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

[JohnGrisham]

7 hours ago, Bambi said:

Coming from poverty, I never for a moment considered my self underprivileged in the slightest. Financial wealth of the family you are born into is probably m0re of a disadvantage than an advantage. Children born into wealth take it for granted and may well be less motivated, not more motivated. And contacts can only get you so far. If there is no merit, substance or character, your life and contribution to society may be more of an illusion than reality. In high school, many of my classmates came from very wealthy families, and yet, I have achieved far more than them. Why? I knew what I wanted, I knew my only path was entirely dependent upon myself, I was motivated, ambitious and with a plan, which got me where I am today. I did not need wealth nor family contacts, just determination, focus, hard work and execution of my plan. This has nothing to do with fairness. We all can have a list of excuses, it gets you nowhere. Yes, my poor circumstances exposed me to prejudice. This was a blessing as it only made be both stronger and sensitive to the human condition. I went out of my way to befriend and defend those whom I encounters who faced discrimination of whatever kind. I don't get it. We are all capable of reaching our human potential regardless of circumstances in Canada. 

While it has worked out for yourself, and myself to similiar extents(not without some hiccups), it isn't really all that reflective of many from our backgrounds. Determination and resolve can only get you so far, i know many of my childhood friends who were just as smart if not smarter than I, but they just couldn't focus on school to the same extent.  I worked a lot in high school, so i relied alot on natural intelligence to do well. My friends that also worked, didn't have that same innate ability to absorb and just didn't have the time to buckle down and get the work done needed to hit 90s+. Had they not had to work, they easily would've had the time.  

 

[premed989]

Oh man, I probably should have been better prepared for such a reaction to my rant.

This wasn't meant to be a sob story about how hard my life was. I mean, I think, on the whole, I've had it pretty good. I just find it kind of obnoxious that people deny their privilege when it comes to these things. My rant was about how strongly I believe being in low socioeconomic circumstance makes it harder for you to get in. 

I mean, my family was above median. What about the bottom third of the ladder? Many of the students I went to high school with grew up in the ghettos. Like, the proper ghettos. Those community housing projects near Chinatown for example. A lot of them had doctor aspirations just like you or I, who will probably never make it. Most of the people who live in those ghettos are new Canadians who can't afford to live anywhere better. It's not because their parents are lazy, or are drug abusers, or whatever you may think about people living in ghettos - they have regular family values. AFAIK (and it is a pretty tight-knit neighbourhood) none or almost none of them were able to enter medical school, from my generation. Shouldn’t poor kids have a shot at becoming doctors too?

And it can be pretty hard for students of low SES when they do get into medical school, because there’s a bit of an old boys club mentality once you’re in (old rich boy’s club). Like the indigenous student who talked about being bullied because she got in through facilitated admissions. The staff here at McMaster talked about how students actively made her feel like “she didn’t deserve to be in medical school”. That made me feel horrible, like most of my class. It also made me feel a bit angry, because I’ve read some of the threads here about facilitated admissions and sometimes it is not very nice.

I mean all the experiences I have described about being in low socioeconomic circumstance is made infinitely worse when your part of a population which is also marginalized. It is not a surprise that many indigenous families have experienced pretty traumatic events in their lifetimes. Many of these families have histories of drug/alcohol abuse from all of this – not a great upbringing. And anyone who says stigma isn’t a real issue when it comes to making it harder for indigenous students to get into medical school is blatantly proven wrong by these particular students who bullied her after she got in. Even among med students there seems to be a belief that indigenous kids are less capable than regular kids.

Getting into medical school is hard, and we all rightly should be proud of our accomplishments. There are a few students however, that walk around with the attitude that, because I got into medical school, I’m better than everyone else. Yeah, I’m not afraid to speak my mind. The belief that other people can’t get into medical school simply because they’re not as smart or capable as you is a toxic attitude to have. That said, most medical students are great, I really, really like my class. But, there’s always the couple of students who totally deny their privilege. They become defensive when you point out their privilege because they have to be better than their peers who didn’t get into medical school. These are the kinds of students that end up bullying that poor indigenous student, who would actively make her feel that she didn’t deserve to be here.

I mean, I find it pretty obnoxious when people deny their privilege on this forum, but to do it to an indigenous kid, telling her essentially that you're better than her despite all the privilege you've had as compared to her growing up, is some next level thing.

[premed989]

Also, thanks for all the comments and support. I hope you appreciate that it takes a lot of courage to write about this, to open up your personal life to the internet, with the expectation that you might possibly get attacked for it. 

I'm not afraid to speak my mind though, and this is how I honestly feel about this whole issue. So thanks for appreciating that.

[Birdy]

@premed989 

You may see me around. I'm a non-traditional student in the class of 2018 at Mac, and I've had plenty of moments where I've grumbled about the fact that such a large proportion of the class comes from very privileged backgrounds and don't necessarily realize how much that protects them from the reality their patients experience. Sometimes I do feel like some staff and other learners look at patients who are a lot like me almost like exhibits in a zoo because the different life experience makes it so hard for them to view their patients fully as people and connect with them.

Thing is, though, for the most part I am seeing my classmates growing into compassionate doctors who try to be very aware of the needs of their patients. I think your classmates will surprise you as you get to know them and as you guys interact with patients more. 

[ralk]

One thing I hope all posters and readers remember is that when it comes to discussions of advantage vs disadvantage for getting into medical school, the arguments being made (at least the valid ones) are probabilistic, not deterministic. Canada is indeed a place of opportunity, where almost anyone can become a physician. And, it is one of sufficient meritocracy that individuals with every conceivable advantage are not guaranteed to become physicians either. Yet, it remains a place where some groups are far, far more likely to become physicians than others, without clear differences in merit.

Likewise, when it comes to compassion towards patients, especially disadvantaged ones, and having reasonable perspective to treat these patients, there is nothing that says physicians with privileged upbringings cannot be as competent as their less-advantaged - or even that every less-advantaged physician is necessarily strong in these regards - but merely that those who come from privilege are less likely to understand and relate to those patients under their care (and there is research to back up such an assertion).

Applying definitive statements to individuals is therefore inappropriate. Maybe a particular individual is a jerk to patients because they grew up with a silver spoon in their mouth. Maybe they're just a jerk and would have been either way. Maybe a person from a lower SES background would have gotten into medical school if they were born to a wealthier family, but there's no guarantee of that. This thread has started trending towards discussion of individuals and that's not really appropriate or useful. We can't apply much meaning to individual circumstances because each individual's path is too complicated to effectively parse out and we can't redo their lives to determine how that path would have changed. What we can do is talk about groups. Any structural, policy, or societal changes that occur would be targeted on a group level, not towards individuals. There are actions the medical community could take collectively to encourage more socioeconomic diversity among physicians - or at least better perspectives on socioeconomic status among physicians - that we have yet to do. And, contrary to Cain's rather defeatist assertion, complaining about it may be one of the better ways to push for such changes.

[mononoke]

12 hours ago, premed989 said:

Oh man, I probably should have been better prepared for such a reaction to my rant.

This wasn't meant to be a sob story about how hard my life was. I mean, I think, on the whole, I've had it pretty good. I just find it kind of obnoxious that people deny their privilege when it comes to these things. My rant was about how strongly I believe being in low socioeconomic circumstance makes it harder for you to get in. 

I mean, my family was above median. What about the bottom third of the ladder? Many of the students I went to high school with grew up in the ghettos. Like, the proper ghettos. Those community housing projects near Chinatown for example. A lot of them had doctor aspirations just like you or I, who will probably never make it. Most of the people who live in those ghettos are new Canadians who can't afford to live anywhere better. It's not because their parents are lazy, or are drug abusers, or whatever you may think about people living in ghettos - they have regular family values. AFAIK (and it is a pretty tight-knit neighbourhood) none or almost none of them were able to enter medical school, from my generation. Shouldn’t poor kids have a shot at becoming doctors too?

And it can be pretty hard for students of low SES when they do get into medical school, because there’s a bit of an old boys club mentality once you’re in (old rich boy’s club). Like the indigenous student who talked about being bullied because she got in through facilitated admissions. The staff here at McMaster talked about how students actively made her feel like “she didn’t deserve to be in medical school”. That made me feel horrible, like most of my class. It also made me feel a bit angry, because I’ve read some of the threads here about facilitated admissions and sometimes it is not very nice.

I mean all the experiences I have described about being in low socioeconomic circumstance is made infinitely worse when your part of a population which is also marginalized. It is not a surprise that many indigenous families have experienced pretty traumatic events in their lifetimes. Many of these families have histories of drug/alcohol abuse from all of this – not a great upbringing. And anyone who says stigma isn’t a real issue when it comes to making it harder for indigenous students to get into medical school is blatantly proven wrong by these particular students who bullied her after she got in. Even among med students there seems to be a belief that indigenous kids are less capable than regular kids.

Getting into medical school is hard, and we all rightly should be proud of our accomplishments. There are a few students however, that walk around with the attitude that, because I got into medical school, I’m better than everyone else. Yeah, I’m not afraid to speak my mind. The belief that other people can’t get into medical school simply because they’re not as smart or capable as you is a toxic attitude to have. That said, most medical students are great, I really, really like my class. But, there’s always the couple of students who totally deny their privilege. They become defensive when you point out their privilege because they have to be better than their peers who didn’t get into medical school. These are the kinds of students that end up bullying that poor indigenous student, who would actively make her feel that she didn’t deserve to be here.

I mean, I find it pretty obnoxious when people deny their privilege on this forum, but to do it to an indigenous kid, telling her essentially that you're better than her despite all the privilege you've had as compared to her growing up, is some next level thing.

I've never seen this happening in our class, but this is pretty shocking and unacceptable...did those bullies get a professionalism lapse?

[Bambi]

On ‎2017‎-‎09‎-‎03 at 11:19 PM, JohnGrisham said:

While it has worked out for yourself, and myself to similiar extents(not without some hiccups), it isn't really all that reflective of many from our backgrounds. Determination and resolve can only get you so far, i know many of my childhood friends who were just as smart if not smarter than I, but they just couldn't focus on school to the same extent.  I worked a lot in high school, so i relied alot on natural intelligence to do well. My friends that also worked, didn't have that same innate ability to absorb and just didn't have the time to buckle down and get the work done needed to hit 90s+. Had they not had to work, they easily would've had the time.  

 

On the other side of the coin, I have known many students who have been blessed with wealth and so-called privilege, they took it for granted and did not amount to very much as they were not motivated and felt they had an easy life regardless of how the loaf was sliced. In a sense, I feel sorry for them as they have not been motivated to reach their potential. 

On the other hand, I could only go up - and it all depended upon me. I needed to work in summers, which not only built character but gave me valuable life experiences that helped to reinforce my CanMEDS competencies, not that I realized it at the time. One of my jobs was doing sales on commission, which I never did before, and I became the top salesperson in the organization, outperforming people who were older and on the full time sales staff. Indeed, I trained the newbies as I became a role model. 

In academics, I was far from the brightest light bulb in the class or anything close to it. However, I made up for it by having a very strong work ethic which was fueled by my motivation. My difficult life circumstances, if anything, helped to motivate me in my quest to attain my goal. Life is what it is, it is certainly not fair. Deprived circumstances may be a hurdle but it is not an excuse for lack of success. I, you and many others I know in similar circumstances are the proof that it all depends upon the individual. Put in the effort regardless of individual adverse circumstances, persevere, have a strong work ethic, be organized, have a plan, persevere and you will eventually succeed. 

[indefatigable]

On September 5, 2017 at 7:15 AM, Bambi said:

On the other side of the coin, I have known many students who have been blessed with wealth and so-called privilege, they took it for granted and did not amount to very much as they were not motivated and felt they had an easy life regardless of how the loaf was sliced. In a sense, I feel sorry for them as they have not been motivated to reach their potential. 

On the other hand, I could only go up - and it all depended upon me. I needed to work in summers, which not only built character but gave me valuable life experiences that helped to reinforce my CanMEDS competencies, not that I realized it at the time. One of my jobs was doing sales on commission, which I never did before, and I became the top salesperson in the organization, outperforming people who were older and on the full time sales staff. Indeed, I trained the newbies as I became a role model. 

In academics, I was far from the brightest light bulb in the class or anything close to it. However, I made up for it by having a very strong work ethic which was fueled by my motivation. My difficult life circumstances, if anything, helped to motivate me in my quest to attain my goal. Life is what it is, it is certainly not fair. Deprived circumstances may be a hurdle but it is not an excuse for lack of success. I, you and many others I know in similar circumstances are the proof that it all depends upon the individual. Put in the effort regardless of individual adverse circumstances, persevere, have a strong work ethic, be organized, have a plan, persevere and you will eventually succeed. 

Although aggregation by groups does really give a broad idea  to what extent SES and other demographic factors are a determinant in med school admissions, psychological factors clearly play an extremely important role.  Some may feel hopeless with respect to greater barriers (e.g. needing to work part-time jobs, count nickles and dimes, line item budgets ..) and others may use that opportunity to grow as an individual through life experiences with discipline and add to CanMeds.  Similarly, some born into privilege may take it for granted and not fully understand the discipline and effort it may take to reach that level of privilege or status, whereas others may take the opportunity to help further their own ambitions through contacts and knowledge.  

College GPA success in the US was most recently highly correlated to high school GPA, SAT scores, and psychological factors like planning for grades and persisting in challenging academic situations.  But surprisingly, many psychological factors, including other motivation measures (like optimism and self-esteem), didn't really matter that much for predicting GPA - but could be important for med school admissions since there's increasing emphasis on non-cognitive traits.  Also surprisingly, SES wasn't that much of a predictor, but it is correlated to SAT scores and it was considered college students are mostly high SES individuals.        

[OwnerOfTheTARDIS]

I come from a generally higher socioeconomic background, but the past several years my family has experienced extreme financial hardship due to illness that prevented the income earner in my family from working, to the point that while in undergrad I paid quite a bit of the rent on my family's home and bought quite a few of our groceries, so I think that I see a little bit from both sides of the spectrum.

I feel like what underlies the entire issue is how do you judge soft skills? 

I pity the admissions staff because it seems to me like an insurmountable task. For example, coming from a low SES background may teach an individual compassion and determination, but it may also make an individual bitter and cynical. Similarly, a person coming from a high SES background could either become pretentious and ignorant or the could be highly empathetic with excellent interpersonal skills that they developed through the opportunities their background afforded them. Alternatively, if you have 2 students who both have a 3.2 GPA and a similar low SES background, there is a good chance that one may have much higher academic potential but was held back due to work/family commitments while the other may have struggled to succeed academically regardless of their situation. How do you know which one will be able to succeed in medical school?

Once in medical school, I feel that SES differences become smaller because we all have access to a line of credit - while I won't be going on any fancy vacations soon, I can very comfortably afford food and rent and don't have to work during the school year. 

[Bambi]

Even working in the summer may well be futile as it is likely a zero sum gain, I.e., your provincial bursary will likely be reduced by your summer earnings, thereby creating a situation where effectively you are working for nothing. During med school, enjoy your summers as this will be the last such times until your retirement.

[indefatigable]

4 hours ago, OwnerOfTheTARDIS said:

I come from a generally higher socioeconomic background, but the past several years my family has experienced extreme financial hardship due to illness that prevented the income earner in my family from working, to the point that while in undergrad I paid quite a bit of the rent on my family's home and bought quite a few of our groceries, so I think that I see a little bit from both sides of the spectrum.

I feel like what underlies the entire issue is how do you judge soft skills? 

I pity the admissions staff because it seems to me like an insurmountable task. For example, coming from a low SES background may teach an individual compassion and determination, but it may also make an individual bitter and cynical. Similarly, a person coming from a high SES background could either become pretentious and ignorant or the could be highly empathetic with excellent interpersonal skills that they developed through the opportunities their background afforded them. Alternatively, if you have 2 students who both have a 3.2 GPA and a similar low SES background, there is a good chance that one may have much higher academic potential but was held back due to work/family commitments while the other may have struggled to succeed academically regardless of their situation. How do you know which one will be able to succeed in medical school?

Once in medical school, I feel that SES differences become smaller because we all have access to a line of credit - while I won't be going on any fancy vacations soon, I can very comfortably afford food and rent and don't have to work during the school year. 

It seems to me as if the purpose of CASPER and LORs which are still used to some extent are precisely to judge those soft skills before the interview stage.  Of course, UBC looks at experiences much more to get a sense of an individual before an interview without testing those skills directly.  Clearly, the interview is all about soft skills, regardless of how it is done.  

Many med schools also heavily use MCAT scores, but would probably have similar drawbacks to GPA for individuals in low SES backgrounds (some would argue even higher drawbacks).  I agree that having walked along different paths does give a greater insight into people's motivations and struggles.