Grand rounds traditionally provide medical professionals with helpful information presented by clinical experts. But the Icahn School of Medicine at Mt. Sinai (ISMMS) used a recent grand rounds session as a platform to perpetuate divisiveness and incorrect assumptions.
The Institute for Medical Education at ISMMS hosted Dr. Dowin Boatright for an April 18, 2023 presentation of Exploring the Experiences of Historically Excluded Students in the Medical School Learning Environment and the Impact of Those Experiences.
After presenting statistics regarding the care of non-white and non-English-speaking patients and “diversity’s influence on medical education,” Dr. Boatright began speaking about “declines in the diversity of medical school matriculants.” To make this point, he cited information on “URM matriculants” from the mid-1990s. He attributed these declines to “additional cases nationally challenging affirmative action.”
Dr. Boatright warned that “another period of stagnation” for diversity in medical school admissions with “very high-profile Supreme Court cases challenging affirmative action” was on the horizon. He is referring to the Harvard and University of North Carolina cases, brought by Students for Fair Admissions (SFFA). These cases challenged the Constitutionality of race-based admissions in higher education and argued that discriminating against applicants based on skin color violates the Civil Rights Act of 1964.
For decades, the Supreme Court allowed public and private universities – including medical schools – to perpetuate such discrimination under the guise of “affirmative action.” This essentially told the schools that racial discrimination, done in the name of increasing diversity, was legal. On June 29, 2023, the Court affirmed that our Constitution and laws are color-blind and that every person is equal under the law. The rulings mean that universities must not discriminate against applicants based on race/ethnicity, including medical schools, when considering applicants for admission.
Dr. Boatright further defended his position by stating that the downward trend continued until the Liaison Committee on Medical Education (LCME), which oversees accreditation of medical schools, “began to exert its own influence on diversity.” He referred to two 2009 standards from the LCME (MS-8A and IS-16), pointing out that they use the word “must” regarding the development of programs and policies aimed at increasing diversity in medical school admissions.
“For the first time, medical schools were required to have programs and practices in place to have diverse students, faculty, and residents, and to retain those individuals. And if they didn’t,” Dr. Boatright continued, “and meet subsequent criteria, those medical schools could be cited by the LCME and ultimately lose their accreditation.” He did not indicate which, if any, medical schools have received such a citation or were at risk of losing their accreditation for failing to implement diversity initiatives.
There is a good reason for that. As noted in a Wall Street Journal editorial on July 25, 2023, the LCME itself confirmed that its diversity requirements are not the rigid mandates that professors like Dr. Boatright assumed. “In a letter responding to a questionnaire from the House Committee on Education and the Workforce,” the WSJ piece reported, “LCME says that ‘nothing’ in the text ‘mandates which categories of diversity a medical school must use to satisfy this element.’”
Dr. Boatright is known as being one of three physicians who published Blackface in White Space: Using Admissions to Address Racism in Medical Education (October 2020). The authors’ claim? “[T]hat most medical schools are white spaces where explicit and implicit racism occurs constantly and often goes unmentioned and unpunished.”
Boatright and his co-authors voiced a clear directive: “Stop admitting applicants with racist beliefs.” Among the recommendations for admissions officers to take was secondary essay prompts, which “could be enhanced to more clearly elicit applicants’ positions on race.” As we reported last year, secondary interview questions that address the topics that Boatright supports are a means to identify accepters and dissenters of the health equity and social justice initiatives of several medical schools.
The Icahn School of Medicine at Mt. Sinai is forthcoming about its goals for achieving “anti-racist transformation in medical education,” and hosting Dr. Boatright and his message aligns with those goals.
However, propagating racial divisiveness and unsubstantiated claims about medical school admissions and accreditation in the name of grand rounds is intellectually dishonest and contributes nothing to the professional development of busy physicians. If anything, the Harvard and UNC cases he bemoans exposed racially discriminatory policies in the admissions process and have ended the practices that ISMMS and Dr. Boatright endorsed. We applaud the Supreme Court’s rulings and will continue to pursue the restoration of merit to the admissions process in all medical schools, including ISMMS.
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