Friday, September 30, 2022

The Decline and Fall of American Medical Education

One would like to think that science is inviolate. You can wokeify the humanities and the social sciences; you can wokeify the arts; but it is far more difficult to practice diversity, equity and inclusion when your discipline has objective standards.

After all, we remember that MIT opened its admissions to more underqualified students a couple of years ago. The school discovered that the less qualified students could not do freshman math and thus could not advance to sophomore year. They were too far behind and could not catch up in time. So, good-bye diversity quotas.

It feels fair.

And yet, the medical profession has been moving toward diversity quotas, and has been systematically lowering standards for minority applicants. The American Medical Association is all-in with it, and is encouraging medical schools to choose candidates according to skin color.

Among those who are standing up against the madness is retired physician Dr. Stanley Goldfarb. Naturally, in this and in many other cases, those who are objecting are retired. As you know, free and open discussion of this and many other issues has been banned. Those who raise such issues, pointing out obvious problems, will be fired, canceled or ostracized. 

If you think that this is going to improve the quality of medical education, you should, as Dr. Goldfarb entitled his book: Take Two Aspirin and Call Me by My Pronouns. 

In Goldfarb’s words:

This focus on diversity means we’re going to take someone with a certain skin color because we think they’re OK, that they can do the work. But we’re not going to look for the best and the brightest. We’re going to look for people who are just OK to make sure we have the right mixture of ethnic groups in our medical schools.”

The edicts are being imposed from the top, from the AMA and the Association of American Medical Colleges. They have just jumped on the systemic racism bandwagon, blaming minority underperformance on something that white people think:

After the May 2020 murder of George Floyd, the powerful American Medical Association (AMA) and Association of American Medical Colleges (AAMC) claimed that systemic racism was to blame for racial disparities between white and black patients.

Last year, the AMA announced a three-year strategic plan to “aggressively push forward” new policies that encourage people of color to enter the medical profession, in order to help eliminate the disparities between white and minority patients.

In Jan. 2022, Step One of the US Medical Licensing Exam, which for years gauged the progress of medical school students and assessed their suitability for prestigious residency programs, was changed from numerical grades to a pass/fail, giving students more time to “authentically develop” their interests in such things as “community engagement.”

One hates to be persnickety here, but why will more minority physicians reduce disparities between white and black patients? If the minority physicians are underqualified, and if they know more about community engagement than about illness, they are more likely to provide substandard medical care to minority patients.

And of course, the new standards entail discrimination against better white and Asian applicants. So, the best people are no longer allowed to become physicians and this will generally dumb down the profession. Moreover, how do these new policies impact research? Are they being applied in graduate biochemistry programs? Clearly, the best research is going to be conducted by the smartest people, not by the people who understand community engagement:

Goldfarb said this new push for diversity and equity has meant that some high-performing white — and often Asian — students can’t get into medical school because those slots are being given to black and Hispanic students who don’t have to show such high grades or test scores.

“It’s manyfold harder for a white medical student who has average grades to get accepted into medical school, maybe 30 or 40 times harder than a minority student with the same grades,” Goldfarb said, adding that the parents of a young white man with a 4.0 GPA in college recently reached out to him when their son’s applications to US medical schools were rejected.

And, the diversity quotas will necessarily diminish the reputations of black physicians. Shelby Steele made this point some two decades ago, and it has not sunk in yet. Clearly, if an individual is looking for a doctor and can choose between one who knows medicine and one who knows community engagement, which one do you think he will choose?

“This is the downside of affirmative action,” Goldfarb added. 

“The brilliant black doctors of the future like a Ben Carson, who was considered one of the premier pediatric neurosurgeons in the world, may be looked at by someone who says, ‘Hey this person doesn’t belong at Johns Hopkins — he’s only here because they wanted more diversity in the neurosurgery department.’”

For black physicians, systemic racism seems to be the all-purpose excuse for underachievement and underperformance. We have it on the authority of minority physician Dr. Ashley Denmark:

“Goldfarb represents the privilege that a lot of white male doctors enjoy, which is the ability to express themselves freely without recourse,” Denmark told The Post, adding that she was abruptly fired from her last position as a doctor in Missouri because of her work with Project Diversify Medicine and for filing a complaint alleging discrimination.

She continues:

“Doctors like me don’t get the support a white doctor like Goldfarb does. Racism ends in a funeral for a lot of black and brown patients. All we want is more doctors who look like our community. And he is wrong about how changing standards will impact medical education. We still have to pass the same boards and same rotations after we graduate.”

One ought to notice that the grading system has been distorted in order to allow more minority physicians. And, ought we not to challenge the notion that white doctors are unqualified to deal with minority patients because they lack sufficient empathy.

At Penn, a senior vice dean for medical education set about destroying the medical curriculum several years ago:

Goldfarb, who began at UPenn in 1969, said the change at the medical school began in 2018 when Dr. Suzanne Rose arrived on campus and was named senior vice dean for medical education.

“We’d had a very stable leadership for quite a while and resisted going the way some other medical schools were going but she brought in this new ideology,” Goldfarb said. “She wanted to link up to what the American Medical Association was doing in education, which was promoting woke ideas, and there was a phrase that she told me that always stuck with me. She said we have too much science in the curriculum — which meant physicians should be more akin to social workers in their activities, particularly primary care physicians, rather than learning hard science that relates to patient care.”

Again, this feels like a caricature. She thought that the medical school was teaching too much hard science. The physicians needed to be more empathetic, have more feeling, and know less about medicine. Is it not strange that a female sub-dean would militate for feminine values, to the detriment of masculine values?

If you think that this is going to end well, for anyone, think again.


IamDevo said...

As one could deduce from my frequent posting of comments, I am a regular consumer of the wit and wisdom to be found on this site. Of course, the "wit and wisdom" is always that provided by Our Gracious Host, and only rarely to be found in the articles he critiques. As a reasonably observant person, I have come to the conclusion that OGH is the Edward Gibbon of our times. Of course, whereas Gibbon described the decline of a civilization long in the past, OGH (and we, his readers) are living in the decline, not looking back at an earlier age. Perhaps that makes OGH more of Cicero, although I hope he can avoid a similar fate.

Anonymous said...

The medical profession is just catching up with the way we pick Supreme Court justices these days.

ErisGuy said...

I wonder how many years, even decades, doctors and nurses voted for civil rights, minority racial promotion for the arts and humanities, Democrats, figuring science was immune to the stupidity they inflicted on others. Crocodile come the doctors at last, huh? They wanted ,they willed it, they worked for it, and surprise—they got it. It’s 44 years too late. Everyone chose the “let’s feel good about ourselves” route in 1978.

autothreads said...

And he is wrong about how changing standards will impact medical education. We still have to pass the same boards and same rotations after we graduate.”

Anyone willing to bet that Dr. Ashley Denmark does well on standardized tests? Apparently, she's an example of the old saying, "What do they call someone who graduates last in their med school class?" "Doctor."