{"id":187110,"date":"2026-05-11T05:59:39","date_gmt":"2026-05-11T13:59:39","guid":{"rendered":"https:\/\/lukeford.net\/blog\/?p=187110"},"modified":"2026-05-11T06:01:05","modified_gmt":"2026-05-11T14:01:05","slug":"medicine-without-merit","status":"publish","type":"post","link":"https:\/\/lukeford.net\/blog\/?p=187110","title":{"rendered":"‘Medicine Without Merit’"},"content":{"rendered":"

Dr. Forrest Bohler writes for Compact<\/a>:<\/p>\n

The requirements for admission into medical school vary markedly depending on who the applicant is. According to data from the Association of American Medical Colleges (AAMC), the academic thresholds required for acceptance differ substantially between racial groups. The average MCAT score of a white applicant who is accepted into a medical school is 512.4<\/u><\/a>, approximately the 85th percentile<\/u><\/a> nationally. By contrast, the average MCAT score for accepted American Indian applicants is 502.2<\/u><\/a> (56th percentile<\/u><\/a>), for accepted black applicants 505.7<\/u><\/a> (67th percentile<\/u><\/a>), and for accepted Hispanic applicants 506.4<\/u><\/a> <\/u>(69th percentile<\/u><\/a>).<\/p>\n

The disparities are even more pronounced when we look at the applicant pool as a whole. White applicants overall, including those who are rejected, have an average MCAT score of 507.8<\/u><\/a>, roughly the 73rd percentile<\/u><\/a>. In other words, accepted black, Hispanic, and American Indian medical students matriculate with lower MCAT scores, on average, than white applicants who have not yet been accepted to medical school. The same pattern appears when we turn to undergraduate GPA. White applicants apply with an average GPA of 3.7<\/u><\/a>, but require an average GPA of 3.8<\/u><\/a> to gain admission, while accepted black, Hispanic, and American Indian applicants matriculate with average GPAs of 3.59<\/u><\/a>, 3.66<\/u><\/a>, and 3.64<\/u><\/a>, respectively.<\/p>\n

I ended that phone call with a realization: If I wanted to succeed in medicine, I couldn\u2019t leave room for doubt. So I pursued a NIH research fellowship, received research training, published scientific papers, and obtained letters of recommendation from prominent virologists. When I reapplied, I was accepted to multiple medical schools and received significant scholarship offers to many of them. But once again, my state\u2019s flagship institution rejected me. I don\u2019t claim to know precisely why. But patterns are hard to ignore. <\/p>\n

\n

When I arrived at medical school, it became clear that admissions were only the beginning. The same ideological framework that governed entry into the system shaped the culture inside it. Orientation included an entire day devoted to diversity, equity, and inclusion (DEI). We were asked, and even pressed, to publicly recount moments of discrimination from our lives. The exercise assumed a shared framework of identity and victimhood. At one point, a student asked the DEI instructor to explain the meaning of \u201cdemisexual,\u201d which was written next to the \u201cGender Unicorn<\/u><\/a>\u201d they were teaching us about. After a long pause, the instructor admitted she didn\u2019t know how to define it.<\/p>\n

Similar things were happening at medical schools nationwide. The same year, students in the first-year cohort at the University of Minnesota were presented with an \u201canti-racism\u201d pledge<\/u><\/a> during their White Coat Ceremony that went well beyond traditional professional oaths. The pledge, read aloud<\/u><\/a> by the entire incoming class, included a formal land acknowledgment and required students to affirm a recognition of \u201cinequities built by past and present traumas rooted in white supremacy, colonialism, the gender binary, ableism, and all forms of oppression.\u201d
\n…The consequences of DEI policy adoption have manifested, in some cases, at the level of institutional performance. One of the most prominent recent examples comes from the David Geffen School of Medicine at UCLA, which publicly embraced aggressive DEI initiatives and race-conscious admissions practices. In the years that followed, reporting based on internal data<\/a> and whistleblower accounts described a precipitous decline in student academic performance, including more than 50 percent of medical students failing standardized clinical exams in core subjects in family medicine, internal medicine, emergency medicine, and pediatrics. For context, the national failure rate for these same exams is roughly 5 percent.
\nNow the Justice Department has found<\/a> that UCLA violated civil-rights law. But the response to outcomes like these has not been a reckoning with preparation or admission standards, but an assertion that standardized exams and graded assessments are the problem. Instead of addressing deficiencies, institutions are encouraged to mask them, relabeling objective measures of knowledge as inequitable and biased rather than confronting what the results reveal. This impulse ultimately reached the USMLE Step 1 exam, one of the most consequential national board exams medical students must take to graduate, which was converted<\/a> to pass\/fail in part to \u201cminimize racial demographic differences that exist in USMLE performance.\u201d Rather than addressing differences in academic competency, medical education chose to discard the ruler.<\/p><\/blockquote>\n

The data Bohler cites checks out. AAMC numbers do show large gaps in MCAT scores and GPAs between admitted students of different races. The pattern he describes, that admitted Black, Hispanic, and American Indian students matriculate with lower averages than rejected White applicants, tracks the published data. The UCLA David Geffen failure rates have been reported and the DOJ did find civil rights violations there. The Step 1 conversion to pass\/fail did cite racial score differences in its rationale. The AOA suspensions happened at Mount Sinai, UCSF, and Washington University. The renaming of DEI offices to euphemistic alternatives is documented. LCME Standard 3.7 (formerly 3.3) and the ACGME diversity language did lock diversity goals into accreditation. The decline in White male medical students from 31 percent to 20.5 percent is accurate to AAMC reporting.
\nHis strongest passage is the self-reinforcing cycle. Admit students with divergent academic preparation, watch performance gaps persist, declare the assessments biased, weaken the assessments, repeat. The AOA story illustrates this cleanly. Washington University expanded eligibility for URiM students while keeping a top-third cutoff for everyone else, then suspended inductions when even that did not fix the numbers. The logic of the apparatus is to discover that every objective measure is the problem.
\nNow where the piece weakens.
\nThe admissions officer phone call. Admissions officers rarely tell rejected applicants they did not fit the demographic. Legal exposure makes that kind of candor uncommon. The story might be accurate. It might also be reconstructed through later resentment. Either way an unverifiable anonymous conversation cannot carry the weight he places on it as the inciting moment.
\nThe personal arc undermines parts of his case. Bohler wins the Outstanding Student Award twice, seven institutional scholarships, AOA induction, and the Excellence in Diversity Award. He frames this as strategic adaptation. Fair enough. But a White man who collects most of the top distinctions at his medical school is not the cleanest example of a system that grinds down White men. His success cuts against his framing and he handles the tension only obliquely.
\nThe Kirk operating room anecdote and the “pregnant female surgeon of color about to get an abortion” line are appalling if accurate. Specifics that ugly call for specifics. No city, no specialty, no date, no identifying detail. The reader has to take it on faith. For a piece that wants to indict a profession this is thin sourcing.
\nThe merit baseline goes undefended. Bohler treats MCAT and GPA as the natural measure of who should become a doctor and any departure from them as corruption. The MCAT predicts Step 1 scores well. It predicts clinical performance less well. It predicts patient outcomes weakly. Medical school admissions have always weighed legacy ties, geographic origin, athletic background, mission fit, personal essays, and interview performance. The contrast is not between pure merit and corrupted merit. It is between one set of preferences and another.
\nHe skips history. American medicine excluded Black physicians by law and custom for most of its existence. The Flexner Report of 1910 shut most Black medical schools. The current shape of the profession was not generated by a neutral process either. None of this justifies lowering standards now. But the omission is convenient and it lets him present the pre-DEI baseline as the natural order.
\nHe skips the concordance research. Studies on Black patients with Black physicians, and on Black infant mortality under Black pediatricians, show effects on outcomes and trust. The research has limits and the magnitudes are contested. But a piece arguing DEI harms patient care should engage the strongest empirical case on the other side. He does not.
\nHe flattens the faculty. The “old White men in medicine” comments, the Tuskegee Airmen confusion, the preceptor’s mass shooting rant. All presented without naming anyone or providing context. Some faculty say stupid things. Some institutions push ideological orthodoxy. None of these episodes tell us how representative they were of his training. He admits as much late in the piece, where he writes that most faculty are not ideological crusaders and most students are trying to learn medicine. That admission is buried. It deserves to sit higher in the structure.
\nThe piece is a mix of solid institutional reporting and personal score-settling. The reporting holds up. The score-settling colors the presentation in ways that make the argument easier to dismiss for readers who do not already share his priors.
\nAn editor’s pass might cut 40 percent of the anecdotes, link the empirical claims to sources, engage the strongest counterarguments on concordance and on the limits of MCAT\/GPA as predictors of clinical quality, and let the AAMC numbers, the AOA story, the UCLA failure rates, and the accreditation pressure carry more of the load. The piece is most convincing where it is most concrete and least personal.
\nThe closing recovers some of what the middle loses. The line about people the rest of us will be deprived of as physicians pulls the focus back to patients, where it belongs. That is the argument that might land with readers outside the audience that already agrees with him. He gets there. The piece would land harder if he got there sooner and stayed there longer.<\/p>\n","protected":false},"excerpt":{"rendered":"

Dr. Forrest Bohler writes for Compact: The requirements for admission into medical school vary markedly depending on who the applicant is. According to data from the Association of American Medical Colleges (AAMC), the academic thresholds required for acceptance differ substantially … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[29728,29729],"tags":[],"class_list":["post-187110","post","type-post","status-publish","format-standard","hentry","category-affirmative-action","category-medicine"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t