Last Friday, Do No Harm founder and board chair Stanley Goldfarb, MD, took to the debate stage at the University of South Florida to consider the question “Does ‘DEI’ Help or Hurt Medicine?”
Our man did stellar work, and we encourage readers to dig into his opening statement here or watch the full debate here.
Among the contentions produced by Dr. Goldfarb’s opponents were a number of claims that misrepresent the scientific record or fail to grapple fully with available data.
The following is an analysis of some of those claims, offered for the edification of readers who have watched the debate — and of those who haven’t.
Claim #1: Small MCAT Score Differences Don’t Matter
Appealing to fairness, Dr. Bonzo Reddick, district health director for Georgia’s Coastal Health District, asked the debate audience to imagine two medical-school applicants: one with an MCAT score of 520 and one “from rural Georgia who got a 510” (1:25:30).
Dr. Reddick would have us think that such a score disparity is insignificant. Yet, as Dr. Goldfarb pointed out (1:29:12), what may seem to be a small difference in MCAT achievement does matter. As the AAMC’s own data reveal, an 11.2-point difference represents one full standard deviation. While differences between a 510 and 520 may sound small, they are big, and they lead to a big difference in applicants’ future performance.
Claim #2: MCAT Scores Are “Kind of a Wash” Above a Certain Threshold
Referencing his years as chair of the Community Medicine Department at the Mercer University School of Medicine, Dr. Reddick contended that “[o]nce you get to a certain [MCAT] score … it’s kind of a wash at that point.” For example, “[e]very student who got a 503 or higher on their MCAT had unimpeded access” — i.e., academic success — “through medical school” (52:16).
But national data do not align with the phenomenon Dr. Reddick claims to have observed. AAMC studies using the current MCAT find that scores continue to predict medical-school outcomes and performance on licensing examinations. Other research has linked licensing performance with later practice outcomes.
The observation that students above 503 can succeed is one thing. (For what it’s worth, an MCAT score of 503 represents the 58th percentile, a relatively low bar considering that 55,000 applicants vie annually for 23,000 medical-school slots.) But that observation should not be treated as the equivalent of concluding that a 503 and, say, a 520 tell admissions committees the same thing.
Claim #3: “Mission-Aligned Admissions” Are Valid Even if “Holistic Admissions” Aren’t
In his opening statement, Dr. Reddick conceded that “you hear a lot of people moving away from the term ‘holistic admissions’ because it kind of gets juxtaposed against ‘merit’.” Instead, Reddick continued, admissions committees have begun thinking in terms of “mission-aligned selection,” in which decisionmakers create “a selection process that helps us achieve the goals of our mission” (46:20).
As Do No Harm has previously written, so-called mission-aligned selection is merely a fig leaf used by medical-education programs intent on engaging in ideologically motivated or racial admissions policies. The AAMC’s “Mission-Aligned Selection and Retention” guidance makes this clear, urging medical schools to consider applicant criteria (e.g., “attributes” and “experiences”) that are neither academic nor objective.
In short, just as “holistic admissions” deemphasized academic merit as an admissions criterion, so does its replacement, “mission-aligned selection.” That is unacceptable.
Claim #4: Medical-School Applicants Should Be Screened for “Soft Skills”
In his own opening statement, Dr. Henri R. Ford, dean and chief academic officer at the University of Miami Miller School of Medicine, voiced his preference for medical-school applicants who possess “the four C’s” and are thus “caring, considerate, compassionate, and collaborative.” Ford went on: “If we relied strictly on MCATs and GPAs, we could end up with individuals who lack those ‘soft skills’” (32:08).
The problem with this line of thinking is that, as a Do No Harm member and academician points out in an email to us, “[e]ven if we are to assume that ‘soft skills’ are important, they — unlike MCAT scores and GPA — are subjectively evaluated. Who is to say one student has more ‘soft skills,’ empathy, and leadership than another? How is it measured and by who?”
Exactly so.
Claim #5: The Casper Situational-Judgment Test is a Valid Measure of “Soft” Attributes
Taking up Dr. Ford’s theme, Dr. Reddick suggested that the Casper test, which bills itself as an “an open-response situational judgment” exam, is appropriately used by some medical schools “to actually assess how … people think when [they] get presented with an ethical challenge” (1:26:36).
Unfortunately, like the AAMC’s PREview exam, which purports to assess such attributes as “reliability, resilience, adaptability, [and] ethical responsibility,” the Casper test ought to provoke skepticism. Both represent another way for medical schools to devalue traditional metrics of merit and competence in favor of admissions methods that make room for the DEI agenda.
By all means, medical schools should teach future doctors to be ethical and adaptable. (At institutions with reasonable academic standards, medical students will necessarily learn reliability and resilience.) As Dr. Goldfarb rightly pointed out, however, “we should take in the most talented students, and if we are interested in inculcating [soft skills] in them, well, we should inculcate those skills in medical school” (59:03).
Claim #6: DEI Isn’t About Lowering Standards
Dr. Ford contended that DEI in medical education “has never been about lowering the standards” (1:36:10). But if that’s true, why do standards keep lowering?
As Do No Harm has chronicled, pre-clinical grades in American medical schools are now practically non-existent, having given way to less predictive “pass/fail” measures. A number of medical schools have paused their chapters of Alpha Omega Alpha, a national medical honor society. And, as Dr. Goldfarb reminded listeners, Step 1 of the United States Medical Licensing Examination moved to “pass/fail” precisely because “underrepresented in medicine students were hurt by generally having lower ‘step’ scores” (1:48:11).
That these moves have accompanied the intrusion of DEI ideology and practice into medical education is highly instructive. The timing is no coincidence.
We invite readers to watch the debate on their own and consider these and other assertions. We think you’ll come away in agreement: DEI has no place in medical-school admissions. Merit alone should be our guidepost.
