What happens when race trumps merit?

Heather MacDonald is an author, and a keen observer.  The piece below is my edit of an excerpt of her new book.  (Click for link to her excerpt.)

Medical education, medical research, and standards of competence have been upended by a trendy theory among "experts:" that racial disparities in the medical profession are due to systemic racism.

Questioning that theory is professionally suicidal. The result is almost certain to be a declining quality of overall medical care and scientific progress.  But because the "experts" control the universities and the medical profession, we seem to be locked into this result.

Virtually every major medical organization—the American Medical Association (AMA), American Association of Medical Colleges, American Association of Pediatrics and so on—has embraced the idea that the U.S. needs to lower med-school admission standards for blacks and Latinos.

The AMA claims doctors must "dismantle white supremacy, racism, and other forms of exclusion and structured oppression, as well as embed racial justice and advance equity within and across all aspects of health systems."

The AMA claims the lack of "just representation"--apparently meaning having every group represented in medicine in the same percentage as its population--is due to "deliberate exclusion." It claims the solution is to create "identity-based preferences" throughout the medical profession.  

According to these so-called "experts," the *only* reason science and medicine are overwhelmingly staffed by whites is racism/white supremacy.  Keep that in mind.

As a result of this *theory,* med schools are either accepting minorities with lower test scores, or even junking long-accepted tests entirely, to admit more members of favored races and groups.  

But as with all charges of "disparate impact," claiming the disparity is due to racism implicitly posits that there is no difference in the academic skills of whites and Asians on the one hand, and blacks and Hispanics on the other.  But is that true?

At the end of their second year of medical school, students take Step One of the the U.S. Medical Licensing Exam (USMLE), which tests knowledge of anatomy, biochemistry, physiology, cell biology and pharmacology.  High scores on Step One predict success in a residency, and highly sought-after residency programs such as surgery use those scores to help select who will be admitted.

Fewer black students are admitted into competitive residencies than their percentage among med students because their average Step One test scores are a full standard deviation below those of whites.  A score one standard deviation below the mean would be in the bottom 16% of the class.

The wokies have already modified Step One to try to shrink that gap, by giving credit for non-academic, subjective skills such as "communication and interpersonal skills." But even after that change, the standard deviation in scores has persisted.

In the wokie world that can only mean one thing: The test itself must be racist.  The unstated assertion is that the test doesn't actually measure medical knowledge, but in the "woke" vernacular it "disadvantages" underrepresented minorities.

Yale has already sought to conceal widely varying performance by going to a pass-fail grading system--a policy pushed by minorities and wokie administrators.  So building on that "success," the solution to concealing poorer scores on Step One was obvious: don't score it.  

And sure enough, since January of last year Step One has been changed to pass-fail.  This allows med-school administrators to admit more minorities without being vulnerable to the charge that they've lowered standards for those admitted--because there are no longer any scores.  

Medical school bureaucrats cheer this idea.  A career advisor at one med-school described a conversation she had with a student who had done so poorly on her Step One test that she would have a hard time landing her preferred residency in obstetrics and gynecology.

The advisor insisted that the student's test scores were less important than her "passion for social justice." (How that passion might help a doctor treat a uterine rupture during delivery isn't clear.)

In the advisor's view, changing Step One to pass/fail will help students more "effectively tell their stories to residency committees."  This seems clearly to show that to the woke gate-keepers, a student's "story" is more important to saving lives than academic knowledge.

Requiring academic mastery to become a doctor has a disparate impact on blacks.  Is that due to racism, or to the fact that a far lower percentage of blacks prize academics and hard study?  The "experts" have settled on the first reason, because it makes them safe from criticism.  So as with every other "disparate impact" argument, those same "experts" demand we change the system to make knowledge less important for admission to med-schools and demanding residencies, and to make it easier to admit those with less of it.

Does that sound to you like a sound policy, or one that will lead to poorer results?

Of course in practical terms it doesn't matter, since you can't change what the wokiez have ordered.  Of course the "elites" will know which doctors are to be avoided, so they won't be impacted.  You won't know.  Tough break, eh?