With End of Affirmative Action, a Push for a New Tool: Adversity Scores

“Over the years, medical schools have made some progress in diversifying their student bodies, with numbers ticking up. But just like undergraduate admissions, wealth and connections continue to play a determining role in who is accepted. More than half of medical students come from families in the top 20 percent of income, while only 4 percent come from those in the bottom 20 percent, according to data from the Association of American Medical Colleges.

There is also a family dynamic. Children of doctors are 24 times more likely to become doctors than their peers, according to the American Medical Association. It’s hard to know why the profession passes down from generation to generation, but the statistic drove the association to adopt a policy opposing legacy preferences in admissions.

[..] the number of Black doctors remains stubbornly low: About 6 percent of practicing doctors in the United States are Black, compared with 13.6 percent of the American population who identify as Black. [..]

Leaders in medicine say training more Black and Hispanic doctors could help bridge the vast divides in American health care. Research shows that doctors from underrepresented racial and ethnic groups are more likely to work in primary care or in locales where doctors are scarce.

And patients have better outcomes when treated by doctors from similar backgrounds, said Dr. Jesse M. Ehrenfeld, president of the American Medical Association. [..]

In the Davis scale [developed by Dr. Mark Henderson, head of admissions at the University of California Davis], first used in 2012, eight categories establish an adversity score for each candidate. Factors include family income, whether applicants come from an underserved area, whether they help support their nuclear families and whether their parents went to college.

The higher an applicant rates on the disadvantage scale, the bigger the boost.

There is no set formula on how to balance the scale with the academic record, Dr. Henderson said, but a simulation of the system revealed that students from underrepresented groups grew to 15.3 percent from 10.7 percent. And the share of economically disadvantaged students tripled, to 14.5 percent of the class from 4.6 percent.

At the same time, scores from the MCAT, the standardized test for medical school applications, dropped only marginally. [..]

At schools in other states without affirmative action, such as the University of Michigan, admissions officials have complained that enrolling more socioeconomically disadvantaged students has not significantly increased the share of Black, Hispanic and Native American students.

“Those tools certainly have utility, but they fall short of accomplishing what a race-conscious admission practice does,” said Dr. Ehrenfeld of the American Medical Association.”

Full article, S Saul, New York Times, 2023.7.3