HOW RACIAL PREFERENCES REFUSE TO DIE HOW RACIAL PREFERENCES REFUSE TO DIE
Wednesday January 31 , 2001
New York Post.com Opinion
By SALLY SATEL
Last Friday, a Maryland district court judge heard a momentous case: whether the University of Maryland School of Medicine discriminated against a white applicant named Rob Farmer. Most people think affirmative action in medical school admission ended in 1978 when Allen Bakke won a reverse discrimination case against the Regents of the University of California.
It didn't. Racial preferences are very much alive in American medical education. Yet, not only is the practice bad for medicine, but the rationale for racial preferences withers under scrutiny. In 1995 Rob Farmer, then 34, applied to UMSM, his hometown medical school. He was the classic "disadvantaged" applicant: Raised in near-poverty by a single mother, he left home after high school and worked his way through college. He scored a very respectable 80th percentile on the MCATs.
Yet his application for the UMSM class of 2000 was rejected. In itself, this is unremarkable. After all, getting into medical school is tough. But four of Farmer's classmates, all African-Americans, were accepted. Two had grades and scores comparable to his, but the other two had markedly lower qualifications. One scored in the 22nd percentile on her MCATS, and the other in the 32nd.
This clear disparity drove Farmer to file a lawsuit. In the UMSM class of 2000 as a whole, preferences in admission were obvious. A black student with a B or B+ college grade-point average or an MCAT score in the bottom half (of all test-takers nationwide) had a 70 percent chance of admission; Asians, whites and Hispanic students with those grades had less than a 2 percent chance. Differential performance at admission is reflected in subsequent performance during medical school.
Fifty-two percent of the African-American students failed either one or both of the two phases of the U.S. licensing exam given during medical school; a number failed multiple times. Three non-black students failed once. The two-tiered admissions structure at UMSM mirrors that of medical schools across the country.
In California, between 1987 and 1993, the average minority accepted to a state medical school had MCAT scores comparable to the lowest one percent of his white and Asian counterparts. Defenders of racial preferences are quick to point out that there is no proof that weak pre-medical students make weak doctors. We do, however, have ample nationwide data on performance during training. According to the Association of American Medical Colleges, 39 percent of minority students in 1996 were unable to graduate with their class compared to 15 percent of non-minorities.
A 1994 study published in the Journal of the American Medical Association disclosed that the failure rate on boards taken after the second year of medical school was four times higher for black medical students than for whites. (As expected, minority students who entered with solid grades and scores did just fine.) Behind the push for racial preferences in medical schools is a well-meaning justification: the notion that minority patients will fare better if they are treated by doctors of similar heritage.
"This is not a quota born out of a sense of equity or distribution of justice," said former Senate leader George Mitchell, as chairman of the Pew Health Professions Commission. It is "a principle that the best health care may need to be delivered by those that fully understand a cultural tradition."
More testy was H. Jack Geiger, a public health professor, who called anti-preference actions "ethnic cleansing in the groves of academe" and predicted a "potential public health disaster." A disaster? Only if the most important concern Americans have about their doctors is their race. In fact, a large survey conducted by the Commonwealth Fund in 1994 found that the doctor's "nationality/race/ethnicity" ranked 12th out of 13 possible factors.
Whether Farmer can prove he would have been admitted to the University of Maryland's medical school even in a race-neutral system remains to be seen, but clearly the notion that educational resources are best devoted to producing good doctors of any race is one that still needs defending.
Sally Satel is a psychiatrist and author of "PC, M.D. - How Political Correctness is Corrupting Medicine," just out from Basic Books, and is currently serving as an expert witness in the case.
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