The United States is projected to face a shortage of over 100,000 doctors by 2030, leaving millions of Americans with inadequate access to health care. Yet, some voices within the medical community would like to see medical schools prioritize the training of students in political activism, even if that means higher costs for students and more distractions from quality medical education.
A recent article in the American Association of Medical College’s (AAMC) journal Academic Medicine featured the perspectives of five medical students and residents on expanding medical schools’ curricula to include more instruction in public policy advocacy and added flexibility for student-activists to attend protests. The publication of this article is the latest example of the AAMC’s fervent support for institutionally sanctioned activism, alongside its Diversity, Inclusion, Culture, and Equity (DICE) Inventory, which grades medical schools based in part on how engaged those institutions are in political and legislative advocacy. Other instances include vocal opposition to efforts by communities to restrict dangerous gender transitions for minor patients.
The article, “The Case for Advocacy Curricula and Opportunities in Medical Education: Past Examples to Inform Future Instruction,” argues for three primary changes: adding “advocacy-centered formal teaching,” expanding extracurricular advocacy opportunities, and accommodating academic interruptions due to student-activism. These aims may not seem wholly unreasonable at first, but there are several reasons that institutions and the medical community should reject them.
Foremost, creating advocacy curricula requires institutions to add additional classes, which in turn will lead to needless increases in the cost of attendance. An additional course at the University of New Mexico School of Medicine, such as the one praised by the authors of the article, costs thousands of dollars. Meanwhile, medical student debt has ballooned from $88,495 in 2000 to $241,600 in 2022. The financial burden of medical school remains a formidable barrier for many potential medical students, especially for students from the lowest income brackets. Adding expensive activism-focused coursework that is irrelevant to the practice of medicine is at best a decadent luxury for the wealthiest students; at worst, it is a perverse prioritization of ideology over concern for the financial limitations of most students’ budgets.
The high cost of medical school has national implications. Rising tuition costs and student debt undermine efforts to address physician shortages in high-need, low-paying states. The shortage of physicians varies considerably based on geography, and states that have lower average salaries for physicians are further disadvantaged when the costs of medical school increase and new doctors have to prioritize paying off student loans.
Training and coursework, however, are not enough for student-activists, who also want more opportunities for students to participate directly in political advocacy. But their demands are not just for more student-led groups on campus—they insist on schools accommodating their absences from class or rotations to attend protests and political rallies. The AAMC went even further, urging medical schools to overlook arrests of applicants and students if they were related to Black Lives Matter protests.
Medical students, like all Americans, enjoy the freedom to assemble and speak freely, but medical schools should not be compelled to accommodate, overlook, and even endorse students’ political activities, especially when those students violate the law.
The trend of medical education towards radical political activism distracts from the pressing needs of the American health care system to fill out its ranks of quality, capable doctors. The AAMC is driving much of this shift, and it is emboldening the most vocal students towards the same end. Meanwhile, a majority of Americans have a negative view of the health care system, and roughly half of Americans are dissatisfied with the quality of their medical care. Activism will not fix this crisis of confidence—but well-equipped, financially unencumbered doctors will.
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