MCATs, Affirmative Action, and DEI, Oh My

[Derec]

My dear: Racial and gender preferences still favor white and male. Sadly enough. And in this country known as the United States, that has been true since colonial times.

No, they don't and I am sick of people like you pretending that it's still 1950s in order to justify discrimination against certain groups.
Racial preferences have benefited blacks, Hispanics and American Indians for decades. Gender preferences have benefited women for decades, especially in things like engineering.

Now what is happening is that candidates who are not white or the ‘good’ kind of Asian are no longer automatically chosen, with other candidates moved to the rear of the line, if they are ever allowed in line in the first place.

Wrong! What is happening now is that candidates who are not white or Asian need far lesser GPA and MCAT to get into med school.

White people like to make themselves feel better by believing or telling themselves to believe that the only way any person of color or female gets chosen ahead of a white or preferred type Asian is because of Affurnstive Action. It’s comforting to believe that you lost out because of preferences for a demographic you don’t fit.

Except that Affurnstive[sic] Action is a reality. SCOTUS banned most AA in 2023, but it is clear that med schools still try to practice it. Like by assigning >2x "mission fitness" to black students vs. Asians or 3x "mission fitness" to American Indians. "Mission fitness" is just a subjective metric that can be easily abused this way just like the infamous "personality scores" at Harvard.

People with expertise have shown over and over again that a great deal of the bias you think you see does not actually exist, except to the extent that t that there is a lot of self selection going on.

They have shown nothing of the sort.

Most students at any level tend to attend schools in their home state.
Most state schools give preference to in state students, both for admissions and for tuition. This, in part is because state taxes pay for the universities/med schools and partly in hopes of retaining their graduates.

Which would average itself out with nationwide numbers.
None of what you wrote justifies requiring higher MCAT and GPA of applicants of certain races. And even more outrageously, you claim that despite all that "racial preferences" somehow favor whites. This is an almost Trumpian level of delusion.

 

[Toni]

My dear: Racial and gender preferences still favor white and male. Sadly enough. And in this country known as the United States, that has been true since colonial times.

No, they don't and I am sick of people like you pretending that it's still 1950s in order to justify discrimination against certain groups.
Racial preferences have benefited blacks, Hispanics and American Indians for decades. Gender preferences have benefited women for decades, especially in things like engineering.

Now what is happening is that candidates who are not white or the ‘good’ kind of Asian are no longer automatically chosen, with other candidates moved to the rear of the line, if they are ever allowed in line in the first place.

Wrong! What is happening now is that candidates who are not white or Asian need far lesser GPA and MCAT to get into med school.

White people like to make themselves feel better by believing or telling themselves to believe that the only way any person of color or female gets chosen ahead of a white or preferred type Asian is because of Affurnstive Action. It’s comforting to believe that you lost out because of preferences for a demographic you don’t fit.

Except that Affurnstive[sic] Action is a reality. SCOTUS banned most AA in 2023, but it is clear that med schools still try to practice it. Like by assigning >2x "mission fitness" to black students vs. Asians or 3x "mission fitness" to American Indians. "Mission fitness" is just a subjective metric that can be easily abused this way just like the infamous "personality scores" at Harvard.

People with expertise have shown over and over again that a great deal of the bias you think you see does not actually exist, except to the extent that t that there is a lot of self selection going on.

They have shown nothing of the sort.

Most students at any level tend to attend schools in their home state.
Most state schools give preference to in state students, both for admissions and for tuition. This, in part is because state taxes pay for the universities/med schools and partly in hopes of retaining their graduates.

Which would average itself out with nationwide numbers.
None of what you wrote justifies requiring higher MCAT and GPA of applicants of certain races. And even more outrageously, you claim that despite all that "racial preferences" somehow favor whites. This is an almost Trumpian level of delusion.

Derec, you keep making the same claims over and over despite being shown, in great detail by better minds than mine ( Don) that you are wrong.

What I see is a bunch of white boys who are crying no fair discrimination merely because they are no longer first in line. Hurts, don’t it?

Abd yeay, I used boys because grown men take responsibility for their own lives.

 

[Toni]

You are conflating taking a leave of absence or leaving a program for any reason with 'academic failure.' This is obviously untrue.

I am definitely not. I was citing 5 year graduation rates, which takes into account taking a leave of absence of one year.
I also cited Step 1 failure rates, which are one academic reason somebody would not continue their med school journey.

Nobody, and certainly not I, is claiming that everybody who leaves med school does that for academic reasons. But many do, and both Step 1 failure and not graduating in 5 years is strongly associated with MCAT and undergrad GPA. The former is already an academic reason, and not graduating in five years being associated with undergrad academic performance is a strong indicator that academic failure in med school is a major reason for not graduating. Not the sole reason, of course, but a major one. Otherwise, we'd expect a much lower association with undergrad academics.

Re: people I know personally who I know are brilliant but absolutely unsuited to being a medical provider? Yeah: I think everyone breathed a sigh of relief when one did not get into medical school because, brilliant though she is, she isn't actually interested in biology or chemistry at all and much preferred to do math and physics. Frankly, she applied to medical school as an act of rebellion.

Fair enough. But why do you think being suited to being a medical provider is more common among blacks and Hispanics, which would have to be true to account for the marked difference in MCAT and GPA in absence of racial discrimination. We keep coming back to that.

Few people leave medtcal school, Derec, not many. The reasons quoted were primarily financial and personal issues with academic reasons being the third in terms of percentage.

You seem to believe that being white or Asian makes one more likely to be a good physician. I don’t think that race matters one bit.

Again, you are vastly ignoring Don’s detailed discussion of who chooses which medical schools to apply to and why and how that skews stats, particularly when one considers that different medical schools have different t cut offs for GPA and MCAT and that most state schools heavily favor in state applicants. You are comparing apples to watermelons.

 

[Don2 (Don1 Revised)]

What is happening now is that candidates who are not white or Asian need far lesser GPA and MCAT to get into med school.

Derec, where medical schools maintain a hard MCAT threshold, that minimum applies equally to all applicants, regardless of race. Once an applicant clears that threshold, admissions committees use a consistent rubric that weights a wide variety of metrics--not just GPA and test scores--to evaluate the candidate as a whole.

Like by assigning >2x "mission fitness" to black students vs. Asians or 3x "mission fitness" to American Indians. "Mission fitness" ...

You are completely misrepresenting my point. "Mission fitness" is not an arbitrary racial multiplier; it is an evaluation of a candidate's alignment with a school’s specific goal, which often includes providing healthcare to underserved communities. Committees measure this through secondary essays, interviews, and proven track records of community service. When schools consistently weight these factors, certain demographics will naturally score higher in the aggregate because their backgrounds or experiences align more closely with those specific community needs. Just as some demographic groups aggregate higher on standardized tests, others aggregate higher on mission alignment.

This does not exclude anyone. An individual white or Asian applicant can score perfectly on mission fitness, just as an applicant from any background can score a 528 on the MCAT. You are confusing population-level statistics with individual capabilities. Individuals are not aggregates, and aggregates are not individuals.

Ultimately, medicine is a hands-on profession centered on a goal of treating the sick. Your premise that standardized test scores are the sole valid metric for admission--and that any deviation from them is proof of a rigged system--ignores a range of other variables that actually predict a good doctor that will meet public needs.

 

[Derec]

Of one must choose between two candidates with the same MCAT score, why shouldn’t the one who is from a group with less representation be admitted?

Make the case.

Because it is incredibly unjust to the individual. A med student that just happens to be Asian is not responsible for there being a lot of Asian students in medical schools. He or she is not benefitting from there being a lot of Asians at the school either. So why should he or she be penalized just because of group membership?

And in reality it's not even "the same MCAT score", but some score (and GPA) below the white and Asian students who are rejected instead.

Make the case that MCAT plus GPA should be the only things that count.

That's just your flimsy strawman, not anything I have ever advocated for.

As I’ve said, I know people who are quite intelligent t n the science way, with stellar GOAs and MCAT scores who dud not get into Ned school because they were not particularly good at the people portion of the job. I like them, abd respect them but no one who knew them thought they’d be good doctors despite everyone being blown away by their brilliance.

And as I said, there is no reason why Asians and whites would be worse in the "people portion of the job" than blacks and Hispanics. So that is not a good reason to give the latter a preference despite mediocre grades and scores.

 

[Derec]

Even at the lowest ends for MCATs, 92% are graduating, or 1 in 10 is being put into a position that is "above their ability".

Wrong. Look at the damn tables instead of making up numbers. At the lowest MCATs (of which there were only 20 out of 57,078) 70% graduate within five years. For lowest MCAT bin with N>1000, which is 494-497, it was 82%. So almost one in five not graduating in five years.
I really do not understand where you pulled out the 92% number, except maybe from where the Sun don't shine.

 

[Derec]

Wherever the bar is set, it should be the same regardless of melanin or Spanish-speaking abuelos.

You could make a reasonable case for proficiency in an under-served language being of value.

True. But a lot of US-born Hispanics no hablan español. Hence by quip about the abuelos (grandparents). And there are of course underserved languages other than Spanish.

 

[Derec]

That’s ridiculous.

Taking anyone from a not great school to a great school should improve performance unless what you mean by a great school is exclusionary.

A great school also has higher standards, a not so great school which is less selective has lower standards.
Take a B student from Clayton State University and put him in Georgia Tech or Emory and he'll probably struggle to even maintain a C in the same classes.

 

[Toni]

You insist there is something other that what we can test that makes the admissions fair. Thus you are the one claiming the mysterious factor--identify it!

I have done it a number of times - it's called experience and expertise of the personnel of the medical college. You're the one who makes the mysterious claim of unfair admissions.

They aren't suggesting how to measure it, they have a history of discrimination, why should we trust them to be telling the truth??

The history of discrimination has been against women and most persons of color.

Yeah, Derec, I'm not a fan either but unfortunately, that's history for you. Recent and ancient.

 

[Toni]

That’s ridiculous.

Taking anyone from a not great school to a great school should improve performance unless what you mean by a great school is exclusionary.

A great school also has higher standards, a not so great school which is less selective has lower standards.
Take a B student from Clayton State University and put him in Georgia Tech or Emory and he'll probably struggle to even maintain a C in the same classes.

Maybe. But take an A student from (insert mediocre school) and give them a shot at an education at an excellent school and guess what? People rise to the occasion. Not always. I mean: Trump and his entire administration or 'administration.' But yeah.

Yeah, I've been in class with fellow students who transferred in from a community college and were told they were ready for upper division classes because they took the gen eds in community college and guess what? They were not ready for upper division and in fact not really ready for sophomore level coursework. Despite earning As in all of their community college courses.

I also know people from small mediocre schools with great GPAs whose SAT and ACT scores were significantly higher than people from excellent high schools with mediocre GPAs.

Guess what? Poor people are often quite intelligent and given the opportunity, can excel. But often they have to do it while carrying a lot of other responsibilities that kids from wealthier families don't have to carry. Who is smarter?

 

[Toni]

Of one must choose between two candidates with the same MCAT score, why shouldn’t the one who is from a group with less representation be admitted?

Make the case.

Because it is incredibly unjust to the individual. A med student that just happens to be Asian is not responsible for there being a lot of Asian students in medical schools. He or she is not benefitting from there being a lot of Asians at the school either. So why should he or she be penalized just because of group membership?

And in reality it's not even "the same MCAT score", but some score (and GPA) below the white and Asian students who are rejected instead.

Make the case that MCAT plus GPA should be the only things that count.

That's just your flimsy strawman, not anything I have ever advocated for.

As I’ve said, I know people who are quite intelligent t n the science way, with stellar GOAs and MCAT scores who dud not get into Ned school because they were not particularly good at the people portion of the job. I like them, abd respect them but no one who knew them thought they’d be good doctors despite everyone being blown away by their brilliance.

And as I said, there is no reason why Asians and whites would be worse in the "people portion of the job" than blacks and Hispanics. So that is not a good reason to give the latter a preference despite mediocre grades and scores.

Whether it is student A or student B who is accepted, it is 'unfair' to the other student.

But nice reveal that you cannot conceive of a world where the better student is not white or Asian. Or that a black or brown student can be equal to a white or Asian student, which was exactly my premise.

This is why your 'arguments' always fail: you always reveal your basic bigotry--you've already determined who you think is the 'better' candidate with the 'better' credentials based solely upon their being, in your example, Asian.

 

[Toni]

So because you showed up late to the discussion, I’m supposed to rewind the whole damn conversation and explain how we got here? Nigga, please.

No, you don't have to rewind the entire conversation. But it seems reasonable to expect that you refrain from being an asshole for no good reason.

In complete sincerity, and without any intent to mock, have you at least considered that sometimes you're simply not as clear as you think you are? Or that perhaps sometimes you misinterpret other people's posts?

With all due respect, perhaps you could take your own advice here.

 

[Derec]

Specific schools may have missions such as to increase doctors in underserved communities. Some candidates during interviews/essays etc may show an interest to work in such communities. Hours of community service in those environments may count as evidence. That may give them an edge. This can be correlated to race and somewhat self-sorting.

Pretty much all premeds are told to do both clinical and nonclinical volunteering in some way connected to "underserved". It has become cliche. But subjective measures like interviews and essays are a great way for adcoms to smuggle in racial consideration even though they should not.

Different schools have different MCAT thresholds or none at all. Different schools have different demographics. Some lower and no threshold schools have significantly more under-represented minorities. There can be self-sorting here, too, where mid and high scorers do not apply to these schools.

But it should all average out when looking at national data. Unless there is a racial bias in admissions for the purposes of increasing "diversity".

 

[Derec]

Derec, where medical schools maintain a hard MCAT threshold, that minimum applies equally to all applicants, regardless of race.

That is true as far as it goes. But note that minimum MCAT is much lower than the average MCAT.
Take Medical College of Georgia. Average MCAT: 512. Minimum threshold: 496. That's a huge gulf, and plenty of space to smuggle in racial preferences. Unfortunately, MCG does not publish averages by race, and the only reason Duke did so was because of a DOJ lawsuit.

Once an applicant clears that threshold, admissions committees use a consistent rubric that weights a wide variety of metrics--not just GPA and test scores--to evaluate the candidate as a whole.

Including, inappropriately, race.

You are completely misrepresenting my point. "Mission fitness" is not an arbitrary racial multiplier; it is an evaluation of a candidate's alignment with a school’s specific goal, which often includes providing healthcare to underserved communities. Committees measure this through secondary essays, interviews, and proven track records of community service. When schools consistently weight these factors, certain demographics will naturally score higher in the aggregate because their backgrounds or experiences align more closely with those specific community needs. Just as some demographic groups aggregate higher on standardized tests, others aggregate higher on mission alignment.

You are missing my point. Unlike MCAT and GPA, evaluating these other things is highly subjective, and thus fertile ground for an adcom to bring in both their subconscious biases as well as any conscious desire to skirt the 2023 SCOTUS decision. Compare with Harvard College's infamous personality scores. I do not believe Asian students are >2x more disinterested in providing healthcare to the underserved than blacks any more than I think Asian applicants to Harvard consistently have bad personalities.

This does not exclude anyone. An individual white or Asian applicant can score perfectly on mission fitness, just as an applicant from any background can score a 528 on the MCAT. You are confusing population-level statistics with individual capabilities. Individuals are not aggregates, and aggregates are not individuals.

And you are confusing scores on a test with a concept such as "mission fitness" which is as subjective as it is nebulous. Perfect candidate to smuggle in considerations of race.

Ultimately, medicine is a hands-on profession centered on a goal of treating the sick. Your premise that standardized test scores are the sole valid metric for admission--and that any deviation from them is proof of a rigged system--ignores a range of other variables that actually predict a good doctor that will meet public needs.

I do not think standardized tests or even grades are the "sole valid metric". But I think weird secondary essays are virtually useless other than as a figleaf for adcoms to give a boost to whomever they like.

 

[Derec]

Not just the graduation rate but also the three stage USMLE.

Since everybody is so in love with standardized tests..

Both Step 1 and graduation rates are highly associated with MCAT and undergrad GPA, as repeatedly shown. Admitting people with lower academic metrics in order to increase "diversity" puts them at higher risk of failure.

 

[Derec]

But that isn't discrimination of a race. And over 40% of the latest Harvard class 2029 is Asian.

Note that this is after they've been sued.
Before, it was <30% Asian.

Using race to thumb a scale (at some point) isn't "discrimination of a race"

How could it not be?

 

[Derec]

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.

That does not explain why the difference in average MCAT scores also exists for individual schools like Duke. Schools don't generally publish such race-level data, but we have them for Duke because of a recent investigation.

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.
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.

From here.

_Some_ Asians are foreigners who can only apply to a few elite schools. This is not true for the AN/NA cohort.

"Non-U.S. Citizen and Non-Permanent Resident" is actually a separate AAMC category, which means that Russians, Chinese, Nigerians and Colombians on student visas are not included in the white, Asian, black and Hispanic categories, respectively.

Perhaps Asians more often would not want to go to a safety school, but would rather go into pharma, biotech, biomedical engineering etc. We use acceptance rates and matriculant rates as the same, but Stanley Zhong shows one can get accepted but not go.

Pure speculation that this differs by race to any significant extent.

Perhaps less Asians show willingness to participate in missions to work in underserved communities. Examples: tribal areas/reservations.

There are underserved communities everywhere. Rural Appalachia, swamps of Louisiana (straight from True Detective!), Atlanta hood.
And it is again pure speculation that fewer (not less, Asians are countable!) Asians engage in such activities.

None of this is intended to state there are no issues of discrimination against Asians. Just that it is an assumption that all or most of the observed differences are due to discrimination.

Med schools are not even denying that they engaged in racial preferences prior to the SCOTUS decision. Did they change their practices, or are simply hiding it behind things like "mission fit"? I think that if they really had stopped discriminating by race, then the characteristics of their admitted classes, and the characteristic of AAMC data overall, should change significantly.

ETA: So perhaps it is also true that Harvard, Yale, and a few other medical schools use race to adjust admission criteria/scores and a majority of medical schools do not do that.

A lot of "perhaps".

 

[Derec]

There's a study that has a table. I have only skimmed some sparse text around the table. Something like there was a survey of doctors working for the Indian Health Services, not everyone responded. The goal of the survey was not demographics, I don't think, but questions were asked and this racial/ethnic breakdown is in the table for respondents:

Race/ethnicity*
White 261 (78)
American Indian/ Alaska Native 48 (14)
Hispanic 32 (9)
Asian 26 (8)
Black 13 (4)
Native Hawaiian/ Pacific Islander 1 (1)
Other 1 (1)

I don't think it is entirely unreasonable to extrapolate this, but again I have not read the study in full. What I immediately observe is there are only 8% Asian doctors but Asian doctors in the general population are much larger than that. Also, there are 14% NA/AN doctors but NA/AN doctors in the general population of doctors are like less than 1%.

Is this really surprising? This is a survey of specifically Indian Health Service, which is only a subset of underserved communities. There are also a lot of white doctors, does that make you conclude that whites are more drawn to serving underserved communities than say blacks?

Racial and ethnic minority physicians are more likely to practice primary care and serve in underserved communities.

Does "racial and ethnic minority" not include Asians? No, matter, maybe they just mean URMs.
And how much of it is out of choice? What I mean by this, if certain groups have lower MCAT/GPA when admitted, and those academic metrics are associated with things like passing Step 1 the first time, as well as shelf and Step 2 scores. These are in turn associated with what specialty one is competitive for. If you fail Step 1 once, they'll let you retake it and graduate, but you are most likely headed for primary care, even if you initial plan was derm or CT surgery. Step 2 score is also important for specialty competitiveness.

And if you choose to go into primary care, there are different tiers of residencies - top FM, IM or peds programs will be attached to major teaching hospitals and are a lot more competitive than some HCA program in some backwater.

If my thesis is correct, and URMs being more likely to get jobs in underserved communities not out of choice but because of their residency, then that is not an argument to admit a 502 black vs. a 502 Asian student. Both will be more likely to fail Step 1 and not do as well on Step 2 compared with a 512 or any race, and thus will be more likely to end up in a community program in Bumfuck, AR and thus more likely to continue working in similar settings than somebody who did their IM residency at Mass General or Emory.
The only difference is, of course, that a 502 black student has a good chance of getting into med school, while a 502 Asian does not. So there are more URM low stats med students, and if working in underserved areas selects for low stats students, than that would be enough to explain these findings. We do not need to assume that URMs are more altruistic and more likely to chose to work in clinics/hospitals serving the underserved.

 

[Derec]

Also, do we know that each of these applicants are unique and only counted one time? Is applicant A counted 5 times if A applies to 5 schools? Is applicant B counted 15 times if they apply to 15 schools??

No. The data count every person once. 2023-24 AAMC tables have 52,577 unique applicants and 22,981 matriculants. That means that 43.7% of applicants got accepted to at least one school, and the rest were not accepted anywhere.

 

[Derec]

You don't eliminate current discrimination by pretending that it is against white and Asian men, either.

No pretense. That's reality.

You seem perfectly fine with allowing the status quo from 50 years ago to continue, with formal laws against actually barring black people and women from certain roles.

I would not be fine with that, despite the aspersions you and others are casting. Also, this was more than 50 years ago, and you underestimating the time frame is the testament to your living in the past.
50 years ago University of California System, far from excluding blacks, had a quota guaranteeing them a certain number of seats in medical schools. 48 years ago, SCOTUS said that while they are free to have racial preferences, they may not do it with something as crude as a quota. And half a century later, there are people like you who have become denialists of racial preferences, even though med schools have never denied that they have been practicing them.

How's that working out for the world?

Racial discrimination is not working very well, no matter who the beneficiary happens to be.