Thursday, September 01, 2011

Medical Profession Handles Diversity Well

In my four years in the Midwest, I have yet to pick a physician. I have seen a doctor once for an infection, but no settling down and finding an MD for me. I would need to find an MD open to new patients, but unlike other Americans, I wouldn't give a crap about my doctor's race (nor gender). It doesn't matter to me. I've had male, female, Asian, and white doctors. If you're board certified, you're good for me. It does to some people though, and of course, some people think the medical profession needs to be more diverse. In defense of the medical profession, they do a great job of bringing a diverse physician workforce to the marketplace for Americans. It just seems like the diversity of the medical profession is not the PC community's preferred version of diversity. Let's check out the facts and see what can be done.
Physicians don't reflect the exact racial proportions of the US. That is easily seen in the above "aspiring docs" link. The "aspiring docs" link reveals that since 1980, medical schools have done a great job of increasing minority students. All minorities have icnreased their share of medical school enrollment and Asians have made huge gain. The data is incomplete (here) because 22% are unknown, but there is overrepresentation by Asians and underrepresentation by Hispanics and blacks. Possibly a better indicator for MD diversity work is to check out exact numbers of medical school enrollees by race (here). Whites make up 58.2% (under), Asians make up 20% (over), Blacks 6% (under), Hispanics 8% (under), so there are differences, but there is plenty of minority representation. Oddly enough male-female splits are 55% male to 45% female despite women outnumbering men in undergraduate programs.

Is this acceptable? It is tough exactly lining up percentages. Who loses spots to make up the 6% black and 6% Hispanic underrepresentation? Do we tell Asian students they need to come back down more in line with their 4% population %? Heck, even Whites have a reason to bitch. This is the danger of representation whining. What is even worse is dumbing down acceptance standards to achieve diversity. A realignment would also really really hurt Asian applicants. Look back at this chart and look at the average MCAT scores and GPAs for Asian applicants. Asian enrollees have higher MCAT averages than any other group. Limiting their numbers would push that MCAT average up as you would have to be even better to be accepted if limited by quotas. It is surprising to see Asian and black scores side by side as Asians are nearly 2 standard deviations higher than blacks. When lives are on the line, do we want to sacrifice aptitude for the sake of a few extra different faces? I would rather have a meritocracy where no matter the background, the best of the best were selected for medical schools. Medical schools seem to have taken that track in the last 25 years by boosting Asian acceptances with the high scores and high GPAs.

Is there a solution? There is probably nothing medical schools can do themselves to boost black or Hispanic enrollment (without severely compromising admission standards), but there is plenty those communities or lower level schools (junior and high schools). The important thing to consider with medical schools, like all other graduate schools, is that there is a giant filtration process that starts with graduating high school. Eeverythign starts with finishing high school. Black and Hispanic high school dropout rates are much higher than white and Asian dropout rates (more here). Then you have enrollment in college. Then you have to complete college, take the MCATs and score above the average for applicants (not enrollees) for your group. Underrepresented communities need to focus on their kids finishing high school. The high school science programs could explain the importance of science and its application with medicine. These schools can also explain that being pre-med in college means you took the 4 courses required to qualify. That way, college does not become an all or nothing focus for students entering college hoping to go to med school.

Is the current system fair? Sure if you think rewarding higher scores is fair. Is it fair if you're a PC kumbaya dreamer? No, but you're have to find solid excuses and outlets for a lot of brilliant Asian students, and you'd have to lower admission standards significantly for underepresented groups. If that happens, you might see more patients requesting to be seen by a similar physician. This would be determining winners and losers not by ability but by race, and no one likes that... except when it benefits them. Medical schools have done a tremendous job of expanding minority enrollment in the last 25 years, and they do not need any new programs to serve the needs of the PC police. We live in an imperfect world, and when we discuss wishes for diversity we should be honest with ourselves about what we mean.

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