How Affirmative Action creates negative stereotypes about minority physicians

Simply put, accepting less qualified medical school applicants produces less qualified doctors. In this way, affirmative action perpetuates negative stereotypes about minorities in medicine.

Recently, a Facebook post by Alphonse Maddin rejected my assertion that accepting less qualified physicians compromises quality of care for patients. Mr. Maddin makes some strange assertions is his post, which I won’t respond to, but I want to respond to his assertion regarding medical school academic standards.

First, let me discuss physician-licensing requirements in the USA. The USMLE is a multipart exam designed to test physician qualifications prior to licensure. The passing score is determined by the population taking the test- the top 90% pass the USMLE. The medical schools look at MCAT scores for applicants because they are a strong predictor of USMLE performance. Students who do well on the MCAT have a tendency to do well on the USMLE. Therefore by accepting less qualified applicants with lower MCAT scores for any reason, the medical schools actually lower the bar for medical licensure. Less qualified students will do worse on the USMLE, reducing minimum requirements and lowering academic standards for physicians. It’s a self-fulfilling prophecy.

Let’s take things a step further. If the medical schools accept less qualified Hispanic and black applicants because of affirmative action, those students will in general perform worse on the USMLE, because MCAT scores are a strong predictor of USMLE performance. More of these minority medical students will become physicians because the medical schools have concurrently reduced their physician licensure requirements. The population of minority physicians will be in general less qualified than the population of nonminority physicians. The patient who encounters these less qualified minority physicians may make the assertion that in general minority physicians are less qualified than nonminority physicians. Statistically speaking, the patient would be correct. This is how affirmative action perpetuates negative stereotypes about minority physicians.

If on the other hand, if medical schools 1) accepted students only based on merit and 2) set a universal licensing standard by determining the essential knowledge a physician should have and then allowing only students who passed the test based on those standards (no relative target) to become physicians, things would be different. There would be no negative stereotypes because minority physicians would be every bit as qualified as any other physician.

In business school, they teach you that perception is reality. Creating negative stereotypes about the qualifications of minority physicians is more damaging to them in the long term than any short-term benefit from affirmative action.