“A medical school tradition comes under fire for racism.” – from NPR

How, in the year 2018, could institutionalized racism still exist? Black and Hispanic unemployment levels are at a record low, [1] [2] [3] college scholarships are awarded to blacks and Hispanics at a higher percentage than whites and Asians, [4] and – especially relevant to the discussion at hand – blacks and Hispanics are twice as likely, and in some cases even four times as likely, to be accepted into medical school compared to whites and Asians. [5] What inequalities could possibly exist in such a world (except those against Asians and Whites, but let’s not talk about that right now)?

We will analyze this polemic line-by-line, and, in doing so, we will continue in our journey to end all social inequalities.

The problem presents itself fairly quickly: the prestigious Alpha Omega Alpha honor society [6] – or rather, the lack thereof. Icahn School of Medicine in New York City decided to indefinitely discontinue student nominations to this respectable group of elites because of – you guessed it – not enough diversity. Straight from the horse’s (or donkey’s, as it were) mouth:

“AOA perpetuates systems that are deeply flawed,” says Dr. David Muller, the dean for medical education at Icahn. “We can’t justify putting people who are historically at a disadvantage at an even greater disadvantage. It just doesn’t seem fair to dangle in front of our students an honorific that we know people are not equally eligible for.”

Giselle Lynch, a senior at the school (whose right to free speech, protest and assembly I will readily defend to the death), is the one who pushed for change, leading to Icahn’s decision to ultimately discontinue their participation in student nominations for the Alpha Omega Alpha society. [7] (Notice how within the first two sentences of the declaration, they state that social justice and equality are their “highest values” and that scores from standardized tests such as the MCAT and NBME do “not accurately reflect or predict the qualities of great physicians, scientists, and citizens” – file this away for later).

Lynch’s inspiration to push for social change ultimately came from her dismay at the lack of diversity she saw when looking at photos of past AOA students from Icahn:

“Where are we? We’re nowhere here,” says Lynch, remembering her reaction. “AOA is an award of student excellence. What was the argument that was being perpetuated about us if we’re not being included?”

Just to clarify, this lack of diversity is not a problem that is specific to Icahn – blacks and Hispanics are far less likely to be nominated to the society nationwide, according to a 2017 study [8] – remember that the statistic I cited earlier was for acceptance into medical school, not nomination for an honor society.

On top of the irreparable trauma of not being nominated into this society of elite future physicians, “[minority] students have more stressors they have to deal with, low levels of racism that exist in our patients and our clinical environments,” says Dr. Catherine Lucey, vice dean for education and the University of California in San Francisco. To the good cheer of minority students everywhere, however, changes are taking place:

Lucey says that UCSF changed its selection criteria for AOA in 2016 to focus less on grades. The number of minority students selected for the honor society that year increased to match the percentage of minorities in each graduating class.

Read that statement back a few times out loud until it really starts to sink in. Actually, read the whole article back to yourself once more, and let me know if you come to the same set of conclusions that I have:

The Alpha Omega Alpha Honor Society is inherently discriminatory against minorities because of a disproportionate number of black and Hispanic nominees compared to the number of blacks and Hispanics currently enrolled in medical schools across the country. The underlying reason for the disproportionate number of black and Hispanic nominees is never specifically addressed – the AOA is discriminatory because of the basic fact that there are disproportionate black and Hispanic nominees.

Because of the AOA’s discriminatory nature, Icahn Medical School (and others) have decided to discontinue nominating their students. Dr. David Muller says that “It just doesn’t seem fair to dangle in front of our students an honorific that we know people are not equally eligible for.” Muller admits that “we” (which I assume refers to the staff at Icahn, but could possibly refer to the medical community in general, or even to society in general) are in possession of the knowledge that not all students are equally eligible for a merit-based nomination to an elite honor society.

UCSF, rather than completely ending nominations to the AOA, decided to “…change its selection criteria for AOA in 2016 to focus less on the grades,” which resulted in: “The number of minority students selected for the honor society that year increased to match the percentage of minorities in each graduating class.” In other words, the UCSF believes that a student physician’s grades – an objective measure of their ability to acquire, organize, and integrate knowledge – is not as important as it once was. When medical students’ grades at UCSF are a less-weighted criterion for AOA nominations, the number of minority students that are nominated for the AOA “increased to match the percentage of minorities in each graduating class.”

To summarize, having a diverse cast of nominees for an honor society is more important than its constituent students’ grades – so important, in fact, that Icahn decided to postpone nominations to the honor society altogether, rather than allow a disproportionate number of minority students to be nominated – forcefully taking from all students – (at least everyone is getting screwed equally so there can be no accusations of discrimination!) – of the opportunity to be inducted into the AOA, an invaluable distinction on any aspiring doctor’s resume that is a clear display of their sense of purpose, commitment and discipline as elite students.

The insanity continues:

Dr. Jonathan Giftos, an internist in New York who was president of the Icahn chapter when he graduated in 2012, says disparities in the honor society are important to address because when medical education favors white students that can mean fewer minorities in leadership roles.

Note how Dr. Giftos claims that “medical education favors white students.” How, Dr. Giftos, does medical education favor white students when AAMC records show that black and Hispanic medical students who have the same GPA and MCAT scores as whites are accepted into medical school at a staggeringly higher rate? [9] For example, a black student with a GPA of 3.60-3.79 and an MCAT score of 27-29 has an 86.6% rate of acceptance into medical school; a Hispanic student with a GPA of 3.60-3.79 and an MCAT score of 27-29 has a 71.6% rate of acceptance into medical school; a white student with a GPA of 3.60-3.79 and an MCAT score of 27-29 has a 43% rate of acceptance into medical school. Am I missing something here? 88.6 and 71.6 are both higher numbers than 43. These charts prove beyond any shadow of a doubt that discrimination occurs against students in the application process for medical school – not against minority students, but against whites and Asians.

Giftos concludes: “It feels like a layering on of accolades that makes people who are doing well do better, have more access and power and opportunity.”

Here it is! The most powerful line in this entire piece – twenty or so words that perfectly encapsulate the relativistic post-modern hellscape that we find ourselves inhabiting these days. Dr. Giftos, with the smug and theoretical eloquence of Ellsworth M. Toohey, says that rewarding successful people inspires them to continue improving themselves, thus obtaining more power and opportunity in exchange for increasing the value that they provide.

In a Capitalistic, merit-based society, a person’s economic worth (whether that is measured in salary, assets, etc.) is equivalent to the value they provide; the business owner makes more than the employee because he willingly takes on the risk of starting a business and putting forth an initial investment; of developing the logistical and legal framework for his business; and for creating jobs and opportunities for those that will come work for him. This does not mean that the business owner is inherently “superior” or “better” than the worker – all men are equal before the Law – but it does mean that the business owner provides from value than the worker, and as such, deserves more compensation.

Dr. Jonathan Giftos, who I assume earned a Bachelor’s Degree, completed medical school, completed a residency, and is now a practicing physician seems to think that a merit-based system of selection for nominations to an honor society for medical students is somehow inherently discriminatory. If Dr. Giftos is ever preparing to go under the knife for a major operation, do you think that he will choose his surgeon based on his qualifications, or based on his own personal need for more diversity in his life?

Sebastian Martin Haller, 09/08/2018

[1] https://www.washingtonexaminer.com/policy/economy/black-hispanic-unemployment-rates-hit-record-lows-in-april

[2] https://www.bloomberg.com/news/articles/2018-05-04/black-and-hispanic-unemployment-in-america-reach-record-lows

[3] https://money.cnn.com/2018/06/01/news/economy/black-unemployment-rate-record-low/index.html

[4] https://nces.ed.gov/pubs2010/2010015/tables/table_25.asp

[5] https://www.aei.org/publication/acceptance-rates-at-us-medical-schools-in-2015-reveal-ongoing-discrimination-against-asian-americans-and-whites/

[6] http://alphaomegaalpha.org/

[7] http://changenow.icahn.mssm.edu/leadership-letters-aoa/

[8] https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2607210

[9] https://www.aamc.org/data/facts/applicantmatriculant/157998/factstablea24.html