You might expect that medical students today are learning more than ever about medicine as time, research, and experience improve our understanding of human health. You might expect our medical schools would be producing the finest doctors ever with all this new knowledge. You would be wrong.
What’s wrong? Dr. Stanley Goldfarb, writing in The Wall Street Journal, says DEI is what’s wrong. Dr. Goldfarb is chairman of Do No Harm and a former associate dean at the University of Pennsylvania Perelman School of Medicine. He’s been an outspoken critic of woke medical education and his articles have been referred to before in this blog. (Woke Medical Education Update)
For those of you unfamiliar with DEI, it stands for Diversity, Equity, and Inclusion. Those are fancy terms for what amounts to reverse discrimination; a misguided attempt to undo past discrimination against people of color. Rather than heed the words of Dr. Martin Luther King, Jr. to judge people by the “content of their character, not the color of their skin,” DEI attempts to judge people only by the color of their skin, and white is always wrong.
How has DEI impacted medical education?
Dr Goldfarb explains, “For years, medical schools have emphasized discrimination and indoctrination at the expense of merit and excellence, to the detriment of patients. While the Trump administration has taken steps to right this wrong, a more far-reaching response is needed. For the sake of every American’s health, the president should reform the accreditation system for medical schools. The crisis in medical education is directly connected to DEI. For years, the Liaison Committee on Medical Education, which accredits M.D.-granting programs, required medical schools to establish programs “aimed at achieving diversity.”
Goldfarb goes on to tell us medical schools responded by embracing diversity in hiring and admissions. They changed their curricula to teach economic and social lessons that ladder up to the false claim that America is systemically racist. The LCME has tacitly approved this shift by issuing vague standards that give medical schools far too much leeway. The resulting lack of rigor allows unprepared students to slide through undemanding courses while undercutting the preparation needed to become excellent doctors.
The traditional medical school curriculum is comprised of two years of classroom study of all the subjects needed to complete a comprehensive medical education. The next two years are spent in clinical applications of those subjects while treating patients.
Goldfarb says the traditional two years of pre-clinical education required to become a doctor has been significantly reduced at more than a third of medical schools. This gives short shrift to the foundational curriculum in genetics, biochemistry, biostatistics and epidemiology. A senior associate dean at Rutgers told the American Medical Association in 2021, “It’s better, to me, to shorten the foundational science curriculum.” That leaves students with a diminished ability to understand medical literature and make health recommendations.
At UCLA’s David Geffen School of Medicine, according to reporting based on interviews with faculty members, more than 50% of students failed basic tests on family medicine, pediatrics and emergency medicine. Nationwide, the percentage of medical students who pass the first part of the licensure exam has fallen every year since 2020, dropping from 97% to 89% for students pursuing an M.D. Clinical skills have declined for years, made worse by DEI’s distraction from clinical education.
President Trump is addressing the problem. He signed an executive order calling out the LCME by name. The committee responded by formally abandoning its diversity mandate. Yet the LCME has kept a separate mandate that medical schools teach students to “recognize and appropriately address biases in themselves, in others, and in the health care delivery process.”
Unfortunately, this committee is sponsored by the American Medical Association and the Association of American Medical Colleges, both of which continue to champion DEI. (The AMA today represents only about one in four medical doctors. I personally dropped my AMA membership many years ago when I couldn’t tolerate their stance on abortion.)
The solution to the current problem is finding a new accreditor for medical schools. The Department of Education should be soliciting applications for a replacement, but this process will take time and the medical licensing exam and graduate medical education programs would also have to acknowledge the new accreditor.
I am proud to say as a Floridian that Florida and five other states are leading the way. They established the Commission for Public Higher Education to accredit their public university systems. They need to add a medical school accreditation component.
Dr Goldfarb says “Florida’s public medical schools are the best candidates for ditching the LCME. They’ve largely rejected DEI and embraced merit. That’s exactly what a new accreditor should do—for the benefit of physicians, patients and public health. Ultimately, this is about ensuring Americans have the best physicians providing the best care. DEI has distracted medical schools from their purpose, and while it’s vital to cure the ideological disease, it’s just as important to refocus medical education on its lifesaving mission.”
