https://twitter.com/ConceptualJames/...27047128842241
Twitter thread by Houman David Hemmati, MD, PhD (@houmanhemmati)
[https://twitter.com/houmanhemmati/st...54712215322624 to https://twitter.com/houmanhemmati/st...54866821566465]
There's been a lot of recent attention on #DEI in college admissions thanks to @GovRonDeSantis @RonDeSantisFL pushing to ban DEI-based admissions in Florida & to DEI in medicine w/@IngrahamAngle @wsj @nypost reporting on @AAMCtoday adding DEI to medical schools. But the scope of DEI in medical school admissions hasn't been known by the general public. As a former admissions committee member of a top-20 med school, I was shocked to learn how much med schools have recently shifted away from merit & questions about "why medicine" goals as a physician to overtly DEI-based admissions questions. Here's what I have found:
Of all the allopathic (MD) and osteopathic (DO) medical schools in the United States, the majority have questions on their 2022-2023 application cycle applications that relate to “DEI” issues. Typically, the question is: “How would you contribute to the diversity of our medical school.” For someone who doesn’t meet the currently-accepted definition of “diversity”, that’s already a hard enough question to answer. Yet many med schools go (far) beyond basic DEI to ask about identity, sexual orientation, anti-racism and proof that the applicant is committed to social justice issues. These questions are used to screen and weed out applicants. If you don’t pass, you won’t get an interview and your application is dead.
A for-profit admissions advising site has done a great job of publishing every medical school’s 2022-2023 secondary (school specific) application questions. They’re located here (I have no affiliation with the site/company):
Here’s a list of US med schools that I found to contain at least one DEI question on their application. Note that many are surprisingly in “red” states like FL and TX where you’d least expect it: [list hidden to save space]
Among these DEI-focused med schools, there are some that take DEI to an entirely new level, making you wonder whether they’re recruiting future doctors or future social justice warriors like the PhD social justice “doctor” Barbara Ferrer who leads @lapublichealth. Take @StanfordMed which asks: “The Committee on Admissions regards the diversity (broadly defined) of an entering class as an important factor in serving the educational mission of the school. You are strongly encouraged to share unique attributes of your personal identity, and/ or personally important or challenging factors in your background. Such discussions may include the quality of your early education, gender identity, sexual orientation, any physical challenges, or any other life or work experiences.”
Or @UCIMedSchool which asks “Do you identify as being part of a marginalized group socioeconomically or in terms of access to quality education or healthcare? If so, please describe how this inequity has impacted you and your community.” @dgsomucla echoes those themes by asking “Do you identify as being part of a group that has been marginalized (examples include, but are not limited to, LGBTQIA, disabilities, federally recognized tribe) in terms of access to education or healthcare? (Yes/No) • If you answered “Yes” to the above, answer the following prompt: Describe how this inequity has impacted you or your community and how educational disparity, health disparity and/or marginalization has impacted you and your community.” Not wanting to be left out, @UCSFMedicine asks “Do you identify as being part of a marginalized group socioeconomically or in terms of access to quality education or healthcare? Please describe how this inequity has impacted you and your community.” And @KeckMedUSC simply asks “Are you a member of a group that is under-represented in medicine? (Yes/No) • If yes: Which Group? How does under-representation affect your community? “ Notice a pattern? If you’re not oppressed or marginalized in their particular way, you’re not as worthy.
It gets interesting from here. @WesternU won’t let you apply unless you think DEI is “important” by asking “What does diversity, equity, and inclusion mean to you and why are they important? “ Not to be undone, GWU in DC asks “Describe how current issues regarding advocacy and social justice have impacted your motivation for medical school?” Too bad if you want to be a doctor to just help sick people or keep people healthy. While other med schools like @FSUCoM in Florida care a lot about identity by asking “If there is an important aspect of your personal background or identity, not addressed elsewhere in the application, that you are comfortable voluntarily sharing with the Committee, we invite you to do so here. Many applicants will not need to answer this question. Examples might include significant challenges in access to education, unusual socioeconomic factors, identification with a minority culture, religion, race, ethnicity, sexual orientation or gender identity. Briefly explain how such factors have influenced your motivation for a career in medicine.”
U Kansas continues the identity theme by asking applicants “Please tell us about your identity. How has your identity impacted the development of your values and attitudes toward others, particularly those with values different from your own? Please include how your values and attitudes will foster a positive learning environment during your training, and benefit your future patients through the practice of medicine.” Can you apply if you identify as a human? Such factors also matter to U Kentucky which asks “Please share unique, personally important, and/or challenging facts in your background, such as the quality of your early educational environment, socioeconomic status, culture, sexual orientation, race, ethnicity, or life/work experiences. Please discuss how such factors have influenced your goals and preparation for a career in medicine.”
Interestingly, U Louisville makes it clear that certain non-diverse cultures are less capable of delivering “equitable care” when they ask “How have your cultural experiences shaped the way you see yourself contributing to the medical field and strengthened your ability to provide equitable care for a diverse patient population?” @TulaneMedicine asks the seemingly bread and butter DEI question “Tulane University School of Medicine values the diversity of its patients, faculty, staff, and students. Do you identify with a particular group that you believe is underrepresented among medical professionals? These include groups oriented around, but nt limited to: ethnicity, race, sexuality, religion, disability, and economic background.” The military medical school even gets in on it when @USUhealthsci overtly invokes DEI in their application by asking “Our Admissions Committee assembles classes of students with a wide range of backgrounds, skills, experiences, and talents. Please describe how a special quality or experience of yours has informed your ability to participate well in a diverse, equitable, and inclusive environment.”
@harvardmed at least acknowledges that not every applicant will meet the DEI litmus test by saying “If there is an important aspect of your personal background or identity, not addressed elsewhere in the application, that you would like to share with the Committee, we invite you to do so here. Many applicants will not need to answer this question. Examples might include significant challenges in access to education, unusual socioeconomic factors, identification with a minority culture, religion, race, ethnicity, sexual orientation or gender identity. Briefly explain how such factors have influenced your motivation for a career in medicine.”
Med schools in Michigan are aboard the DEI and systemic injustice train as well! @michiganstateu asks “American society may be experiencing a watershed moment as it reckons with various systemic injustices. Use the space below to share your thoughts about this statement.” And @UMichMedSchool has a two-parter with “• Describe your identity and how it has impacted the development of your values and attitudes toward individuals different from yourself and how this will impact your interactions with future colleagues and patients. • If you recognize and/or represent a voice that is missing, underrepresented, or undervalued in medicine, please describe the missing voice(s) and how increased representation in medicine could impact the medical community.”
The hands-down winner of the med school admissions DEI contest is @umnmedschool in Minnesota with its EPIC DEI application and DEI-driven “pathways” that segregate students based on identity:
Describe a time when you personally experienced, observed, or acted with explicit bias. What did you learn about yourself and the experience?
The University of Minnesota Medical School is committed to building an anti-racist community. Please share your reflections on, experiences with, and greatest lessons learned about systemic racism. (Consider this country's history, racism, racial injustice, anti-black racism, and the impact of the murder of Mr. George Floyd on the Minnesota/Twin Cities community).
How will your unique attributes (religion, race, ethnicity, socioeconomic status, ideology, intellectual heritage, and/or experiences) add to the overall diversity of the University of Minnesota Medical School community?
Select your pathway interest(s) below (you may select more than one). Once you make your selection there will be additional questions that you will be required to answer:
- Indigenous Health Pathway
- Rural Health Pathway
- Urban Communities Pathway
- 2SLGBTQIA+ Pathway: The University of Minnesota Medical School is committed to dismantling the health disparities affecting Minnesota’s 2SLGBTQIA+ communities. Describe your experiences engaging and/or working with 2SLGBTQIA+ communities and explain why 2SLGBTQIA+ inclusive health care is important
- Immigrant | Refugee | Global Health Pathway
And this continues with @MOmedicine asking “"How will your diversity/diverse experiences (e.g., gender, gender identity, race, ethnicity, sexual orientation, veteran status, from rural or underserved community, first generation student status) add to your career in medicine?" And @WUSTL similarly asks “Is there anything else you would like to share with the Committee on Admissions? Some applicants use this space to describe unique experiences and obstacles such as significant challenges in access to education, unusual socioeconomic factors, and/or identification with a particular culture, religion, race, ethnicity, sexual orientation, or gender identity and/or possibly challenges related to COVID or other issues in preparation for medical school.”
@GeiselMed at @dartmouth has an interesting DEI question: “Geisel School of Medicine values social justice and diversity in all its forms. Reflect on a situation where you were the “other.”” Are you allowed to answer with “When I applied to med school as a non-diverse applicant”?
The most shocking example of a med school overtly threatening to CANCEL you and rescind admission or kick you out if your PAST OR PRESENT social media presence has ever said anything offensive is New York Medical College (which even has a @Diverse_NYMC Twitter account) that actually says (not a joke!): “Please review the NYMC Social Media Policy. If you select YES, we ask that you please briefly explain what has been posted. In keeping with New York Medical College’s (NYMC) and Touro College and University System’s policies on prospective student online conduct, College staff members do not “police” online social networks and the College is firmly committed to the principle of free speech. However, when the College receives a report of inappropriate online conduct, we are obligated to investigate; New York Medical College reserves the right to rescind admissions for misconduct or lack of professionalism wherever it occurs, including online. Is there anything in your social media presence (past, or present) that would bring discredit or dishonor on you, the institution, the program or profession (if applicable) or that could be considered derogatory, hateful, or threatening? (Yes/ No)” WHAT?!? I think they made this for @kevinnbass
@StonyBrookMed doesn’t give you the option to say “none” when they ask “What, in your opinion, is the role of a physician in addressing systemic racism and societal injustices?” And @OHSUSOM REALLY wants to make sure you understand and adhere to their definition of diversity: “Please discuss how your personal experience demonstrates the ability to overcome adversity and contributes to diversity in the provision of healthcare. Please include any insight into the diversity that you would bring to OHSU School of Medicine and the profession of medicine in the context of OHSU's definition of diversity: Diversity at OHSU requires creating and sustaining a community of inclusion. We honor, respect, embrace and value the unique contributions and perspectives of all employees, patients, students, volunteers and our local and global communities. Diversity may include age, color, culture, disability, ethnicity, gender identity or expression, marital status, national origin, race, religion, sex, sexual orientation, and socioeconomic status. We respect diversity of thought, ideas and more. Diversity maximizes our true potential for creativity, innovation, quality patient care, educational excellence and outstanding service.”
In comparison to other DEI med schools, @GeisingerCwlth seems boring when they only ask “Geisinger Commonwealth values diversity and is committed to maintaining an inclusive environment. How will you contribute to our commitment to diversity, social justice, equity, and inclusion?”
In another example of “Did they really say that?!” Philadelphia College of Osteopathic Medicine actually comes out and asks “PCOM recognizes and affirms the dignity of all members of the PCOM community. Do you self-identify as part of the LGBTQIA community? (Yes/No) • If yes, please use this space to specify your identity within the LGBTQIA community, if you wish.” Wow. Just wow.
Finally, in Texas, @utmbhealth asks “John Sealy School of Medicine values inclusion and advocacy. Describe a time when you advocated for someone whose social identity (e.g., race, gender, sex, sexual orientation, religion, socioeconomic status, ability status, etc.) differed from yours. Explain the situation and why advocacy was necessary” & @UTHealthRGV (@BillFOXLA stomping grounds) asks “The University of Texas Rio Grande Valley School of Medicine has commitments to diversity, inclusion, and health equity. What do these terms mean to you? What is their importance to medical education and practice, as well as to the health of our society in general?” Finally, @UofUHealth asks “ The School of Medicine aims to create a culture of inclusion and anti-racism in health education and healthcare delivery. How have you promoted or advocated for health equity in your experiences? How do you envision contributing to the UUSOM and the communities we serve?”
We need to ask whether these DEI admissions questions/policies, which are so obsessively focused on sexual orientation, gender identity, skin color and other factors, do anything to create doctors who deliver better care. Back in my day, med schools believed that any good person could be trained to take care of any patient, regardless of who they are, by treating every human with equal value, equal compassion, and an equal commitment to better health. Do doctors now really need to look and/or act like their patients to deliver them quality care? Sure, there can certainly be cultural and language benefits in many cases, but med schools are clearly going beyond that by selecting for progressive social justice activists and people with “diverse” identities rather than focusing on who is going into medicine for the right reasons and who is most likely to perform well in the future. It’s time for a serious discussion about this.
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