Ever Feel Like Med School Is A Big Rich Kids Club?

[Neurophilic]

A course on social determinants of health can't compensate for a lifetime. In my own experience, 90% of wealthy students manage to complete such courses and still remain in complete and total denial of their privlege. Shocking, but very true

Don't throw unverified stats around because I'm pretty sure this fact is clearly wrong . Where did this stat come from? Purely anecdotal. 

[thethirdlaw]

Don't throw unverified stats around because I'm pretty sure this fact is clearly wrong . Where did this stat come from? Purely anecdotal. 

 

A friend of mine worked on a program over the last few years in which med students role-play in a game to mimic the difficulties created by some of the SDH. Many were dumbfounded by the limitations that face a large proportion of Canadians everyday, some thought that there was no way the conditions were real and made the learning experience into a joke. He did admit that some did benefit, and you could see that they pulled lessons away from it. But overall, they were oblivious to the real life hardships that people battle everyday and how it can affect their health. Anecdotal, sure, but it highlights a severe deficit in both medical education and selection criteria.

 

Note, I'm not the poster you originally replied to, just throwing out some stories, hearsay but whatever, into the discussion pile.

[62E]

Since I started med school, I have been amazed by the extremely biased socioeconomic background of my classmates.  I grew up in a middle class home and feel comparatively disadvantaged.  It seems like the norm for my classmates to have full parental support through med school, all designer clothing and a summer/winter home to vacation in.  I wonder how much of this is due to selection via admission practices, or just the fact that these students grew up in more supportive environments.  I'd be curious to know how my experience compares to other schools.

 

Students who are wealthier have access to greater resources and better environments which leads them to make better choices and be better students. Naturally any merit based system will tend to select for those who are wealthier because of this.

 

From my personal experience such students tend to be better/more eloquent speakers, which comes out very strongly in interviews. I've seen this phenomena occur frequently business programs (e.g. QC, Ivey) where students from lower socioeconomic backgrounds often have to learn to diverge from their roots (both in language and culture) to attain a presentable, professional self. This puts such students at a disadvantage when it comes to interviews even if they are technically capable people.

[Neurophilic]

A friend of mine worked on a program over the last few years in which med students role-play in a game to mimic the difficulties created by some of the SDH. Many were dumbfounded by the limitations that face a large proportion of Canadians everyday, some thought that there was no way the conditions were real and made the learning experience into a joke. He did admit that some did benefit, and you could see that they pulled lessons away from it. But overall, they were oblivious to the real life hardships that people battle everyday and how it can affect their health. Anecdotal, sure, but it highlights a severe deficit in both medical education and selection criteria.

I'm not denying the deficit but it's pretty bold to claim that 90% of wealthy students take relevant courses and still remain in denial of their privilege. Additionally, the study looks at med students and not specifically those who have taken courses that talk about SDH so it doesn't really defend the anecdotal claim made.  

[Neurophilic]

Students who are wealthier have access to greater resources and better environments which leads them to make better choices and be better students. Naturally any merit based system will tend to select for those who are wealthier because of this.

 

From my personal experience such students tend to be better/more eloquent speakers, which comes out very strongly in interviews. I've seen this phenomena occur frequently business programs (e.g. QC, Ivey) where students from lower socioeconomic backgrounds often have to learn to diverge from their roots (both in language and culture) to attain a presentable, professional self. This puts such students at a disadvantage when it comes to interviews even if they are technically capable people.

And all of this plays into account for who adcomms perceive to be the better future doctors. It's not that they are deliberately choosing higher SES applicants. It just so happens that the higher SES applicants tend to become better applicants and more suitable due to the advantages offered by being part of a higher SES. 

[_ _]

I agree with you, and I've spoken with a dean about this, they know the system is broken. They're working on it, but it's behind closed doors and who knows what'll happen. And beyond that, it's a difficult change to make, the selection process needs to fair and objective, but the road for applicants to even set foot in the selection process isn't.

Interesting, but good to hear. Judging by the blog post Queen's released this year I gathered they were becoming (slowly) more aware. Whether this is part of the efforts your referring to or not, I also saw questions directly relating to this in nearly every interview this year

[ralk]

And all of this plays into account for who adcomms perceive to be the better future doctors. It's not that they are deliberately choosing higher SES applicants. It just so happens that the higher SES applicants tend to become better applicants and more suitable due to the advantages offered by being part of a higher SES. 

 

Adcoms use proxies when evaluating applicants. GPA, MCAT, ECs, LORs, these are all correlated with suitability, but none are definitively indicative of it. Individuals with wealth have more resources to succeed at these proxies that students with less wealth don't, and therefore may improve their performance on proxies without improving their actual suitability. Your argument seems to be that wealth is an advantage, but is an advantage in that it makes applicants into more capable candidates. There's probably some truth to that. However, what I believe the other posters are getting at is that in many cases, wealth is an advantage in that it makes applicants look like they're more capable candidates without actually improving their fundamental capability, thereby causing applicants with less wealth who are equally capable or more capable to be passed over.

 

Additionally, the point has been raised that coming from a low SES background may in itself be a qualification, just not one that medical schools currently consider. Wealthier students can and should gain exposure to those of different backgrounds, but gaining that understanding doesn't necessarily lead to an appreciation of the situation lower SES patients face. It's not just empathy that matters, it's functionality. Access to medical services is a huge example - physicians tend to want to work days, yet many people work during the day. Many physicians just assume that patients can make it to daytime medical appointments, or that these appointments are so vital it's worth missing work. Yet, for many lower SES people, that's not the case - missing a day of work can mean being unable to pay rent, or losing that job. We're now seeing a coordinated push to encourage doctors, mostly FPs, to have more evening/weekend availability, but it's slow progress. It's hard to appreciate how important those non-daytime hours are when you've never had to face the conundrum of health vs wealth.

[daftjustice]

Adcoms use proxies when evaluating applicants. GPA, MCAT, ECs, LORs, these are all correlated with suitability, but none are definitively indicative of it. Individuals with wealth have more resources to

Additionally, the point has been raised that coming from a low SES background may in itself be a qualification, just not one that medical schools currently consider. Wealthier students can and should gain exposure to those of different backgrounds, but gaining that understanding doesn't necessarily lead to an appreciation of the situation lower SES patients face. It's not just empathy that matters, it's functionality. Access to medical services is a huge example - physicians tend to want to work days, yet many people work during the day. Many physicians just assume that patients can make it to daytime medical appointments, or that these appointments are so vital it's worth missing work. Yet, for many lower SES people, that's not the case - missing a day of work can mean being unable to pay rent, or losing that job. We're now seeing a coordinated push to encourage doctors, mostly FPs, to have more evening/weekend availability, but it's slow progress. It's hard to appreciate how important those non-daytime hours are when you've never had to face the conundrum of health vs wealth.

Interesting idea of parsing between the possession of empathy in the abstract vs. its practical application. Certainly there are some people who can regurgitate the facts about differential health outcomes across the SES gradient, while what this really means will never really "click" for them.

 

 

As an aside, it would be interesting to see if FPs who came from low SES backgrounds are more likely than their "high-SES background peers" to have evening/weekend availability at their practices.

 

 

 

 

[_ _]

Don't throw unverified stats around because I'm pretty sure this fact is clearly wrong . Where did this stat come from? Purely anecdotal. 

Good one. It's not a fact. It's a figure of speech. Replace it with 'many' or 'majority' if it bothers you that much

[JohnGrisham]

All these points are valid, however, it is clear that those from lower SES are less likely to do as well, with respect to education, as those from higher SES (due to upbringing and environmental nourishment). Don't we want the most competent doctors that we can have? There are already very limited seats. Do you think it would be right to make a quota to have the majority of the seats saved for those from lower SES? One cannot really control the family they are born into and the SES they are raised in. Would it be fair to deny someone the opportunity because we need to fill a specific quota or match a specific demographic even though they are more likely to be successful? If we do this we need to sacrifice physician quality as well as meritocracy. I think a solution to this should be to introduce prerequisite courses which teach about the social determinants of health and perhaps the issues and problems that those of lower SES families face. In fact, the new MCAT has included some of this in the psych/soc section. By doing this we don't necessarily have to sacrifice physician quality to attain that truly empathetic doctor. With all of that said, I want to clarify that when I say that we would be sacrificing physician quality by introducing more low SES individuals into the field, I am not saying that lower SES individuals cannot make great physicians. I am simply following the trends associated with SES and education. Those in higher SES tend to do better not because they are better, but simply because they have better/more opportunity.

Again, let's take UBC as an example, class of 288, interviews around 600. You could take any of those 600 likely and switch them out with the current class and they would be likely equally competent. Not to mention those that simply didn't even make the cut off but would also do just fine.

 

We need to stop making competence based comparisons when it is not based on that but simply supply and demand.

[JohnGrisham]

No I didn't miss that. Yes there are many qualified applicants but I was talking about selecting the most qualified, whether it is an extra .01 GPA or 10 MCAT points. I think any actual merit should take priority over demographics. When med schools do end up choosing some of the qualified applicants from a larger pool of qualified candidates, they do exactly that - they choose the most qualified of that group.

Merit for the sake of merit is absolutely meaningless. That makes you no better of a physician at all, and does not help patient outcomes.

[BTJJ]

My parents were middle class professional - teacher and nurse. Back in the 70s (I'm much older than y'all), teaching was a respected profession. Most of our neighbourhood was working class, although there was a doctor, a couple engineers and a few entrepreneurs in the neighbourhood (again, in my parents' generation - born in the 30s - working class was the norm). My dad had financial stresses, but we never wanted for anything.

 

I attended law school in the mid-90s. I felt like the poor kid. Among my classmates was the grandson of a Supreme Court justice, a daughter of an Ontario court of appeal judge, children of lawyers, accountants, doctors, etc. A few came from prominent Canadian business families. This state of affairs was for all the reasons mentioned above. High performing parents tend to pass on better genetic material to their children; parents of wealth can provide better opportunities for their children; higher status parents have higher expectations for their children. If life is a marathon, some kids start at the 10 mile mark, others start at the start line. But at the same time, don't deprecate the achievements of the privileged. The grandson of the Supreme Court judge I mentioned was not only one of the most brilliant students in our school, he was kind and generous.

 

Nevertheless, 21st century Canadian society is one of the most mobile in the world in terms of socio-economic status. If you feel poorer than your classmates, wear it as a badge of honour. And if your own parents supported you to the best of their abilities and resources, don't minimize their efforts, thank them for all they've done, and let them brag a little bit about "my son/daughter, the doctor".

[BTJJ]

Access to medical services is a huge example - physicians tend to want to work days, yet many people work during the day. Many physicians just assume that patients can make it to daytime medical appointments, or that these appointments are so vital it's worth missing work. Yet, for many lower SES people, that's not the case - missing a day of work can mean being unable to pay rent, or losing that job. We're now seeing a coordinated push to encourage doctors, mostly FPs, to have more evening/weekend availability, but it's slow progress. It's hard to appreciate how important those non-daytime hours are when you've never had to face the conundrum of health vs wealth.

 

This is a great observation. One of the frustrations many people have with the medical profession is the attitude of some physicians that their time is so much more valuable and important than anyone else's.

[Edict]

Adcoms use proxies when evaluating applicants. GPA, MCAT, ECs, LORs, these are all correlated with suitability, but none are definitively indicative of it. Individuals with wealth have more resources to succeed at these proxies that students with less wealth don't, and therefore may improve their performance on proxies without improving their actual suitability. Your argument seems to be that wealth is an advantage, but is an advantage in that it makes applicants into more capable candidates. There's probably some truth to that. However, what I believe the other posters are getting at is that in many cases, wealth is an advantage in that it makes applicants look like they're more capable candidates without actually improving their fundamental capability, thereby causing applicants with less wealth who are equally capable or more capable to be passed over.

 

Additionally, the point has been raised that coming from a low SES background may in itself be a qualification, just not one that medical schools currently consider. Wealthier students can and should gain exposure to those of different backgrounds, but gaining that understanding doesn't necessarily lead to an appreciation of the situation lower SES patients face. It's not just empathy that matters, it's functionality. Access to medical services is a huge example - physicians tend to want to work days, yet many people work during the day. Many physicians just assume that patients can make it to daytime medical appointments, or that these appointments are so vital it's worth missing work. Yet, for many lower SES people, that's not the case - missing a day of work can mean being unable to pay rent, or losing that job. We're now seeing a coordinated push to encourage doctors, mostly FPs, to have more evening/weekend availability, but it's slow progress. It's hard to appreciate how important those non-daytime hours are when you've never had to face the conundrum of health vs wealth.

 

Agree so much with the availability thing, if any doctor is to work part time or full time i'd much rather them work evenings/weekends over days. I remember being frustrated that the doctors would always be closed by the time my parents or I got off school/work. Luckily, never had any of these minor health issues actually turn out to be big but again i remember it being a goal of mine to ensure I would have longer opening hours if i ever became a doc. 

[62E]

Adcoms use proxies when evaluating applicants. GPA, MCAT, ECs, LORs, these are all correlated with suitability, but none are definitively indicative of it. Individuals with wealth have more resources to succeed at these proxies that students with less wealth don't, and therefore may improve their performance on proxies without improving their actual suitability. Your argument seems to be that wealth is an advantage, but is an advantage in that it makes applicants into more capable candidates. There's probably some truth to that. However, what I believe the other posters are getting at is that in many cases, wealth is an advantage in that it makes applicants look like they're more capable candidates without actually improving their fundamental capability, thereby causing applicants with less wealth who are equally capable or more capable to be passed over.

 

There's data on affirmative action policies in America that shows how minorities that benefit from affirmative action in the university/college admission process—despite also benefiting from extremely generous student aid/scholarships—tend to make up the lower distribution of class averages in their respective programs.

 

Kids from wealthy families not only have access to invaluable resources that gives them an edge when it comes to academics, but tend to have grown up in a supportive environment surrounded by successful individuals to inspire & guide them. Those who grow up in a lower class area have to contend with lower quality schools, stressed out teachers, relatively less family/environmental support, and fewer successful mentors that they can turn to.

 

With regards to GPA & MCAT, higher standards almost certainly translates into admitting stronger students; there's plenty of data on that out there. However, the correlation between GPA & MCAT and one's competence as a doctor is likely to be much weaker (since the skill sets utilized by a student and a doctor are almost very different). Still, until there's data showing better patient outcomes with physicians who have come from a low SES background, it will continue to make the most sense for medical schools to admit the best students.

[ralk]

Nevertheless, 21st century Canadian society is one of the most mobile in the world in terms of socio-economic status. If you feel poorer than your classmates, wear it as a badge of honour. And if your own parents supported you to the best of their abilities and resources, don't minimize their efforts, thank them for all they've done, and let them brag a little bit about "my son/daughter, the doctor".

 

Totally agree, it's worth keeping in mind that we do have a society with decent social mobility and that no one, ever, should feel embarrassed or guilty about their background - no one controls who their parents are or how they grew up.

 

However, that doesn't negate the need for change and we should acknowledge that there is a representation problem in medicine. I mean, I came from a relatively advantaged background, but not by medical school standards, where I'm at or below the median. That's concerning and while there are no easy solutions, it's worth taking steps to address that disparity where possible.

 

Agree so much with the availability thing, if any doctor is to work part time or full time i'd much rather them work evenings/weekends over days. I remember being frustrated that the doctors would always be closed by the time my parents or I got off school/work. Luckily, never had any of these minor health issues actually turn out to be big but again i remember it being a goal of mine to ensure I would have longer opening hours if i ever became a doc. 

 

Feel the exact same - already thinking of ways to find an appropriate balance between accessibility for patients and accessibility for family

 

There's data on affirmative action policies in America that shows how minorities that benefit from affirmative action in the university/college admission process—despite also benefiting from extremely generous student aid/scholarships—tend to make up the lower distribution of class averages in their respective programs.

 

Kids from wealthy families not only have access to invaluable resources that gives them an edge when it comes to academics, but tend to have grown up in a supportive environment surrounded by successful individuals to inspire & guide them. Those who grow up in a lower class area have to contend with lower quality schools, stressed out teachers, relatively less family/environmental support, and fewer successful mentors that they can turn to.

 

With regards to GPA & MCAT, higher standards almost certainly translates into admitting stronger students; there's plenty of data on that out there. However, the correlation between GPA & MCAT and one's competence as a doctor is likely to be much weaker (since the skill sets utilized by a student and a doctor are almost very different). Still, until there's data showing better patient outcomes with physicians who have come from a low SES background, it will continue to make the most sense for medical schools to admit the best students.

 

I've seen those studies on affirmative action policies, in addition to some which indicated a fairly high drop-out rate for beneficiaries of affirmative action, which is part of the reason I'm not a huge fan of them in most cases. It's also not entirely surprising to see those results in retrospect - affirmative action is really a one-time boost, not a reversal of years of disadvantage or a prevention of continuing disadvantage. Student aid can help reduce the economic disadvantage while in university, but it doesn't necessarily eliminate that disadvantage, and does absolutely nothing to address the social disadvantages low SES students face. Stories about social isolation or having to try to keep up with their much wealthier friends' social spending habits are fairly common. The point is that when SES disparities don't change, it's not too surprising that performance disparities don't change either, especially within a higher-SES setting like academia. Even in those studies, those benefiting from affirmative action may simply be looking like they're less capable relative to their peers, just as they were before they were admitted.

 

Now, undoubtedly there are some advantages to being wealthy that translate into actual gains in competency. If we were able to perfectly select candidates based on future performance, it wouldn't surprise me to see a distribution of students on the higher end of the SES spectrum. Much of what higher SES parents think help don't have much evidence behind them (private school, for example, doesn't seem to do much), but you throw enough plausible approaches at your kids, something'll make a difference. However, it's important not to assume that disparities are due to differences in fundamental competency - too often that assumption has been left unchallenged, yet used to justify inaction that perpetuates disparities that aren't due to differences in fundamental competency.

 

As for GPA and MCAT, it's true there are some correlations with performance in medical school and I would never suggest eliminating them as factors in admission. However, the correlation is not that strong, and it's very specific - that is, undergrad GPA seems to correlate better with medical school GPA, while MCAT correlates better with standardized tests like the USMLE, particularly Step 1. Crossing over to dissimilar measures of performance in medical school (eg MCAT to medical school GPA) lowers the correlation. It also doesn't have quite as much relevance in Canada, where most of us don't have a GPA in medical school and standardized tests hold minimal importance. We also have some natural tests on the importance of maintaining high GPA/MCAT standards on student performance and it doesn't seem to matter all that much. For example, some schools have geographic preferences that result in some or all people getting in with somewhat lower GPA/MCAT combinations, yet there doesn't seem to be much indication that performance from students in these cohorts is in any way concerning. If there is a difference in competency, we're either turning a blind eye to it, or it's just not significant enough to matter.

[ieatpremeds]

Interesting discussion, here's the latest data available from the NFS with regards to parental incomes.

 

http://nationalphysiciansurvey.ca/wp-content/uploads/2013/02/2012-Stu-Q26-EN.pdf

[_ _]

Interesting discussion, here's the latest data available from the NFS with regards to parental incomes.

 

http://nationalphysiciansurvey.ca/wp-content/uploads/2013/02/2012-Stu-Q26-EN.pdf

Interesting! So what we've been speculating it is true then.....

[ieatpremeds]

Interesting! So what we've been speculating it is true then.....

It's very true. Not very surprising, wealth is often correlated with connections and opportunities. That being said, I do not believe that our medical classes are filled with out of touch social elites.... some of my wealthiest classmates are the most down to earth and understanding. However there is a gap somewhere and a debate on whether individuals from lower/average socioeconomic backgrounds would make for better doctors one I'd love to watch.

[Heisencat]

Random rant/story from my class:

 

A few days ago, I was talking to a rich kid (double doctor family) who's in my class and the topic of awards came up. He expressed disappointment that so many awards given by our school are based on financial need and not actually merit. He was upset because he wasn't qualified for a lot of the awards thanks to his wealth. Lol, wut? First, there are tons of awards/research opportunities that are merit-based at our school for which he would clearly have an advantage. Second, this is a kid who has travelled all over the world and has had/still has access to many amazing learning opportunities. Seriously, some of the kids in my class are so removed from reality that it sickens me when they go about claiming how they want to go on to work in oh-so-sexy global health and health policy with your prototypical "third-world" countries or "inner-city/marginalized" populations. So I absolutely agree with those of you saying we need a more diverse representation of SES in med schools. 

[IMislove]

I like this quote from The Kingsmen, Eggsy to Harry "Because my mum went mental, banging on about losing me as well as my dad. Then we wouldn't be cannon fodder for snobs like you, judging people like me from your ivory towers with no thought about why we do what we do. We ain't got much choice, you get me? And if we was born with the same silver spoon up our arses, we'd do just as well as you, if not better."

[oshaku]

Random rant/story from my class:

 

A few days ago, I was talking to a rich kid (double doctor family) who's in my class and the topic of awards came up. He expressed disappointment that so many awards given by our school are based on financial need and not actually merit. He was upset because he wasn't qualified for a lot of the awards thanks to his wealth. Lol, wut? First, there are tons of awards/research opportunities that are merit-based at our school for which he would clearly have an advantage. Second, this is a kid who has travelled all over the world and has had/still has access to many amazing learning opportunities. Seriously, some of the kids in my class are so removed from reality that it sickens me when they go about claiming how they want to go on to work in oh-so-sexy global health and health policy with your prototypical "third-world" countries or "inner-city/marginalized" populations. So I absolutely agree with those of you saying we need a more diverse representation of SES in med schools. 

 

Similar story: my friend's dad is a rich (income after tax >400k) doctor in the states and he complains about the fact that his son is at MIT which doesn't give merit based scholarship.  This is after his son already got another external merit based scholarship after graduating highschool, that he then lost because of poor academics, and the parents contested with the award committee to get it back because "come on, he's at MIT".  

[a1b1]

Since I started med school, I have been amazed by the extremely biased socioeconomic background of my classmates.  I grew up in a middle class home and feel comparatively disadvantaged.  It seems like the norm for my classmates to have full parental support through med school, all designer clothing and a summer/winter home to vacation in.  I wonder how much of this is due to selection via admission practices, or just the fact that these students grew up in more supportive environments.  I'd be curious to know how my experience compares to other schools.

 

It does feel that way. Most of my classmates are either kids of doctors or have some form of medical connection in their family. It does make sense i suppose. If your parents are rich, then as a child you are able to have the necessary things in life that can give you the best oppertunities to be successful. I.e go to private school, get tutoring if need be, be able to do activities outside of school e.t.c.

 

My family never had much, money wise they had enough to get by but that was it. I did not go to private school where as someone whos parents were richer might of. In my graduating high school class, most of my fellow classmates are now either in jail or pregnant, maybe only 10 of us out of over 100 students went on to university. Not saying getting pregnant is bad, those are life choices and we make of our lives what we want them to be. But the point im trying to bring across here is, if your parents have money, then you probably will have better oppertunities in life and by consequence you will have a better chance at being successful (what ever you define that to be).

[NLengr]

It does feel that way. Most of my classmates are either kids of doctors or have some form of medical connection in their family. It does make sense i suppose. If your parents are rich, then as a child you are able to have the necessary things in life that can give you the best oppertunities to be successful. I.e go to private school

There is good data from Canada that shows that it's the SES status of the kids, not the private school that makes them do better. You could take those same kids, drop them in public school, and they would be just as successful. 

 

http://www.cbc.ca/news/canada/private-school-success-due-to-better-students-not-better-schools-statscan-says-1.3016123

 

Turns out if you cherry pick the kids likely to succeed in life, than they will do better on average than a randomly selected group of kids. Who knew?

[62E]

I've seen those studies on affirmative action policies, in addition to some which indicated a fairly high drop-out rate for beneficiaries of affirmative action, which is part of the reason I'm not a huge fan of them in most cases. It's also not entirely surprising to see those results in retrospect - affirmative action is really a one-time boost, not a reversal of years of disadvantage or a prevention of continuing disadvantage. Student aid can help reduce the economic disadvantage while in university, but it doesn't necessarily eliminate that disadvantage, and does absolutely nothing to address the social disadvantages low SES students face. Stories about social isolation or having to try to keep up with their much wealthier friends' social spending habits are fairly common. The point is that when SES disparities don't change, it's not too surprising that performance disparities don't change either, especially within a higher-SES setting like academia. Even in those studies, those benefiting from affirmative action may simply be looking like they're less capable relative to their peers, just as they were before they were admitted.

I agree for the most part. I'm just saying that low SES environments creates disadvantage that leads to creating weaker students (because of all the additional barriers and challenges they have to deal with on top of school), while a high SES environment creates advantages that leads to stronger students.

 

 

Now, undoubtedly there are some advantages to being wealthy that translate into actual gains in competency. If we were able to perfectly select candidates based on future performance, it wouldn't surprise me to see a distribution of students on the higher end of the SES spectrum. Much of what higher SES parents think help don't have much evidence behind them (private school, for example, doesn't seem to do much), but you throw enough plausible approaches at your kids, something'll make a difference.

Private school is a means for wealthy families to have their children interact with children from other wealthy families more than anything else. The connections made can be quite valuable (though they could be relatively useless if not utilized or if the child has difficulty socializing in the first place).

 

However, it's important not to assume that disparities are due to differences in fundamental competency - too often that assumption has been left unchallenged, yet used to justify inaction that perpetuates disparities that aren't due to differences in fundamental competency.

As for GPA and MCAT, it's true there are some correlations with performance in medical school and I would never suggest eliminating them as factors in admission. However, the correlation is not that strong, and it's very specific - that is, undergrad GPA seems to correlate better with medical school GPA, while MCAT correlates better with standardized tests like the USMLE, particularly Step 1. Crossing over to dissimilar measures of performance in medical school (eg MCAT to medical school GPA) lowers the correlation. It also doesn't have quite as much relevance in Canada, where most of us don't have a GPA in medical school and standardized tests hold minimal importance. We also have some natural tests on the importance of maintaining high GPA/MCAT standards on student performance and it doesn't seem to matter all that much. For example, some schools have geographic preferences that result in some or all people getting in with somewhat lower GPA/MCAT combinations, yet there doesn't seem to be much indication that performance from students in these cohorts is in any way concerning. If there is a difference in competency, we're either turning a blind eye to it, or it's just not significant enough to matter.

If you're talking about competency as a doctor, I agree. IMO capability as a student (which is what I believe GPA and MCAT correlate well with) is a small factor in the grand scheme of things when we look at what it takes to be a good doctor.