty (s) in their 3rd year of a 4 year degree before moving onto residencies.

They typically chose which specialty they would like to pursue by then, and often even earlier.

Which was the point you disputed.

 

[Toni]

It’s been explained to you more than once in this thread that it is not discrimination to use more criteria than GPA and MCAT scores to admit students

Nobody is arguing against that. But race and ethnicity, nor gender, should be among those criteria.

and that the differences in scores are small and not predictive of who will make a good physician.

The differences are not small and they are predictive of med school performance.
The Validity of MCAT Scores in Predicting Students' Performance and Progress in Medical School: Results From a Multisite Study
Take this paper. I do not have access to the full text, only the abstract.

Researchers reported medium to large correlations between MCAT total scores and medical student outcomes. Correlations between total UGPAs and medical student outcomes were similar but slightly lower. When MCAT scores and UGPAs were used together, they predicted student performance and progress better than either alone. Despite differences in average MCAT scores and UGPAs between students who self-identified as White or Asian and those from underrepresented racial and ethnic groups, predictive validity results were comparable. The same was true for students from different socioeconomic backgrounds, and for males and females.

Not every prospective medical student is willing to pursue the less high paying positions in general practice, pediatrics, internal medicine or ob/gyn care.

What data do you have that suggest that this willingness is higher for URMs over ORMs?

But no one can understand these things for you.

Ditto.

Figure 11. Percentage of U.S. medical school matriculants planning to practice in an underserved area by race/ethnicity, academic year 2018-2019

Figure 11 displays the percentage of 2018-2019 matriculants planning to practice in an underserved area by race/ethnicity.

www.aamc.org

 

[Derec]

Which was the point you disputed.

As usual, you are wrong.
I was disputing the point that med schools graduate students into a particular specialty. They graduate MDs (or DOs) which are general medical degrees. Their specialty is based on the residency they matched into and have to successfully complete. It has nothing to do with their med school.

 

[laughing dog]

Which was the point you disputed.

As usual, you are wrong.
I was disputing the point that med schools graduate students into a particular specialty. They graduate MDs (or DOs) which are general medical degrees. Their specialty is based on the residency they matched into and have to successfully complete. It has nothing to do with their med school.

There you go again with hair splitting. You denied people graduated from medical school.

 

[Derec]

Figure 11. Percentage of U.S. medical school matriculants planning to practice in an underserved area by race/ethnicity, academic year 2018-2019

Figure 11 displays the percentage of 2018-2019 matriculants planning to practice in an underserved area by race/ethnicity.

www.aamc.org

Interesting. I would like to know how these numbers correlate with where people actually end up working.
And I also do not think that justifies discriminating against white and Asian students. Regardless of one's declarations when applying to med school, where one works depends on how many jobs are open in certain areas. You can't hire a physician at Bumfuck Medical Center unless that position exists and is funded. And if it exists and is funded, somebody will be hired for it. Sure, most people will apply in desirable urban areas, more than positions are available, and those that don't get hired will apply elsewhere. Whether or not they indicated desire to work in Bumfuck.

Note also that discrepancies between average grades and scores in med school are similar to discrepancies in undergraduate education. So healthcare-specific explanations do not hold water.

 

[Derec]

There you go again with hair splitting.

No, you are.

You denied people graduated from medical school.

I have not! That is a preposterous interpretation of what I wrote, even accounting for your reading comprehension skills.
I denied people graduate medical school as a "cardiothoracic surgeon" or similar. Which they don't. And the distinction between med schools and residencies is hardly splitting a hair. More like splitting a giant log.

 

[JohnG]

Here lies your impasse to this discussion

Exactly. I view people as individuals, not mere ciphers for a racial or ethnic identity.
Discriminating in favor of blacks today is not fixing injustices of yesteryear. It is compounding one injustice by adding another, it is not fixing any injustice.

It’s not yesteryear - it’s happening right now. Of this there is no debate. The data is very clear.

I really think that this is the piece of the puzzle you are missing

 

[Derec]

It’s not yesteryear - it’s happening right now. Of this there is no debate. The data is very clear.

What is happening right now is discrimination against whites and Asians.
What "data" did you have in mind?

I really think that this is the piece of the puzzle you are missing

Show me this alleged "piece".

 

[Rhea]

Interesting. I would like to know how these numbers correlate with where people actually end up working.

You could look it up yourself, instgead of living in a bubble of bias. The web search engines are free.

Recruiting and Retaining Primary Care Physicians in Urban Underserved Communities: The Importance of Having a Mission to Serve - PMC

Objectives. We examined factors influencing physician practice decisions that may increase primary care supply in underserved areas. Methods. We conducted in-depth interviews with 42 primary care physicians from Los Angeles County, California, ...

www.ncbi.nlm.nih.gov

Results. Three major themes emerged in relation to selecting geographic- and population-based practice decisions: (1) personal motivators, (2) career motivators, and (3) clinic support. We found that subthemes describing personal motivators (e.g., personal mission and self-identity) for choosing a practice were more common in responses among physicians who worked in underserved areas than among those who did not. By contrast, physicians in nonunderserved areas were more likely to cite work hours and lifestyle as reasons for selecting their current practice location or for leaving an underserved area.

Conclusions. Medical schools and shortage-area clinical practices may enhance strategies for recruiting primary care physicians to underserved areas by identifying key personal motivators and may promote long-term retention through work–life balance.

Conclusion: If you care about having medical providers in underserved areas, since “where the jobs are” doesn’t matter when there are jobs all over the place, but a huge percent are unfilled in underserved areas compared to a small number in highly served areas, hence the “under” and “highly” parts of “served,” If you care about that, you make sure people with key personal motivators get into medical schools. And this is not indicated by MCAT and GPA numbers.