MCATs, Affirmative Action, and DEI, Oh My

[Derec]

I think that ‘quotas’ are seen by those who believe the only way to reject the best candidates are MCAT scores and GPAs and that race/ethnicity very much does matter to them.

For the millionth time, you are wrong about that, and you keep repeating it. No matter how often you are corrected, you stick to your script.

I very much agree that too many doctors —and anyone else who goes to college or university or even trade school graduates with too much debt. Public universities used to be funded more fully than they are now and one result is driving up the cost of higher education and student debt.

I am not too concerned about medical school debt. Doctors make more than enough to comfortably pay it off. But colleges in general are getting way too expensive, that's true.

I agree that we need more doctors.

It's not necessarily that we need more doctors per se (new medical schools open every year), but what kind of doctors and where. Med students may write in their essays that they aspire to do primary care in Bumfuck, Kansas or whatever, but most in reality aspire to more lucrative specialties in a nice area.

You don’t need to worry much about doctors making too much money. It’s less lucrative than it used to be.

Is it? It is certainly far more lucrative than in most other developed countries.

The big issue is the amount of money that goes to filing insurance claims—and how much of a discount insurance companies insist on while charging customers enormous premiums .

There is also the issue of lawsuits that drive medical malpractice insurance costs up and encourage doctors practicing "defensive medicine", where doctors order medically unnecessary tests just to cover their ass in case of lawsuits.
There is also the issue of US using "fee-for-service" model that makes procedure-heavy practices and specialties far more lucrative, and incentivizes practices having a heavy volume of procedures.

 

[Derec]

In no way does that address the point I made and it's just repeating derec's argument.

Your "point" was they they had some vague language on their website? Your point in no way addressed the point about lack of diversity or equity among NBA players.

 

[Loren Pechtel]

Unless of course you believe all of those things are merely two tentacles of one massive, intercontinental conspiracy to displace the White race. Then it makes perfect sense to see them all as "somehow" connected.

It doesn't have to be a "conspiracy", i.e. people somehow colluding. All that is needed is that people in charge of educational institutions on both sides of the pond believe that diversity and racial balancing is more important than individual merit. This is a common article of faith on the left.

I think it goes deeper than that.

Faith says groups of people are equal. Anything that concludes otherwise must somehow be discrimination and should be removed.

 

[Toni]

Here's a third cent's worth: I think framing this as about scrutinizing beneficiaries is not what's going on. The people being scrutinized are the medical school admissions committees. Nobody is attacking Black and Hispanic people; they're attacking leftists. Nobody here seems interested in figuring out which White or Asian person had his position “taken” by a Black or Hispanic person either, or in which Black or Hispanic person "took" one -- whom they're interested in is who is putting a thumb on the scale. I haven't seen anyone suggest the beneficiaries of AA policies did anything wrong by accepting positions offered to them, even if somebody thinks the policy that led to the offer was misguided. The beneficiaries can thank their lucky stars that what they had turned out to be what the admissions officers were looking for, same as the rest of us do who got accepted anywhere.

Exactly. You can't fix the past, all you can do is make the future better. And that means getting all the thumbs off the scale, both left and right. We are going after left thumbs because those are the predominant ones on the scales. We have just as much hate for right thumbs, but it's been a long time since right thumbs have been able to get near this particular scale.

Yep. It seems fair enough to those starting out with a 150 yard lead in a quarter mile race.

 

[Emily Lake]

Pretty sure the descendants of enslaved people’s, native Americans, Chinese Americans and Hispanic people and Catholics and Jews and more recently Muslims are t terribly fond of being held back, pushed down, lynched, murdered and discriminated because of the sins of others.

Do you have any actual real evidence of this happening in any material numbers? Or is it just plain old narratives?

You don’t know American history?

Do you think the Klan quit being active before we were born? Or that black people were the only targets? What do you know about restricted clubs and neighborhoods? About the history of Chinese who helped build railroad lines? Japanese interment camps? Are you unaware of the animus directed towards anyone that certain Americans might perceive as being from the Middje East after 9/11?

Oh for fuck's sake. You wrote your post in a way that makes it sound like you think it's CURRENT, not 60 years ago. I know you're old and all, but come on, Toni.

Have you read about recent kynchings in the Deep South?

You should probably look into those before you make assumptions about the widespread hate crimes going on in the US. From what I could gather, they've all been ruled suicides except one... and the one was a murder of a black woman by a black man.

 

[Loren Pechtel]

That means that it cannot be manipulated to get the outcome you want, unlike say "personality scores".

That's ridiculous. The whole point of a standardized exam is to do exactly that, set some arbitrarily defined corpus of knowledge as "standard" and rate all takers relative to their familiarity with it. It's always "manipulated". There is no other way for it to be. Exams don't pop magically into existence, they are assembled by a committee based on their intersubjective experience and values.

But it can be examined for fairness. And it's done under highly controlled circumstances that keep people from biasing the results.

We are objecting to the "personality" scores because how do you measure it, how do you verify that it's being done honestly? It looks like someone trying to rig the system.

 

[Emily Lake]

Historically Black means that they were black in the past, i.e. Historically. Historically is an adverb. As such it can describe a verb, adjective, or another adverb, but in this case an adjective Black. It is a fact that these schools are Historically Black because they cropped up during legalized segregation. So at one point in history they were all Black. Later on, after segregation, other races began to apply more and more on a voluntary basis. They do not discourage diversity. Right now, > 11% of the people attending are White. 8% are Hispanic. 1% Asian. (at least according to Google).

Moreover, I wasn't really focusing on HBCUs. I was identifying a category of schools with lower MCAT thresholds of which HBCUs are a part. You could also consider medical schools in Puerto Rico. Please do not say, "yabut, they discourage non-Puerto Ricans from attending." Because that isn't the overall point. [Interesting point: the subpopulation of Hispanics attending medical school in Puerto Rico could contribute to the MCAT differences observed by as much as 2.3 MCAT points all by itself...making the non-PR Hispanic subpopulation avg MCAT into 509.1 and acceptance rate plummet of this subgroup to 36%.] But neither of these are meant to be narrow observations or an exhaustive list of how race is spread across the country and elsewhere.

The point is that for historical (and whatever else) reasons we have geographically and academically non-random spread of races across academia. Native Americans in Oklahoma, Alaska Natives in Alaska, Pacific Islanders in Hawaii and US Samoa, not to mention that Asian students do say they are under immense pressure and at least some of that is about attending a prestigious school.

I wasn't disagreeing with you. It was an additional factor in that particular example that would very likely result in extremely different application rates by race than you might see in other schools. I mean, you see disproportionately female applicants at Vassar for the same reason.

 

[Loren Pechtel]

That sounds like you deny the effects of generational racism exists. It's they only way for your point to work.

Whatever these effects are, and I think they are significantly exaggerated by the left, I do not think a solution is to keep holding certain people to a lesser standard based on their race. I do not think it is really helping blacks in the long run either. Racial preferences have existed in one form or another for 60 years or so, and they have not fixed anything.

One good thing did happen: it used to be that putting blacks in good positions would cause stigma. The forced integration broke that. The job was finished long ago, the current differences are not any large scale discrimination.

 

[Emily Lake]

We see a big difference in flunk out rates. That shows they are not doing the job right. Pretending it's non-academic doesn't make it so.

No we don't. We see a mathematical artifact that falls into Twain's description of lies, damned lies, and statistics.

 

[Emily Lake]

Perhaps Asians apply less frequently to schools with no or lower requirements. In fact, HBCUs on average have lower thresholds and very little Asian enrollment. I think it's like 1%. HBCUs are only a subset of such schools.

Crazy idea... but the fact that a college or university promotes itself as historically black in a way that very clearly communicates that they prefer their attendees to be black... maybe that would discourage people who aren't black from applying in the first place?

Or maybe they are historically black because when they were created black people were barred from attending white colleges and universities.

ORLY? OMG I HAD NO IDEA THAT HISTORICALLY BLACK COLLEGES WERE THE RESULT OF ACTUAL SEGREGATION! SOMEBODY BRING ME THE SMELLING SALTS!

Yes, I agree. Your idea is crazy.

Obviously I was not clear. Noticing that there are very few asian students at a historically black college doesn't strike me as anything anomalous, but rather as a pretty transparent driver of why there would be fewer non-black applicants right out of the gate.

 

[Toni]

I think that ‘quotas’ are seen by those who believe the only way to reject the best candidates are MCAT scores and GPAs and that race/ethnicity very much does matter to them.

For the millionth time, you are wrong about that, and you keep repeating it. No matter how often you are corrected, you stick to your script.

I very much agree that too many doctors —and anyone else who goes to college or university or even trade school graduates with too much debt. Public universities used to be funded more fully than they are now and one result is driving up the cost of higher education and student debt.

I am not too concerned about medical school debt. Doctors make more than enough to comfortably pay it off. But colleges in general are getting way too expensive, that's true.

I agree that we need more doctors.

It's not necessarily that we need more doctors per se (new medical schools open every year), but what kind of doctors and where. Med students may write in their essays that they aspire to do primary care in Bumfuck, Kansas or whatever, but most in reality aspire to more lucrative specialties in a nice area.

You don’t need to worry much about doctors making too much money. It’s less lucrative than it used to be.

Is it? It is certainly far more lucrative than in most other developed countries.

The big issue is the amount of money that goes to filing insurance claims—and how much of a discount insurance companies insist on while charging customers enormous premiums .

There is also the issue of lawsuits that drive medical malpractice insurance costs up and encourage doctors practicing "defensive medicine", where doctors order medically unnecessary tests just to cover their ass in case of lawsuits.
There is also the issue of US using "fee-for-service" model that makes procedure-heavy practices and specialties far more lucrative, and incentivizes practices having a heavy volume of procedures.

Yes, it is more lucrative to be many kinds of doctors in the US. However, in other countries, physicians do not graduate with several hundred thousand dollars of student debt. Some specialties make a great deal more money than others. Some areas pay more than others (and have the commiserate higher costs of living). One problem that underserved areas struggle with with reference to attracting and retaining medical professionals is that it is often the case that the local school system is not particularly good and that there are few opportunities for a spouse to have a career as opposed to a job. Or even a decent job. I know this because in my town, those are issues here. Also a lack of housing. The town is finally doing something about offering more options for housing and for entertainment, etc. making it more attractive for families who did not grow up here going back a few generations.

Another issue that smaller more rural practices deal with is how expensive it is to run a practice, and just how much of the fees paid for medical services actually go towards offsetting costs, and billing insurance companies, etc. Add on the fact that smaller hospitals are being acquired by larger hospitals and there is considerable consolidation going on, often resulting in women needing to travel well over 50 miles for prenatal care and for labor and delivery. In very cold, snowy winters. This is not safe for mother or child and it certainly places a very heavy additional and unnecessary burden on young families with more than one child. This applies to physician's families as well.

A bigger concern than malpractice lawsuits is medical insurance companies practicing medicine without actually having a medical license and/or having non-medically trained persons or sometimes, retired or near retirement physicians or nursesreview claims without having any experience or expertise in that particular field of medicine. An ENT physician is unlikely to know best practices for labor and delivery or the care of neonates or cardiac patients, or the management of diabetes, or a cancer patient's needs, etc.

Insurance companies try to contain (their) costs by denying coverage for routine testing where they can get by with it and otherwise practice medicine without a license or without examining the patient. They are not always knowledgeable about tests, and what the tests are useful to diagnose, etc. I've had a bunch of different jobs and for a short amount of time, I worked in the business office of the local clinic and spent a bunch of time trying to explain tests to the person on the end of the phone line who, I guessed at the time, was at most 22 and maybe had some kind of bachelor's degree in nothing remotely related to biology or medical science at all. Some insurance companies used to routinely deny all claims the first 3 times they were filed, hoping that the patients would simply pay the claim themselves. Of course, each time a claim is filed and denied, it generates a cost and each time a payment is delayed, it is also a financial carrying cost to the practice. Much easier to do with very large clinics. Much harder to do with small clinics. I'm not certain how much the ACA has improved that situation as it has been many years since I held that job. But it was an eye opener.

 

[laughing dog]

In no way does that address the point I made and it's just repeating derec's argument.

Your "point" was they they had some vague language on their website? Your point in no way addressed the point about lack of diversity or equity among NBA players.

Potential NBA players display their talents either overseas or in college: there is plenty of opportunity for both the players to show their true abilities. There is no minor league for medical school: potential doctors do not have the chance to literally practice medicine prior to medical school. Add to that mix that the successful practice of medicine requires hard and soft skills, while the success in the NBA is due probably more to hard skills. All of which makes the analogy between diversity among NBA players and medical school admissions rather silly.

Then add in the recognition that the NBA diversity statement which clearly addresses the diversity of the fan base and all employees of the NBA and it becomes apparent that the analogy is absurd.

 

[Loren Pechtel]

We see a big difference in flunk out rates. That shows they are not doing the job right.

Where is the data on “flunking out”? People leave programs for all sorts of reasons.

Pretending it's non-academic doesn't make it so.

Pretending it’s all academic doesn’t make it so.

The flunk data has been presented by others.

Yeah, it's listed as failing to pass the test to advance. That's functionally the same thing.

 

[Loren Pechtel]

Here's a third cent's worth: I think framing this as about scrutinizing beneficiaries is not what's going on. The people being scrutinized are the medical school admissions committees. Nobody is attacking Black and Hispanic people; they're attacking leftists. Nobody here seems interested in figuring out which White or Asian person had his position “taken” by a Black or Hispanic person either, or in which Black or Hispanic person "took" one -- whom they're interested in is who is putting a thumb on the scale. I haven't seen anyone suggest the beneficiaries of AA policies did anything wrong by accepting positions offered to them, even if somebody thinks the policy that led to the offer was misguided. The beneficiaries can thank their lucky stars that what they had turned out to be what the admissions officers were looking for, same as the rest of us do who got accepted anywhere.

Exactly. You can't fix the past, all you can do is make the future better. And that means getting all the thumbs off the scale, both left and right. We are going after left thumbs because those are the predominant ones on the scales. We have just as much hate for right thumbs, but it's been a long time since right thumbs have been able to get near this particular scale.

mumble Pete Hegseth mumble mumble

"...been able to get near..."

I'm not saying they don't try. I'm saying they haven't been succeeding. I'm more interested in thumbs currently on the scale than thumbs trying to get on the scale.

 

[Loren Pechtel]

Here's a third cent's worth: I think framing this as about scrutinizing beneficiaries is not what's going on. The people being scrutinized are the medical school admissions committees. Nobody is attacking Black and Hispanic people; they're attacking leftists. Nobody here seems interested in figuring out which White or Asian person had his position “taken” by a Black or Hispanic person either, or in which Black or Hispanic person "took" one -- whom they're interested in is who is putting a thumb on the scale. I haven't seen anyone suggest the beneficiaries of AA policies did anything wrong by accepting positions offered to them, even if somebody thinks the policy that led to the offer was misguided. The beneficiaries can thank their lucky stars that what they had turned out to be what the admissions officers were looking for, same as the rest of us do who got accepted anywhere.

Exactly. You can't fix the past, all you can do is make the future better. And that means getting all the thumbs off the scale, both left and right. We are going after left thumbs because those are the predominant ones on the scales. We have just as much hate for right thumbs, but it's been a long time since right thumbs have been able to get near this particular scale.

Yep. It seems fair enough to those starting out with a 150 yard lead in a quarter mile race.

Except they aren't. Those from well off parents start with a lead. I see no way to change that--more money = more opportunity to reach one's full potential.

If you're going to do anything (and I don't think it should be done) you base it on the parent's income/education, not their skin color. In reality we are giving a big advantage to ones that don't need it (came from a good background), while doing nothing about those you're supposedly helping (those from a poor background.)

 

[Loren Pechtel]

BTW, they're still doing it:

https://dukechronicle.com/article/duke-university-trump-administration-finds-school-of-medicine-racially-discriminated-in-admissions-practices-hhs-affirmative-action-20260910

Yeah, I don't believe this administration one bit. But note who published this--you think if the numbers were false they wouldn't say something?!

In the 2024-25 admissions cycle — the most recent included in the letter — Black and Hispanic applicants’ mean MCAT scores were in the 87th and 89th percentile, respectively, while white and Asian applicants were in the 97th and 98th percentile.

 

[laughing dog]

We see a big difference in flunk out rates. That shows they are not doing the job right.

Where is the data on “flunking out”? People leave programs for all sorts of reasons.

Pretending it's non-academic doesn't make it so.

Pretending it’s all academic doesn’t make it so.

The flunk data has been presented by others.

Yeah, it's listed as failing to pass the test to advance. That's functionally the same thing.

If the flunk data has been presented, you should know the drill: provide a link to it or give the thread title and post number.

 

[laughing dog]

BTW, they're still doing it:

https://dukechronicle.com/article/duke-university-trump-administration-finds-school-of-medicine-racially-discriminated-in-admissions-practices-hhs-affirmative-action-20260910

Yeah, I don't believe this administration one bit. But note who published this--you think if the numbers were false they wouldn't say something?!

In the 2024-25 admissions cycle — the most recent included in the letter — Black and Hispanic applicants’ mean MCAT scores were in the 87th and 89th percentile, respectively, while white and Asian applicants were in the 97th and 98th percentile.

LOL - you believe Trump’s DOJ!

 

[Derec]

Much hay was made by the likes of Don2 and Toni about the fact that AAMC data presented upthread are overall figures for all med schools. They argue that since different people apply to different schools, that may explain the discrepancy. And while "may" is never a good argument by itself, let's look at one school that has been in the news - Duke.

Federal probe finds discrimination in Duke medical school admissions
Now, you may poo-pooh the probe because the federal government is controlled by Trump. But let's not even look at their conclusions, but rather focus more on parts of the article that Duke is apparently not disputing.

Duke has disputed the premise that it continues to consider race in admissions. During the investigation, the university told federal officials that race and ethnicity have played no role in admissions since the Supreme Court’s decision and that racial information is hidden from admissions committee members.

Let's start with this denial. "Continues" and "played no role ... since" means that they admit that they used race in admissions until 2023. That goes directly against the claim vociferously argued by these posters that med schools would not do such a thing and that everything can be explained with other factors.

So, is Duke continuing to use race in admissions despite the SCOTUS ruling and their denials? Let's look further.

For the 2024-25 admissions cycle, HHS said 3.3% of white applicants and 3.4% of Asian applicants were admitted to the medical school, compared with 10% of black applicants and 6.7% of Hispanic applicants.

The agency also pointed to differences in average Medical College Admission Test (MCAT) scores among admitted students. Black students admitted during that cycle had an average MCAT score in the 87th percentile, and Hispanic students averaged in the 89th percentile, compared with the 97th percentile for white students and 98th percentile for Asian students.

First of all, it would be crucial too see these same numbers for 2022-23 cycle that is before the SCOTUS decision would be in effect. If they changed and no longer use race in admissions, then these numbers should be very different pre-decision vs. post-decision.

But even looking at just that one cycle, we see the differences in MCAT scores are there. So it looks like MCAT differences in AAMC data are not just an artifact of different people applying to different schools. So, Asians admitted to Duke had an MCAT score of about 521 (I pulled percentiles from here), whites 520 (so pretty much the same as Asians), and blacks and Hispanics had 513 and 514 respectively.
513 is still a good score that would be competitive at most US MD schools, but at Duke those not receiving race preferences need a much better score because Duke is one of the top med schools.
So it looks like they are still discriminating, or else average MCATs should be comparable.

Another thing is the acceptance rate. As I argued before, acceptance rates by themselves don't tell us much as they are a function of both applicant pool and selection criteria. But it is interesting nevertheless to observe that blacks have an acceptance rate about three times higher than whites and Asians. That stands in contrast to overall acceptance rates posted upthread. This may be because more Asians and whites, and fewer blacks apply to Duke. But Duke still wants a certain demographic profile and thus accepts a much greater share of black applicants. So, Don2 is partially right that different schools differ in who applies to them. He is wrong in that this would explain away the discrepancy in MCATs. Because even though fewer blacks apparently apply to Duke, Duke adcoms still make sure they admit a lot of them, even if they have to require less of them compared to their more melanin-challenged brethren.

The agency also said it asked Duke to explain differences in MCAT scores and grade-point averages among racial groups, but did not receive a responsive explanation.

Maybe they should hire Don2 to craft an "eloquent" (Toni's word, not mine) "responsive explanation".

 

[Derec]

No, it is not the whole idea of AA/DEI. The idea of the two is to promote fair treatment and representation for all people, especially historically underrepresented minorities. Nothing in its precept is about anyone getting position that they didn't earn fully on merit.

D - diversity even at the expense of merit or being just to the individual applicant. But only for so-called PWIs, these same people don't demand Morehouse or Meharry or Howard become more diverse.
E - equity. The word specifically invented (in this context) as a counterpoint to equality. They don't want people - e.g. an Asian and black applicant, to be treated equally, but "equitably" which means that the black applicant can be given a preference because it's all about achieving more even outcomes rather than giving individuals equal opportunity.