Ethnicity: is it a factor in medical school admissions?

[Satsuma]

Here's a question: is it a proven fact that students from disadvantaged backgrounds are more likely to return to their communities and work as FPs? I'm asking this because, as an example, for many children of disadvantaged immigrants, there is a very strong pressure on going into the most lucrative and prestigious career possible. So, is a poor black boy from rural Louisiana who was the first in his family to attend college, let alone med, really more likely to return to rural South, or is he more likely to go practice plastic surgery in Beverly Hills and rake in loads of cash and make a new, better life for himself? Are there some sort of stats to show that these speculations about returning to your disadvantaged home community are actually correct?

 

 

If you do a literature search on the topic you will find the subject is studied on a ongoing basis.

[TimmyMax]

Hey,

 

I agree. There is a lot of literature supporting the idea that medical school graduates from rural backgrounds/underserviced areas have a greater tendency to return there to practice than graduates from urban areas. As sats said, you can do a literature search on this, because I don't have the references on me offhand. A name that springs to mind in terms of authors would be Jim Rourke (sp?), who I think is the current dean of medicine at MUN.

[The Law]

Hey,

 

At the risk of being unpopular, I think that the selection process is fine the way it is. Just my two cents on the issue.

 

I agree.

I haven't applied yet, but it seems to be pretty fair.

[TimmyMax]

Hey,

 

There aren't even just a few who have 'slipped through the cracks' of all the checks and balances to find the right people for med?

I'll be the first to agree that there definitely are those that "slipped through the cracks" (there were definitely two of the so-called "questionable admissions" in my class of 133), but all in all, these people are in the minority. That said, no system is perfect (and there likely never will be a perfect system, short of employing polygraphs and private investigators to find out who's lying/embellishing on their application/interview and who isn't), but I think that the current admissions process as it is does an excellent job of selecting people who will be successful in the field of medicine.

Does that mean that otherwise equally qualified candidates are sometimes overlooked? Absolutely, but that is more a function of limited enrollment than anything else, I'd argue.

[tarzi]

As someone already pointed it out - ethinicity and diversity are always on the back of adcom's minds. Even if they concsiously have to abide by the law, it would be difficult to ignore 1. the sex 2. name 3. their "race" during interview and subconscious biases can arise (which is what MMI is supposed minimize).

 

Anyway - with today's climate about diversity and equality, one doesn't even have to ask the question if adcoms consider your ethnicity - this is not racism however. You cannot consider diversity without considering race and sex. However, you also do not need to get paranoid because if you've got it, then nothing will stop you (unless they have open quota's like they used in the past down in the USA).

 

I would say that it is a very small factor...very small.

 

Now, I also believe that the admissions process is fair but could be improved because it takes too long and wastes too much money on our part and the school's part - it's not cost-effective.

 

However, due to the number of spots available - a class of 210 from 800 interviewees DOES NOT represent the BEST 210 applicant's with the best marks, ec's, personality etc. As someone mentioned before, as a function of limited spots - many ppl who get rejected are just as good as those who get accepted - hence, there is an element of luck. For around 4000 applicants per school, I'd guess that at LEAST 500 are 100% qualified in every way to attend med school - but there's only 110 seats....

[Stupor]

The last time that I checked, it was against the human rights code of Canada to discriminate based on race and/or ethnicity. Medical school admission committees are also bound by this charter of rights. Ethnicity plays no role in medical school admission decisions. Pretty much every ethnicity in Canada is represented in the medical school system nowadays.

Actually, such "positive" racism is explicitly allowed by the Canadian Constitution under chapter 15.2 of the Canadian Charter of Rights and Freedoms. Check it out.

 

Affirmative action, or whatever you want to call it, is racism. It discriminates against traditional applicants (whites and Asians) in favour of non-traditional applicants (blacks and Aboriginals). Of course, that last sentence was written with the United States in mind, as affirmative action receives little publicity in Canada. But I imagine it is not very different here (think of the many ethnic-specific scholarships you have seen), except we find it much less contentious due to our multicultural sensibilities (thus the reason for its receiving so little publicity).

 

These are the facts about affirmative action/"positive" racism. Whether it is really positive or justified is another matter...

[The_B]

I understand what you are trying to say stupor, but I hesistate to agree since Racism implies one race doing actions because they believe they are superior to another. Affirmative action is meant to help prop a disadvantaged race (for whatever reason) to the level of everyone in terms of social "chances", be they economic or scholastic. So with all due respect, you got your "facts" wrong.

 

And I agree with Timmy, I like things the way they are. It is not as though there is this huge influx of non-deserving people entering medicine right now.

[Stupor]

Racism implies one race doing actions because they believe they are superior to another. Affirmative action is meant to help prop a disadvantaged race (for whatever reason) to the level of everyone in terms of social "chances", be they economic or scholastic. So with all due respect, you got your "facts" wrong.

Racism is treating people differently because they are of different races. Period. Just as the Jim Crow laws were a case of racism, so is giving advantages to under-represented (i.e. non-Asian) minorities in medical school admissions based on their race alone. That last point is an important one. I have no problem with giving advantage to applicants who perservere through economic hardship, and who are also likely to belong to racial minorites because racial minorities are over-represented in the low-income population. However, the vague mission statements in favour of "diversity" at most medical schools do not preclude them from giving a minority student advantage over others simply because he is a minority. I do not know how often this happens in Canada (or if it happens at all, as some would question), but such affirmative action programs are well-known in the United States, and it is only reasonable for their paralles to exist in Canada. Assuming that such affirmative action programs do exist, what good do they really do? Educated and intelligent medical students are unlikely to be racists and would therefore benefit little from the "diversity" given by token minority students. So the ones who do benefit are the individual minority students, who are advantaged due to the colour of their skin alone. The only valid affirmative action, then, is for Aboriginal applicants who are likely to return to their under-serviced regions upon completion of their education. That is justified because the affirmative action would measurably improve the lot of an entire community. Affirmative action that benefits individuals alone, however, is not justified but nonetheless entirely possible.

 

Affirmative action would still be racist even by your definitions. If all races were equal in ability, then we should let pure competition dictate who is admitted to medical schools. To presume otherwise, that racial minorities need artificial help in order to achieve parity with others, is to insult and do them injustice. Racial minorities in medical school who are just as deserving as the other students could easily be seen as underachievers who are in medical school only because of affirmative action. Instead of mending race relations, affirmative action merely reinforces stereotypes about the difference in intelligence between races by giving a valid argument to racists.

 

It is not as though there is this huge influx of non-deserving people entering medicine right now.

You are right. But this is an argument about principles and not the practical. We have no actual influence over the practice of affirmative action. See it as practice for the MCAT verbal and written sections, I guess?

[Satsuma]

Actually, such "positive" racism is explicitly allowed by the Canadian Constitution under chapter 15.2 of the Canadian Charter of Rights and Freedoms. Check it out.

 

Affirmative action, or whatever you want to call it, is racism. It discriminates against traditional applicants (whites and Asians) in favour of non-traditional applicants (blacks and Aboriginals).

 

Still talking about affirmative action with respect to medical school applications? Just asking since affirmative action in this regard is generally based on geography and not race. If you are a resident of Ottawa applying to U of Ottawa the cut-off you will need to meet is lower than the rest of Ontario or Canada regardless of race. Similarly, a resident of southwestern Ontario will need to meet lower cut-offs when applying to UWO than other applicants regardless of race.

[Kuantum]

Still talking about affirmative action with respect to medical school applications? Just asking since affirmative action in this regard is generally based on geography and not race. If you are a resident of Ottawa applying to U of Ottawa the cut-off you will need to meet is lower than the rest of Ontario or Canada regardless of race. Similarly, a resident of southwestern Ontario will need to meet lower cut-offs when applying to UWO than other applicants regardless of race.

 

That's not affirmative action. Affirmative action is directed at minorities, under-represented groups, or specific groups to compensate for past discrimation by ensuring equal opportunities today. What Ottawa does is just a policy designed to ensure as many people stay in Ottawa/Ontario as possible. Its the same as holding OOP applicants to higher standards than in-province applicants.

[Escapade]

I know that the University of Saskatchewan reserves 3 spots for those of aboriginal ancestry, and from there if someone who has aboriginal descent doesn't get in they're added to the pool of other candidates. I know this because I am metis and have looked into it.

 

Similarly, I think most Canadian med schools do the same.

 

But don't quote me on that!

[Satsuma]

Ah, I see...thanks for clarifying. As far as I recall I have not heard of medical schools in Canada having policies on this "affirmative action" then. So I did a quick search. I found nothing for Canada, but did find much in the US. Apparently many schools have these affirmative action plans, these have been challenged, and their right to have them supported by the courts. It seems the policies at the American schools are not hidden, I suspect if Canadian schools had them, they would be overt as well?

 

I am adding some food for thought that is from the AAMC site (in addition to what is below they also talk about how some places have tried to conceive race-neutral appraoches, such as selecting based on residency in a underserviced postal code):

 

For more than thirty years, medical schools have made a concerted effort to increase the racial and ethnic diversity of their institutions. Affirmative action has served as a successful mechanism for increasing diversity, enabling large numbers of minority students to enroll in medical school. There is still a great deal of work to be done, however, if medical school classes are to accurately reflect our society. Today 1 in 4 Americans is either Black, Hispanic, or Native American; however in medical school these groups comprise only:

 

· 1 in 10 medical students,

· 3 in 100 faculty members, and

· 1 in 100 full professors.

 

Diversity is essential in medical education because medical schools have a societal obligation to select and educate the physician workforce of the future. During this process, medical schools must be ever mindful of protecting and improving the health of the public. From the standpoint of medicine, there are four major practical reasons why diversity is vitally important:

 

1. It shapes the quality of medical education for all students. Creating a diverse medical class has a positive impact on physician skills and knowledge in understanding how culturally determined factors affect health. "Culturally competent" physicians possess skills and attitudes that help them treat people from a wide range of cultural and ethnic backgrounds.

 

2. It helps increase access to medical care. Ethnic and racial minority populations are growing rapidly, and serious health disparities exist among these populations. In order to address this issue the physician workforce of the future will have to rely even more on minority populations to ensure that all Americans receive adequate health care.

 

3. Diversity in the medical research workforce leads to an acceleration of advances in medical and public health research. Diversity in the research workforce will lead to investigations of problems that historically have not received a great deal of attention. These are problems that are often rooted in social, cultural, and behavioral determinants.

 

4. And finally, diversity in the health-care industry makes good business sense. A managerial staff that mirrors the racial and ethnic makeup of a health-care organization's clientele will be more capable of dealing with the needs of individuals from diverse backgrounds.

 

In addition to these practical reasons, there is also a more principled, ethical argument for increasing diversity in medical education. A just society must ensure that an equality of opportunity exists for those interested in a medical career. There are still a great deal of barriers that exist for many racial and ethnic minorities. Some of these barriers include poorly equipped schools serving areas that are home to large numbers of minorities, financial barriers to higher education, and lower levels of academic achievement among parents of minority students.

[Smurfette]

Race is much more of an issue concerning university (and medical school) admissions in the United States than in Canada. Racial disadvantages in North America today are generally not due to overt racism, but rather due to systemic reasons that have been the result of many generations. For example, minority students may be underrepresented because their parents were uneducated and poor and not able to give them the opportunities to go to university. This is a vicious cycle. In the United States, there has been a long history of racial discrimination: the most obvious being the history slavery among African-Americans.

 

Canada has a different make-up. With the exception of the Aboriginal community (residential schools, etc.), most minority groups in Canada do not have a generations of a history of racism. For the large part, minorities in Canada are relatively recent immigrants. Canadian immigrants are selected on the basis of wealth, education, etc, and so many immigrant families are actually advantaged rather than disadvantaged. Therefore, unlike in the US, it doesn't really make sense for Canadian schools to implement broad policies of affirmative action except among Aboriginal communities.

[studentz]

Canada has a different make-up. With the exception of the Aboriginal community (residential schools, etc.), most minority groups in Canada do not have a generations of a history of racism. For the large part, minorities in Canada are relatively recent immigrants. Canadian immigrants are selected on the basis of wealth, education, etc, and so many immigrant families are actually advantaged rather than disadvantaged. Therefore, unlike in the US, it doesn't really make sense for Canadian schools to implement broad policies of affirmative action except among Aboriginal communities.

 

Do you have any idea how long East Asian, South Asian and African populations have been in Canada? Moreover, what about refugees who are generally lacking most of the characteristics selected for by the immigration system?

 

Trust me, there is a generations-long history of racism in this country, there was slavery in this country, and there still is racism in this country. One area where racism exists, and is overt, is at the level of high school teaching and counselling. This plays a huge role in the continued streaming of kids at an early stage into general and college-bound courses from which entry to medical school, for instance, is nearly impossible. I guarantee that the tuition levels we currently face also deter certain low SES groups from pursuing medical or even undergraduate university education.

 

Unlike the US, we do a poor job of recognizing it, instead preferring to say that it's not a problem since it's not as bad or overt as it is in some areas of the US. The AAMC has done a great deal of research showing the benefits of having a representative physician workforce. I don't have timate to detail it here, but go to the website and see for yourselves. And for the record, rural communities aren't the only underserviced areas in this country. Just as a city slicker from Toronto may not be likely to go an practice in rural, Northern Ontario, it's probably just as unlikely that a 6th generation, Caucasian Canadian from the same Northern community would relocate to and set up practice in Regent Park working with African, South Asian and Asian immigrants.

[Smurfette]

Do you have any idea how long East Asian, South Asian and African populations have been in Canada? Moreover, what about refugees who are generally lacking most of the characteristics selected for by the immigration system? Trust me, there is a generations-long history of racism in this country, there was slavery in this country, and there still is racism in this country.

 

Sure, there have been Asian/African's in Canada for a long time. And those that were here experienced horrible racism (eg. Chinese railroad workers, Japanese in WWII, blacks fleeing the South via the Underground railway). I agree that the minority groups that were in Canada were quite disadvantaged. But in comparison to African-Americans and Canadian Aboriginals, these groups are relatively small in number. Most of the "multicultural" makeup of Canada is a relatively recent phenomenon (post-WWII). You're right about the refugees though.

 

One area where racism exists, and is overt, is at the level of high school teaching and counselling. This plays a huge role in the continued streaming of kids at an early stage into general and college-bound courses from which entry to medical school, for instance, is nearly impossible. I guarantee that the tuition levels we currently face also deter certain low SES groups from pursuing medical or even undergraduate university education.

 

LOL, I actually have a personal story about this. I was sent to be tested for ESL in high school even though I never had a problem with English all throughout my 7 years of elementary school. (In fact, I ended up winning subject awards for English and English Literature all throughout high school). I think it's because I was obviously a racial minority (by name and by appearance).

 

Despite that one experience, however, I don't think racism in high school is as bad as you make it out to be. I don't know how it works in the rest of the country, but I felt that there was relatively little streamlining when I went to high school (in BC). I don't know whether that's changed now - there's been quite a few changes to the curriculum in the past few years. I remember everyone had to take the standard English, math, sciences, and social studies. Only once you get to grade 11 was there much choice at all. The only exception to this is was new immigrants could take ESL and transitional English. But they still had to take the normal social studies, etc. Compare this to other countries (eg. some countries in Asia, Europe) where students are streamlined from very young ages into streams of science or arts (academics) and apprenticeships (technical).

[Destiny Gundam]

Geez, don't you guys have better things to do? Ethnicity has nothing to do with your chances. Just look at my 2010 class.

[TimmyMax]

Hey,

 

I agree with Gundam. You can argue about the semantics of affirmative action and what is and isn't racist all you want, but ethnicity has nothing to do with your chances.

Snore...