The War on Merit in Medical Training

The war on merit proceeds apace. With some caveats.

As you know, the American academy has long since been hiring for diversity. The result, in the Humanities and Social Sciences, is that a band of barely literate teachers has taken upon itself the task of turning out a generation or two of functional imbeciles.

America’s college graduates are simply not capable of doing the jobs that are on offer in the new economy. So they gravitate toward government work, toward teaching, toward the media and toward community organizing. Their goal-- to produce a perfectly diverse world, regardless of the intellectual capacities of the students. This involves dumbing down the student body by admitting people for diversity and not for merit.

Of course, in the aftermath of the George Floyd insurrection, the thought police discovered that the war against merit had not yet destroyed programs in science and engineering. So they set out to introduce more equity, in, for example MIT admissions. The result, after a year-long experiment, MIT found that the diversity candidates could not do the work. Thus, it is returning to merit. The same applies to high schools in San Francisco and Virginia.

Naturally, New York City has not drawn any lessons from these experiences, so it is instituting a lottery to determine who gets admitted to the best schools. The result will be that these schools will be dumbed down, and that the best and the brightest children will leave the system. 

And then there is the medical profession. You might expect that the medical education complex admits the best students and provides the best medical education. You would be wrong. In the interest if diversity and inclusion, medicine, from the top down, has chosen to dumb itself down. The next time you consult with a recently graduated physician, be aware of the fact that you might not be dealing with someone who earned his or her way. 

Thus, medical care in America is about to go the way of the Humanities and Social Sciences. Unless someone wakes up and calls a halt to the madness.

At least, Dr. Stanley Goldfarb, a former Professor and Associate Dean for Curriculum at the University of Pennsylvania School of Medicine is trying to put an end to it. He has written a new book, entitled  Take Two Aspirin and Call Me by My Pronouns.

Goldfarb has retired from his academic positions, so he is free to speak out. Other physicians, those who hold academic appointments, do not enjoy the same freedom. Think about that one in the context of free expression.

In an interview for The Public Discourse, Goldfarb explains:

Perhaps a bit hyperbolic, but clearly the prevailing zeitgeist of American medical education is an almost complete and unthinking acceptance of a “woke” mentality. The demonstrations at academic medical centers and medical schools throughout the United States following George Floyd’s killing led to widespread declarations of the need to purge “systemic racism” from American medicine and to adopt “antiracism” as a dominant aspect of the medical ethos.

Among the salient issues is that of disparate outcomes. Patients of different racial and ethnic backgrounds apparently undergo different treatments, producing different clinical outcomes:

In medical care, this has come to mean discrimination against one group of patients to benefit another group, all on the basis of skin color. It also means discriminating against some applicants to medical school, as well as academics seeking career advancement.

And also,

They see disparate outcomes in health care, and they feel guilty and blame themselves. Many academic doctors also see a willing cohort of impressionable students who are reared in Marxist ideas about power hierarchies, and they demand that the students adhere to their concepts of equity.

Administrators feel that it is easier to talk the talk and to try to placate woke students. You might ask where these students learned to be ideologically-driven fanatics, and how their minds were corrupted in undergraduate science course:

On the more cynical side, I see administrators and medical leaders who simply do not want to face the wrath of their woke students; they have decided that it is easier to “talk the talk,” while delaying actually doing anything substantively “woke” that would require massive expenditures. For example, it is easier to accept a few more minority students or hire a few more diversity specialists than it is to open outpatient facilities in black neighborhoods—a move that might actually improve outcomes for black patients.

Accept a few more underqualified candidates, and do not fail them, because otherwise you are racist.

Physicians may not feel comfortable arguing against reduced standards for admission to medical school or to residency training programs. But they must at least stand up against active racial discrimination in health care.

As everyone knows, the underqualified students underperform:

A very recent study in the journal Academic Medicine found that “underrepresented in medicine” residents, or URiM residents, received lower ratings than other medical residents at a number of academic institutions that pooled their data.

Goldfarb continues:

Any inequality must be the fault of the school, the result of a power differential between white racists and black students. This is an amazing blind spot. It could be the poster child for all the problems with adopting “antiracist” approaches in health care and education.

And now, since the medical school admissions exams seem to favor one group over another, the profession is changing the standardized test, the MCAT, to introduce more progressive orthodoxy. 

In particular, under the leadership of Dr. Darrell Kirch, the American Association of Medical Colleges has introduced sweeping changes to the MCAT, which now serves in part as a sort of screening mechanism for progressive orthodoxy.

Of course, this is totalitarianism. It resembles nothing but the Communist governments where students are required to recite the truths of the Red Book of Mao Zedong or to demonstrate their proficiency with Marxist orthodoxy.

In truth, most formerly Communist countries dispensed with such nonsense years ago. After all, when you go to see a physician, will you judge him on his ability to treat your illness or on whether or not he can mouth radical leftist talking points? How long before you do not even have the option?