- Social cohesion is harder
- Mentorship is scarce
- Classmates are often not “woke” (although that’s the case in most places)
- The curriculum is not “woke” (although that’s the case in most places)
- The administration still needs to catch up
I attend a wealthy private medical school in an affluent neighborhood of a large city. For some background on demographics, the students are predominantly while and affluent, followed by students who are Indian and also affluent. There is a large contingent of “medical legacy,” or students who come from a long line of doctors. This is a common picture at many of the “top tier” medical schools around the country.
The lack of diversity in not only the student body, but also the people who teach and mentor us, is a problem.
The opinions below are mine and are shared by many students who do not feel like the atmosphere is a productive one. When choosing a medical school, there is a necessary tradeoff between choosing a place where people are “like me” and a place where opportunities come easily. The decision is a personal one, and I, as an ambitious applicant, decided I could get along anywhere and make it work.
I learned early in my first year that it is not that easy. As an M1, we were assigned to college mentors. As early as the first time I met my mentor, my advocate for the duration of my student-hood, I knew we had very little common ground. My mentor was a sweet, kind pediatrician and mother of three who had never lived outside of the midwest. As an aspiring surgeon, POC, and generally too-loud individual, this was the first of many pairings that made me question if I was a “good fit.” While many classmates who didn’t get along with their assigned mentors would often call home and could ask Mom or Dad how to proceed, I didn’t have that option. I found some guidance, but it was rare and far between, especially because it wasn’t organized through the medical school.
From a social standpoint, as I proceeded through M1 year, I noticed how little I knew of the conversations going on around me. I don’t have friends with yachts, was not an equestrian growing up, did not take family trips to Florida, and didn’t even know common sports. There’s nothing wrong with these interests, but I couldn’t help compare them to mine. Growing up, my family was busy making ends meet, and I was usually working or studying during football games in college.
The gap continued to grow. When my classmates were asked in a class poll about how many would have to worry about eating out more than two times a week, 20% said yes. More surprisingly, more than 80% of the class was shocked by “how high” that number was. Eating out two times in Chicago is easily $40. Spending more than $40/week would put me over my budget in two weeks. Meanwhile, most of the class was having houseparties with the “good” cheese every week.
Beyond the social aspects of conversation and spending, though, there are also more practical concerns when it comes to the training of future physicians. Being surprised about the difficulties of eating out, and having a fairly homogenous set of social mores, also bled into how classmates talked to patients. While there are peers that I think would do a fantastic job in, say, dermatology in Florida, I would not be comfortable with them as my doctor, nor recommending them to any POC or generally, anyone making less than $80,000/year. It takes effort to understand why someone can’t “order delivery” if the corner store doesn’t have vegetables.
It also takes effort to understand why it’s important who’s doing the teaching. All but 4 of our lecturers in M2 year were white, including during the Reproductive module. The problem isn’t that these faculty aren’t good doctors, but that there is notable bias. Jokes about how “women are complicated” in terms of anatomy and arousal, how “psych wards are kindergarden for adults”, and many such comments of varying questionability. Thankfully, the school is open to feedback and follows up with the faculty who say such things. However, this is a more systemic problem. A slap on the wrist does not change that minorities, whether of sex/gender, mental status, affluence, etc. are subtly deprived of respect by people who may not always realize it and are in the position to shape the perspectives of future doctors- the people who are supposed to take care of these populations at their most vulnerable. This is the nature of homogeneity in a med school’s faculty.
Of course, medicine has only recently started to have more women in higher positions. However, there is no shortage of women – and people of color – who could be asked to teach. To the school’s credit, they have taken student feedback to heart and started to ask for more diverse volunteers.
Sadly, all of these efforts remain insufficient. After a lecture on Diversity in Medicine by one of the Vice-Provosts of the university, a large plurality of students – and one of the deans – remarked that the lecture was inappropriate and unnecessary. The lecture was about “who’s in the room” and how POC are only now starting to be in positions where they can influence medicine, medical training, and the biases that have been in play for so long.
Medical training is expensive, and to make it into the door requires opportunities and privileges that are disproportionately available to a very particular group of people. At this school, it is visible. I would keep this in mind as you make your decisions in the coming months.
medmusings 