Saturday, April 27, 2024

Good grades dont always make good doctors

June 21, 2001

I bought a new CD last week. “Pneumonia,” by Whiskeytown. A fine title in the tradition of country music: romantic, tragic and evocative.

For me, however, pneumonia is evocative only of Gram-staining, catalase negative cocci in short chains, pulmonary edema and inflammation.

This is because I am studying for the United States Medical Licensing Examination, Step I. The USMLE, or the Boards, is the test that stands between the first two (classroom) years of medical school and the last two (hospital) years.

It is a simultaneous final examination in anatomy, physiology, pathology, neuroscience, pharmacology, microbiology, biochemistry, embryology, genetics and psychology. It’s hard.

At the conclusion of the first two years of medical school, a student is theoretically trained in most of the hard science of medicine. I’ve supposedly learned most of the theory of medicine that I ever will.

In the next two years, I will be learning about people. I will be meeting and observing the incarnations of health and disease. I will learn their names. And I will begin to understand what medicine is - and how far it is from the classroom lecture.

I have no idea whether I will be able to be a physician. I know I am able to learn, to memorize, to deduce and regurgitate, but medicine is orders of magnitude richer than those tidy skills.

This is, fundamentally, why the study released last week by the Center for Equal Opportunity is as close to pure drivel as I have ever seen.

According to the study, which was conducted by an anti-affirmative action lobbying group, 3,500 white students were rejected from five state medical schools that admitted blacks and Hispanics with lower grades and test scores. MSU’s College of Human Medicine was among those studied.

MSU has a national reputation for producing physicians unparalleled in their ability to care for patients with compassion and humanity. This reputation was not and cannot be fulfilled by simply culling those applicants with high grades and test scores any more than it can by selecting those applicants with odd-numbered birthdays. In short, the qualifications for medical school can’t be quantified.

So the sensational conclusions of the study and the headline are misleading at best, and at worst, idiotic.

But MSU does have a stated commitment to diversity. This commitment is fitting and proper - to treat a diverse nation, a diverse group of physicians is needed. In this column I have previously defended affirmative action as it applies to blacks. I have written that as our history shows legislated, institutional injustices, so must we now make a legislated, institutional effort to correct them.

But I must question the extension of affirmative action to cover all minorities. I must also question the way in which MSU’s medical school fulfills its commitment to diversity.

Affirmative action is no longer an effort to right past wrongs; instead, it is now an effort to make any group of people look like the nation. This is misguided. The very fact all Asians and Pacific Islanders are grouped together is an indication of the idiocy of the policy. According to the government, Jordanians, Manchurians, Samoans and Russians are all the same.

Funny, yes, but with some troubling effects. Asians in America are regarded as wealthy and well-educated; while it is true that 57 percent of Native Americans have at least a bachelor’s degree, only 5 percent of Hmong completed college - and according to affirmative action, both groups are identical so the Hmong receive no benefits. The current affirmative action system is deeply flawed.

But it should not be abandoned; it is needed in some form. For instance, our medical school, as I wrote, should try to educate groups of physicians who can deal with a diverse patient group, although I have to wonder if that goal is better served by a racially diverse group of students, or by a culturally diverse group of students?

Does it matter if some of my classmates are black if most of the rest will graduate without ever having spoken to them - or any other black people? Does it matter there are a handful of gay medical students if there are more who are rabidly homophobic? Does it matter there are a few Jewish students in my school if some of the others regard them as heathens?

If the goal of MSU’s College of Human Medicine is the creation of a group of physicians suited to care for a diverse population, it must do more than admit classes that are themselves diverse. It must admit classes capable of and willing to care for a diverse population.

Last week, my school administration was accused of admitting unqualified students in its pursuit of diversity. I believe it is innocent of that charge. I believe diversity is an admirable goal. And I believe it is falling short of that goal.

Rishi Kundi, a State News graduate columnist, isn’t naming any names. You know who you are. Write to him at kundiris@msu.edu.

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