RUTHFULLY YOURS

America’s top medical schools, worried they have too few minority students, are doing something about it. They are lowering academic standards for admission and trying to hide the evidence. Columbia, Harvard, the University of Chicago, Stanford, Mount Sinai, and the University of Pennsylvania have already done so. The list already tops forty, and more are sure to follow.

Of course, the universities won’t admit what they are doing – and certainly not why. All they will say is that their new standards add “equity” and “lived experience.” Unfortunately, adding those factors inevitably lessens the weight given to others.

The harsh reality is medical schools are downplaying academic achievement and MCAT scores, which give the best evidence of how well students are prepared for medical school. The MCAT is specifically tailored for that purpose. In addition to a section on critical reasoning (similar to the SATs), it examines students on biology and biochemistry, organic chemistry, the physics of living systems, and the biological and psychological foundations of behavior. It’s easy to see how those relate directly to higher education in medical science. Yet med schools want to downplay them and add inherently subjective criteria like “lived experience.”

Med schools are especially eager to get rid of the MCATs. After years of evaluating admissions folders, they know they cannot meet their goals for minority enrollment if they retain their near-total emphasis on academic qualifications. They know, too, that standardized tests and grades leave a statistical trail. They want to kick dust over that trail before the Supreme Court’s expected ruling against affirmative action. They fear the statistics will show marked differences in admission rates for individuals from different groups who have similar scores and GPAs. That’s not a wild guess. Admission teams know the evidence from years of experience.

But dropping the tests, or making them optional, presents a thorny PR problem. Schools fear they would sink below competitors in national rankings, which include MCAT scores. So, they are doing what undergraduate colleges have already done. They are colluding. By withdrawing jointly from US News and World Report rankings, they hope to soften the blow to each one’s prestige. (It’s an interesting question whether this collusion violates anti-trust laws, as their collusion about scholarship awards did.)

What medical schools call “equity” and “lived experience” are code words for discrimination by racial category. They are using this word fog to cloud over four crucial but uncomfortable facts. First, today’s standardized tests are actually fair and unbiased. Medical schools don’t deny that. They know test makers have spent fortunes over the past half century to scrub their tests of any racial, cultural, or ethnic bias. Second, medical schools aren’t claiming the tests are poor predictors of performance. They can’t.

Third, they know criteria like “equity” and “lived experience” are inherently subjective and opaque to outsiders. That’s their magic potion for admissions officers. These education bureaucrats are following the advice Humpty Dumpty gave in “Alice in Wonderland.” Alice asks him, “Must a name mean something?” And Humpty replies, “It means just what I choose it to mean – neither more nor less.” Humpty Dumpty would be enthralled with code words like “lived experience” and “equity.” They mean exactly what Humpty and admissions officers choose them to mean – neither more nor less.

Finally, by emphasizing non-academic “experience,” these schools are downplaying the reality that their applicants have already graduated college, most likely as science majors. That academic background is the most important “lived experience” for graduate study in any rigorous field, including medicine.

To implement the bias they prefer and do it secretly, medical schools are counting on public ignorance and apathy. When patients believe any subgroup of doctors has systematically higher or lower qualifications, they will take that into account. They do the same thing in choosing lawyers, dentists, accountants, and other professionals.

That may be unfair to any individual practitioner, but it’s inevitable. That’s because ordinary patients (or consumers) have no direct way of judging professional competence. They can only look for indirect (and imperfect) signs of a good doctor. Did she go to a top medical school, for instance, or practice at a teaching hospital? If they think it is harder for an outstanding Chinese-American undergraduate to gain admittance, they will reasonably guess she’s a better student and a more-qualified doctor. They may be wrong about that particular doctor, but it’s a sensible guess.

There’s a general ­– and inescapable – point here. When admissions, hiring, or promotion are influenced, either positively or negatively, because of group membership, when outsiders know that and cannot measure quality directly, they will see that “group membership” as a telltale sign of ability.

Are There Any Remedies?

When issues are as divisive as admissions bias and racial discrimination, it’s wise to begin with shared values. America needs lots of well-qualified doctors, and getting more from underrepresented groups is a worthy goal. Getting more African American doctors is especially important, both because of our country’s scarred racial history and because younger students need role models from all groups.

At the same time, these would-be physicians should be admitted and trained without any racial, religious, or ethnic bias, without hiding evidence of discrimination, and without using subterfuge to evade the law or public scrutiny.

Nor should medical schools ever require their applicants, as many do, to submit statements saying they adhere to a leftist vision of “diversity, equity, and inclusion” and will implement it as part of their medical education. That’s ideological bullying, and it has no place in education at any level. It should end immediately.

So should racial bias in admissions. There’s a good way to guard against it. No matter how heavily medical schools choose to rely on MCAT scores, they should require them of all applicants. The schools should be required to retain these scores for all applicants, whether they are admitted or rejected, along with all other relevant data about each applicant (after hiding each individual’s name for privacy). Those mandates will leave a clear statistical trail if legal challenges arise later.

Congress could easily pass such a law for schools that receive federal money. It won’t, not as long as Democrats control the Senate and the White House. Neither will like-minded federal bureaucracies. But the roadblocks in Washington shouldn’t prevent state legislatures from undertaking these actions for universities they fund. They can require all applicants to submit MCATs and grades, and they can require universities to retain them.

State legislatures shouldn’t stop there. They should pass similar laws for undergraduate admissions and for all graduate and professional programs, such as law schools, which are moving swiftly to make these tests optional for the same reasons medical schools are dropping them. Again, these mandates would not tell schools how much weight to give test scores or grades. But requiring their submission and retention would leave a clear statistical record, which rejected applicants could use if they believe they faced discrimination. That looming threat would have a bracing effect on university officials.

Second, medical schools should work hard to increase the number of strong minority applicants. One possibility is to launch intensive, one-year programs in the biosciences, aimed at promising college graduates from underrepresented groups (making sure they are consistent with anti-discrimination laws). Students in these enriched programs would be in a far better position to apply successfully to medical schools on a level playing field. Programs like this already exist for college graduates in the humanities and social sciences who later decide to pursue medical careers.

These intensive programs could offer either certificates or degrees (BA or MA), depending on their length and academic level. Some graduates would go on to medical school. Others would be qualified to begin professional positions in the biomedical sciences.

The fundamental problem here is reconciling three laudable goals: increasing the number of minority medical students, keeping academic standards high, and avoiding illegal discrimination. It’s time to launch intensive programs that make the effort instead of watering down academic standards and pretending no one will notice.