Sunday, May 26, 2024

Merit Must Trump DEI in Medical Education

By Ian Kingsbury

Sunday, May 26, 2024

 

Medical schools have eagerly embraced the DEI (diversity, equity, and inclusion) agenda, which has supplanted merit and excellence. Common sense says that’s a mistake, and a new study makes the folly of that decision clearer than ever.

 

The study, published in the Journal of the American Medical Association on May 6, observes that among newly trained hospitalists, scores on the certification exam of the American Board of Internal Medicine certification are positively associated with better outcomes among hospitalized Medicare beneficiaries. Specifically, patients assigned to internists who scored in the top quartile on the exam were 8 percent less likely to die within one week of hospital admission than were patients assigned to internists who scored in the bottom quartile. Patients assigned to the highest-scoring internists were also 9.3 percent less likely to be readmitted within one week of discharge than were patients assigned to the lowest-performing internists.

 

Together with past research indicating that students who score higher on the MCAT (the medical-school entrance exam) tend to score higher on licensure exams, the study in JAMA is a clear and unsurprising indication that brighter doctors make for better doctors. If logic and wisdom reigned, the findings would be heard as a clarion call for medical schools to abandon the DEI agenda and redirect medical-school admissions to a central focus on merit and excellence.

 

Unfortunately, however, DEI stalwarts have captured most medical schools and medical institutions, so the findings are almost sure to be ignored. Flagrant and recurrent dishonesty and factual sloppiness among identity-obsessed zealots expose that DEI is, rather than a mission to advance standards of patient care through reason and evidence, a political crusade seeking to exact “justice” against perceived systemic problems in American society, consequences be damned.

 

A tragic irony in the dismissal of reason, evidence, and excellence among DEI acolytes is that it’s almost certain to inflict the highest toll on the patients whom DEI ostensibly seeks to help. Consider, for example, the case of the UCLA David Geffen School of Medicine. The school has gone so far in abandoning merit in favor of racial considerations that “up to half of UCLA medical students now fail tests of basic competence.”

 

Prestigious, resource-rich hospitals and clinics would have good reason to steer clear of UCLA graduates. Likely, they will disproportionately work in clinics and hospitals that treat economically disadvantaged patients. In light of the findings of the JAMA study, it’s a recipe for exacerbating health disparities.

 

Similarly bad logic was displayed in a recent hearing that the Senate Health, Education, Labor, and Pensions Committee held on “minority health care professionals and the maternal mortality crisis.” Committee chairman Bernie Sanders (I., Vt.) emphatically asserted that racial disparities in health are explained by the demographic composition of the physician workforce and that more doctors from “underrepresented” groups are needed. The solution, according to Sanders, is “to substantially increase the class sizes of Historically Black Colleges and Universities (HBCUs).”

 

Sanders is wrong in both his diagnosis of the problem and his solution for fixing it. The idea that patients benefit from racially concordant care is a myth. Patients do best with highly capable doctors, not ones who happen to share the same race. To that end, expanding enrollment in HBCU medical schools is a remarkably foolish solution for addressing health disparities. The four HBCU medical schools (Howard, Morehouse, Meharry, and Charles Drew University School of Medicine) feature some of the lowest admissions standards among all medical schools in the country. The results of expanding their enrollment to address health disparities are all too predictable.

 

In medical-school admissions, the case for excellence over identity couldn’t be more obvious. When DEI wins, everyone loses.

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