The political transformation of medicine


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Regarding Stanley Goldfarb’s editorial:Keep politics out of the doctor’s office(April 19): In 2015, under the leadership of Daryl Kirsch, the Association of American Medical Colleges (AAMC) made sweeping changes to the Medical College Admission Test, or MCAT, as well as other admission criteria used by medical schools across the country. As Dr. Kirsch explained in 2011, “I am a man on a mission. I think it is critical for our future to change healthcare. I’m not talking about tweaking. I’m not talking about some subtle improvements here and there. I’m talking about real transformation.”

Transformation is underway. It is a disruptive effort to change the individuals who enter the medical field. The revised MCAT includes a new section that examines adherence to traditional assets; For example, a 2018 AAMC/Khan Academy practical question asked whether a “lack of minorities such as African Americans or Hispanics/Latinas among university faculty” is due to symbolic racism, institutional racism, subtle racism, or personal bias. The answer is supposed to be institutional racism.

The AAMC website provides insight into how the group is changing for medical training. Its homepage contains a doctrinal guide on Gender Affirmation Care for young people. The AAMC also recently introduced a new test that aims to complement the MCAT by testing softer skills such as “cultural aptitude.” An AAMC writer explains that it was designed with the goal of eliminating “mass differences in average scores for African American and Hispanic applicants compared to white and Asian examinees.” “Medical schools and residencies lower their admission criteria,” Dr. Goldfarb notes. This is by design.

AAMC makes up half of the only government-accredited accrediting entity for American medical schools. It administers only the MCAT and National Unified Medical School application. In Understanding Takeover Medicine, start by examining the leaders in medical education.

Devora Goldman

New York

Ms. Goldman, Visiting Fellow at the Center for Ethics and Public Policy, wrote Newsletter on side effects.

As a medical educator, I expect my students to understand the mechanism of action of antibiotics and the pathways of resistance. I also expect them to understand the social determinants that may contribute to ill health and how we can reduce inequalities.

Dr. Goldfarb’s argument is based on anecdotes, so these are my anecdotes: As someone who wrote in the New England Journal of Medicine about my own biases and inner race, I can safely say that awareness of such issues has improved my relationships with my patients. Furthermore, my students prove that the standard has not been lowered in medical schools and residency programmes. Dr. Goldfarb’s statement otherwise is an example of how discrimination persists in medicine.

I am also an infectious disease doctor. In the days when I would dare fight insurance companies to get the drugs they needed for my patients, discussions about inequality give me purpose. In the words of Stephen Wolf, “Poverty is as important as proteins are in understanding disease.” Those who find the need to retire early because of such discussions may be better off. We might be better off without them.

Assistant. Professor Tara Vijayan

UCLA David Geffen School of Medicine

Dr. Goldfarb writes what many doctors believe but are afraid to say, for fear of being labeled a racist.

Jonathan L. Stolz, MD

Williamsburg, Virginia.

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