JAMA Article Promotes “Neurodiversity” in Medical School By Wesley J. Smith
This is a delicate matter, but I think it must be confronted. The Journal of the American Medical Association has published an article that urges “neurodiversity” be given “holistic” consideration when accepting students into medical school in keeping with diversity goals. From “Embracing Neurodiversity in Medicine — Building a More Inclusive Physician Workforce:”
The benefits of diversity have long been recognized with respect to persons with minoritized racial and ethnic backgrounds, women, persons who are LGBTQ+, and others, and there has been a wide range of efforts to increase the representation of these individuals among physicians. Currently, however, these same programs and institutions do not similarly prioritize neurodiversity, the range of developmental neurocognitive differences that underlie individual variation in thinking, learning, and behavior.
What conditions are we discussing?
The term neurodiversity broadly describes the breadth of neurocognitive variation in a group or population, similar to variation along any other axis of diversity. However, in an organizational context, it frequently refers to the inclusion of minoritized “neurodivergent” individuals who identify as having 1 of a range of neurodevelopmental conditions (eg, autism, attention-deficit/hyperactivity disorder [ADHD], Tourette syndrome, learning disabilities such as dyslexia or dyscalculia).
This idea seems particularly perilous. Obviously, if someone with a neurodiverse condition has the ability to enter medical school and eventually practice medicine, he or she should not be discriminated against. But because the responsibilities of doctors are so profound, acceptance must not be based on adjusted or “holistic” considerations.
Alas, that is the very approach that the authors advocate:
Schools must develop approaches for taking into account applicants’ specific cognitive strengths, unusual accomplishments, challenges, and resilience in the face of those challenges. They must seek stories of great future physicians that cannot be told solely through grade point averages and Medical College Admission Test scores. For example, applicants with dyslexia may struggle to meet a medical school’s typical benchmarks with respect to test scores but may have a track record of excellent on-the-job technical skills that speak to their ability to master complex information and sophisticated procedures. Fortunately, many medical schools already engage in this kind of holistic review because it has been shown to be an effective way to increase other aspects of diversity
Destigmatization of neurodivergence should also be built into the structure of the medical school experience by proactively offering appropriate accommodations to students who identify as neurodivergent (which may require something other than additional time on tests) and by building more robust education about neurodiversity and developmental disability into the curricula for all students.
Medical school don’t exist — or, at least, shouldn’t — to fulfill diversity categories, reduce stigma, or promote maximum inclusion. Their overarching purpose should be to train the best among us to become future physicians for the benefit and safety of patients. Applicants should not be rejected solely because they have a neurodiverse condition, to be sure. But they shouldn’t be accepted because they have a neurodiverse condition, either. Entry into medical school should be based on merit, not DEI. The potential consequences are too dire to accept anything less.
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