Med Schools, Grades Ethnic Admissions

The mail reminded me of Christmas all over again, an inordinate number of letters, all addressed to S.Q. Lapius.  Those with M.D. after his name I arranged in one pile, those with racist or bigot after his name I arranged in another pile.  “Throw them in the garbage,” he instructed me.

“Don’t you want to read them?”

“What for?  Their contents have been inscribed on the envelope.  I am sure they will not be enlightening.”

The latest rash of fan mail was in response to his suggestion that the medical schools were discriminating against topnotch students and denying them admission, replacing them with students of lesser proven caliber in order to strike some sort of social balance.

“As a matter of fact,” Lapius said, “there is a case in the courts right now, brought by a prospective law student who claims that he was denied admission to law school because the school felt bound to give his place to a member of a ‘minority’ group, by which is usually meant black or Spanish speaking.”

“But if he is an ‘A’ student he will have no trouble getting in elsewhere,” I said.

“True.  But suppose he is a ‘B’ student, and all the other law schools adopt the same attitude.”

“But don’t the medical schools have to strike some sort of ethnic balance?  After all, doctors deal with so many different types of people.  The nation has to have enough black doctors to deal with blacks---.”

Lapius interrupted me sharply, “---and Mexican doctors to deal with Mexicans, and Norwegian doctors to deal with Norwegians, and Gorgonzola doctors to deal with Gorgonzolas.  The list is endless.  I thought in America we had solved this problem by eliminating all qualifications except that of competence for the making of doctors.  Patients want the best doctors they can get.  When was the last time a person wanted to know your lineage as a prerequisite for becoming your patient?”

I had to admit that was true.  Patients went to doctors because they were recommended by other patients who had been helped.  “But still, there have to be doctors who will practice in the ghettos and poor areas ---.”

“And you automatically assume that a black physician will immerse himself in the ghetto?  He might, but then again he might not.  He might surprise everybody and become a research scientist or get a job with the National Institute of Health.”

“What’s your point?”

“My point is that,” Lapius sighed exasperatedly, “the job of the medical schools is not to solve social problems but to train doctors.  That if they choose to admit inadequate students just because they are disadvantaged, in the hope that they will, upon graduation, return to their own neighborhoods, then they are foisting on the disadvantaged, inferior doctors.  Everybody should have access to the best medical care there is available.  The job of the schools is to create a cadre of the best physicians it can.  It happens to be the job of the government or community to see to it that this care is available to all.  One shouldn’t despoil a great profession in the guise of satisfying a social need.”

“But you must admit that until recently a black student had great difficulty getting into medical school?”

“But that is changed now.”

“But the black community is educationally disadvantaged,” I persisted.

“Of course it is.  But this won’t be changed by admitting a person to medical school on anything except merit.  The poor have always been educationally disadvantaged.  In the old days this was corrected by having City Colleges that the poor could go to free, and these colleges had high educational standards.  The inferior education of the poor can only be corrected by subsidizing in these neighborhoods, excellent schools with high competitive standards.  In the old days, if a student failed, he was forced to run to another career.  Today we permit the students to persist with marginal grades.  It is foolishness.  We have based our educational system on the fact that everyone must initially learn reading and writing and arithmetic.  There are many people who are natural mechanics, builders, artists, athletes, musicians, who are indifferent to the three R’s.  Look at it this way, Harry.  Can you carry a tune?”

I shook my head dismally.  “Only if it’s in a portable radio,” I said.

“Well, suppose you were born into a world where the fundamental communication was musical.  How would you fare?”

“Miserably.”

“Well, that’s my point.  Do you feel that in that case, you should be accepted to play for one of the symphony orchestras?”

“Sure, if they wanted to ruin the orchestra.”

“Well they don’t want to ruin the orchestra.  Only the medical profession.”

“What would you do to redress the balance, Lapius?”

“I would pour millions of dollars into education.  Create schools of many disciplines, with different emphasis.  I wouldn’t create an immediate hostility to education by forcing everyone into the same initial educational mold.  Then, given my way, I would have an open admission to the professional schools, create a competitive curriculum, and graduate only those who met the standards.  This way the late bloomers would have a chance to show their stuff.  Or those with the driving ambition to come out ahead, might even do better than brighter students who were lackadaisical.  That way everyone initially would have a chance at it.  The way it is done today students are discouraged in advance.  Why it costs so much even to apply to medical school that the poor are immediately disadvantaged.”    

“But that would be expensive.”

“Everything is expensive.  It really boils down to just how we want to spend our money.  If the government subsidized medical schools, and created an open enrollment for the first year, they could solve a lot of problems.  Students who couldn’t cope would have to leave. After all, they are setting up an expensive administrative agency to supervise medical care.  The money could be better spent at the educational level.”

“How would you have felt if you had been kicked out of medical school?”

“Rotten.  But not as badly as if I had never been admitted in the first place,” Lapius said, as he started to go through his mail, which meant the conversation was over.