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Thursday, April 08, 2004

 
Diversity in Medical School

The New Physician’s April 2004 issue includes an article on Affirmative Action in medical school admissions programs entitled ‘Reaching Diversity’. Recently, the US Supreme Court (pdf file) decided that it is Constitutionally allowable to consider race in higher education admissions and in doing so managed to both somewhat settle, at least temporarily, the legal issues and fan the flames of ‘discussion’ about this highly contentious and important issue.

Let’s cut to the chase. In my opinion all decisions concerning whom we admit to medical school must come down to the answer to one simple question: Does he/she have the personal attributes that will best insure excellence as a doctor? Anything else is at best neutral and at worst harmful.

The list of such attributes is extremely difficult to 1) generate, 2) agree on and is 3) highly subjective. Nonetheless, it is necessary that we do our best in determining what is important to insure that we end up with the best doctors possible. Any less is both irresponsible and dangerous.

I have heard it said that, “Our diversity is our strength.” I believe that diversity is a great thing and has certainly contributed to any number of wonderful things about this country. It is not, however, in and of itself, ‘our strength.’ Our strength, as Americans, is derived from our historical tendencies towards hard work and constant, never ending, struggle for something better.

On the basis that racial diversity = strength, people build an argument in support of considering race in admission to medical programs (and higher education in general, but I’ll focus on medical school). Is this appropriate, and if so, for what reason? Well, based on what I’ve already said, the only way that race could possibly be an appropriate factor to consider in admissions decisions is if it will allow a person to potentially become a better doctor. The argument cannot be made from an economics point of view. After all, there are rich minorities and poor majorities.

Probably the argument with the most potential in favor of affirmative action in the medical admissions process has to do with doctors’ ability to care for underserved communities. Essentially, some assert that a doctor of African descent (for example) will have an advantage in dealing with and treating others of African descent. I find this reasoning to be insulting in two ways. First, it insults those of African descent, because it assumes that they cannot get into medical school without ‘help’ and, secondly, it assumes that since such individuals are ‘better’ at dealing with those of similar ethnic origin, they must be ‘less good’ at dealing with patients of different ethnic origin.

Notice that nowhere did I mention doctors being better at dealing with people of similar backgrounds, but rather of similar ethnic origin. There is a very important distinction to be made here. As literally everyone with a functioning brain will agree, our skin color has nothing to do with our intelligence or abilities in general. Rather, a much stronger argument might be made for someone’s upbringing having a large influence on what they are ‘better’ at than others. Does anyone honestly think that a black man who grew up in a mansion in England will understand the plight of a poor black man from South Philly better than a white woman from Harlem? This is what the ‘race preference’ argument eventually boils down to, and I find the potential results to be quite frightening. I hope that more people will begin to consider where we are headed if these flawed arguments are ultimately accepted by society.

Update:

Eugene Volokh comments here on racial preferences. As usual, Eugene's hit the nail on the head.

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