"Woke" Med School?!?

Okay, let me start right off by stating for the record that I don’t have a lot of experience with discrimination. I’m a white guy, after all. As white as they come: ancestors on one side from Wales and Austria, on the other from Finland. There’s no hidden Native Americans or other people of color in my line, and I’ve gone way?back in that search.

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But I do have family members who’ve had to contend daily with DWB, so I can say with certainty that racism (at least) is alive and well here. Frankly I’m amazed. I’ve been around a good while (I grew up watching the original Star Trek?on reruns, if that tells you anything) and I’ve been hearing about how we need to stop discrimination for over fifty years. And yet time and again I’m just dumbfounded when some public figure that stumps loudly in the public square for Diversity/Equity/Inclusion, aka DEI, will get caught making some incredibly offensive remarks when they don’t realize the mic is still hot.

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Like, when are we going to learn this lesson? Why is this still a problem?

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Because old habits are hard to break, I guess, and some people will always blame their troubles on someone else and carry that grudge like it’s got a handle. I recently saw a documentary on Nazi Germany in which it was revealed a US Army psychiatrist by the name of Dr. Douglas M. Kelley examined high-ranking Nazis after the war (including Hermann Goering himself). He specifically wanted to determine what mental illness made them the way they were, and was very surprised to find that, as a rule, they suffered from no consistent disorder. As far as mental balance was concerned they were just ordinary people, which meant that what they did, could potentially be done by anyone. It was a realization that later weighed heavily on Dr. Kelley.

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It's because of this ongoing problem with people being all too willing to judge for very superficial reasons that we have DEI policies in the first place. ?Why they are institutionalized is really no surprise to me, one of the defining ideas of the founding of this country was that ‘all men are created equal’. Put aside any post-modern criticisms here: I was taught from early grade school this did in fact mean everyone in mankind. We (meaning the US citizenry of the late 1700’s) weren’t trying to deliberately exclude women, blacks, Irish, Chinese, or what-have-you. I understood in no uncertain terms that it meant that everyone had a right to the pursuit of happiness. (That was the stated ideal. Obviously a very great many have not lived up to that.) But it’s important to note that we were not guaranteed achieving?that happiness. That was up to us.

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The idea is that everyone here should have an equal place at the starting line. But once that gun goes off and we start sprinting, how far we get will be up to us. Up to our wit, our endurance, and our cleverness.

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So how does this fit into the developing debate over DEI policies in medical education? Let’s go back in the process to the beginning:

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There’s no doubt that socioeconomic standing plays a huge role in one’s success in school, and how well prepared one is for real life afterwards. Too many studies have proven this, and how poor neighborhoods lead to poor citizens. DEI has a place here -- this is where we get everyone on the same starting line, and this is how we do it. It is vitally important at the primary and secondary education levels because for the vast majority of us, where we go to school depends solely on where we live. We don’t get to choose. The bus shows up, and off we go.

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But in college it’s a different story. You don’t have to go to the local community college, you can choose another school. Granted it may be another community college in the town where your aunt lives, but you at least have some choice. Maybe you have a skill in sports or academics that can secure you some funding which will broaden those choices. Maybe there’s a scholarship you can qualify for. I went to med school at Case Western, but I had to sell my soul to the Navy to do it, augmented by a significant scholarship I received from the Joseph Collins Foundation for my avocation as an artist. The analogy is that this is where your abilities, your drive, your determination and your resourcefulness will determine how far down the track you get, and how fast. You don’t have to start off at Harvard. I got into Case after starting my first two years at Kent State’s Geauga campus – literally the local community college. And then I worked my butt off.

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The problem I see in implementing DEI criteria in medical school admissions and evaluations, in particular, is that we aren’t just talking some general degree here that is useful for little more than getting you into an HR office (let’s face it, for most corporate jobs, that’s just what that BS or BA is for). It’s a very technical field with exacting performance requirements. As an Army vet (yes, I was in that branch, too) it feels a lot like the debate over allowing women into combat roles. Women want to fight, I thought? Let them! But they’ll have to meet the same physical requirements as the men. They'll have to be able to sprint with that 40-pound ruck a hundred meters just as fast as the rest of us when the artillery starts dropping, because you can’t slow down for someone who’s just not up to the task without putting your whole mission in jeopardy. You want to get paid for my job? You have to do my job. The way it needs to be done. Not scaled back to suit your abilities (or lack of same).

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There’s nothing wrong with encouraging people to shoot for the moon. There’s nothing wrong with getting them a place on the starting line with everyone else. But once that gun goes off, they either perform, or they don’t. And a doc that doesn’t perform, is a detriment to their patients. No one deserves that.