The Association of American Medical Colleges (AAMC) is changing the language it uses to refer to its preferred admissions strategies, potentially offering a fig leaf to medical education programs intent on engaging in ideologically motivated or racial admissions policies.
Previously, the AAMC had touted the admissions practice of “holistic review,” which prioritizes softer attributes such as personal background and deemphasizes objective measurements of merit and academic aptitude.
But, as Do No Harm has shown, many medical schools that promote holistic review are also admitting minority students at much higher rates than a merit-only review process would typically produce. Specifically, some of these students are less academically qualified than their peers. This raises questions about whether these schools are using holistic review to engage in racial discrimination. It is especially troubling as the AAMC was long a proponent of racial preferences in admissions, even submitting a brief to the Supreme Court to argue that the practice should continue.
In short, holistic review appears to often be a convenient shield that may enable medical schools to continue engaging in racial discrimination. Now, it seems like the AAMC is rebranding the term.
It is doing so largely through instruction on “Mission-Aligned Selection and Retention” (MASR), a framework designed to help medical education programs use “a program’s mission to define merit and identify [applicants’] competencies, attributes, and experiences aligned with program goals.”
MASR “emphasizes individualized review.” It considers not only an applicant’s test scores and grades but his or her “context” and ability to “contribute to the mission” of the institution.
In other words, MASR allows medical schools to consider applicant criteria that are neither academic nor objective. While an applicant’s moral character should absolutely be relevant to the application process, it’s easy to see how “mission alignment” can be used as a proxy for ideological alignment with the political goals of a medical school. And one needn’t be a cynic to worry that such a framework could be used to dodge race-neutral admissions standards.
The Supreme Court anticipated this possibility. Indeed, in the majority opinion in Students for Fair Admissions v. Harvard, Chief Justice John Roberts wrote that “nothing in this opinion should be construed as prohibiting universities from considering an applicant’s discussion of how race affected his or her life, be it through discrimination, inspiration, or otherwise.”
But Roberts continued, “universities may not simply establish through application essays or other means the regime we hold unlawful today.”
As Do No Harm has previously explained, “holistic review” risks exactly that error. The practice “emphasize[s] factors unrelated to objective metrics of academic achievement.” It does so, as the AAMC has previously acknowledged, in order to increase racial diversity within medical schools’ student bodies.
Rebranding “holistic review” as “Mission-Aligned Selection and Retention” does nothing to change this reality. Indeed, the AAMC’s latest guidance features at least as many DEI buzzwords as its previous guidance did, employing such racially loaded terms as “equity,” “systems,” and “community” and urging medical schools to admit students with “a broad spectrum of perspectives and experiences.”
To be fair, the new guidance warns that “programs are prohibited by law from considering an applicant’s race … in making selection decisions.” Yet the AAMC’s guidance opens the door for medical schools to do just that under the guise of “mission alignment.”
Already, the ideology behind AAMC’s new guidance is beginning to show up on medical school campuses. During a recent podcast appearance, for example, Dr. Leila Amiri, associate dean for admissions at the University of Vermont’s Larner College of Medicine, remarked that, because Vermont is a “social justice-directed kind of place, we look for, collect, and invite to join social-justice warriors in our applicant pool.”
This came just after Amiri noted: “We hear ‘mission alignment’ a lot. […] To me, the entire application needs to make sense.”
If MASR is the new thinking determining medical school admissions, then evaluating applicants fairly and objectively will become increasingly difficult. Instead, medical schools should select candidates on the basis of objective merit, not alignment with progressive priorities.
