Selecting Medical Students by Ideology

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I just ran across this article from the Weekly Standard.  It addresses something I’ve long suspected.  Which is, we are slowly but surely developing a kind of ideological ‘litmus test’ for aspiring physicians.

https://www.weeklystandard.com/the-politicization-of-the-mcat/article/2012198 

The article discusses the Medical College Admissions Test.  For those of you outside the world of medicine, this is a test you have to take in order to apply to medical school. It was traditionaly a test that required reasonably detailed knowledge of biology, chemistry, organic chemistry and physics.  It is a terrifying test to pre-medical students.  Think SAT/ACT on steroids.  Now, apparently, the test will begin to query aspiring students on whether or not they are guilty of thought-crime. Not only so, but the American Association of Medical Colleges is already engaging in activism with students.

If it has been a bit since you read 1984, and thought about ‘thought-crime,’ here’s a little reminder.

https://en.wikipedia.org/wiki/Thoughtcrime

If you’ll recall, in 1984 everyone’s thoughts, ideas, actions and motives were carefully policed.  Deviations were punished.  You know, like they are on college campuses today!  Here’s a little gem from that great bastion of free speech, Canada:  https://www.insidehighered.com/news/2017/11/22/university-faces-uproar-over-recording-showing-how-teaching-assistant-was-questioned

FYI,  here’s another from a little further South:  https://www.campusreform.org/?ID=10622

The idea that free speech is imperiled in academia is hardly news.  You can follow the organization called FIRE for more on this.  https://www.thefire.org/newsdesk

It should be no surprise that this happens in other places in the world.  The UK and other countries diligently pursue those who post ‘wrong-think’ on social media.  In fact, social ‘credit’ is being used in a huge way in China, in an attempt to encourage good behavior.  The idea is to create a gentler way to control the masses with rewards for good behavior and punishment for bad.  What could go wrong?  https://www.wired.com/story/age-of-social-credit/

And yet, despite the changes in the world around me, I somehow naively assumed that it wasn’t as big an issue in medicine as in the liberal arts or as it was in the world at large.  I thought this even as I could see the evidence in so many posts, articles and advocacy efforts.  I really started to see it when I watched as physicians, good physicians, were bullied off of online physician forums for daring to express more conservative leaning views.

I wrote about it recently for Emergency Medicine News.  In this piece I reflected on what I saw; the growing move of physicians to the left. Or I should say, perhaps, the growing power of physicians on the left, who tend to populate academia, corporate medicine and government positions related to health-care. I’m really not so sure their absolute numbers are any greater than those who lean right.  But they wield influence.  Big time.

https://journals.lww.com/em-news/Fulltext/2018/01000/Life_in_Emergistan__The_Dangers_of_Groupthink.1.aspx

There are obviously problems with this.  One is that physicians who are not progressive tend to simply shut up and shut down even when they have useful, important insights. It’s not worth the hassle, the conflict, the argument, the ‘calling out.’ Conservative physicians, whether atheist or theist, whether economically, culturally or morally to the right, simply fly under the radar, knowing that their viewpoints will not be well received in large teaching centers, at meetings, in online forums.  Many stick to smaller hospitals, or community facilities.  Or they shut up.  In the process they impoverish the markeplace of ideas.

There’s another other problem here. For all of the apparently growing attempts to make physicians move to the left, to encourage students to support progressive causes of all sorts, from single payer to gun-control, from abortion to physician assisted suicide, a uncomfortable fact remains.  The reality is that vast swaths of America (and likely other lands) are fully of patients and families who themselves disagree with Leftism. The popularity of Donald Trump in America and assorted conservative movements in other countries is testament.

In fact, lots of them want conservative, even religious, physicians. Many want physicians who are ardently pro-life.  I heard Dr. John Patrick speak about this and he said (I paraphrase) that if we are ‘patient centered’ in our practices we should recognize that many patients are theists!  https://www.johnpatrick.ca

I mean, we quite reasonably want diversity in some areas.  We want physicians who are both male and female (and in fact, females are overtaking males in ratios of medical students).  We want physicians who are Anglo, Asian, African-American, Native-American, etc.  Medical educators go on and on about sensitivity to ethnicity, to gender, to sexuality, to culture.  But it appears that diversity of viewpoint is not a valuable asset in the opinions of those forming the minds of our future physicians.

Of the many things I’ve read lately that troubled me (and the list is long), this is near the top.

Medical students need to have a good foundation the scientific skills they will use. And in my opinion, they should (on their own), develop a good sense of art and history, of ethics and philosophy.  But it isn’t the job of the medical education establishment to decide which ethic, which philosophy, which political affiliation or which religion (or absence) is allowed into the hallowed halls of our profession.

There are medical schools in the United States which are explicitly Christian in their mission. For example, Loma Linda and Liberty.  But even at a Christian medical school, I would never suggest that a student not be allowed into medicine because they weren’t a believer like me. I have known, and been friends with and colleagues of, atheists, socialists, objectivists, Bahai, Christians, Hindus, Muslims, probably some Buddhists and who knows what else.  They were committed to their patients and to their profession.

Vetting students to ensure progressive ideology in medicine is heinous.  The implications, even if only for an issue like physician assisted suicide, are terrifying.  If you doubt me, simply check out the situation in Canada and European countries where this is the law.

But the implications for creating a wide disconnect with the very patients we treat is just as short-sighted.

This should never have happened. And we should do everything we can to stop this before it becomes even more entrenched than ever.

Edwin