by Sara Russo

A report released this summer by the Center for Equal Opportunity demonstrates the unambiguous use of racial preferences in admissions by five public medical schools and the subsequent failure of minority students at those schools to perform up to par on the U.S. Medical Licensing Examination, a mandatory test for prospective physicians.

"It is MCAT scores and in most cases, grades that predict Step 1 [of the US Medical Licensing Examination] scores," notes the study's authors. "So when admission committees admit individuals with substantially lower test grades and scores, whether or not they are members of minority groups, they increase the likelihood of their students' performing poorly in medical school."

Roger Clegg, general counsel for the Center for Equal Opportunity, argues that the gap between white and black success rates on tests is unlikely to close while racial preferences persist. "As long as there is a double standard for admissions, and black students are admitted who are in the aggregate less academically qualified than white students, then we would expect to see that black students would not perform as well in medical school as the white students we're admitting," Clegg told Campus Report.

The study examined admissions records in two separate years at the five medical schools: the Medical College of Georgia, Michigan State University College of Human Medicine, the University of Oklahoma College of Medicine, the State University of New York's Brooklyn College of Medicine, and the University of Washington School of Medicine.

Researchers found that black and Hispanic students who were admitted to the five medical schools had on average significantly lower undergraduate grades and Medical College Admission Test (MCAT) scores than white and Asian students who were granted admittance. At each of the universities included in the study, the median grade point average for blacks was consistently lower than that for whites, and in some cases the discrepancy was extreme.

For example, at Michigan State University's College of Medicine in 1999, the median grade point average (GPA) for white admittees was 3.61, nearly an A-, while the median GPA for black admittees was 2.93, slightly below a B. Furthermore, the median MCAT score for blacks admitted to Michigan State that year was 29 (out of a possible 51 points) compared to 36 for whites.

Discriminatory admissions practices were also clearly in evidence with regard to Hispanic applicants, who, at four of the five schools, were admitted with lower scores than whites, though the differential in grades and scores between whites and Hispanics was less than that between whites and blacks.

The study's authors also compared the grades and scores of white and Asian admittees, and found only small gaps between these markers of ability, as well as no consistent trend among the five schools favoring one race over another. "Preferences strongly favor blacks over other groups, and, to a lesser extent, Hispanics over Asians and whites," the researchers stated. "Asians do not benefit from any racial preference."

These differences in admissions rates mirror the racial disparities in accomplishment on the first stage of the medical licensing exam. Scores from Michigan State averaged over a three year period show that 14% of black students failed the Step 1 of the exam, and 10% failed to take it, while among white students the failure rate was only 1% and the untested rate, 4%. Thus cumulatively, 24% of black medical students at Michigan State failed to complete the first stage of obtaining a medical license compared to only 5% of white students. Among Hispanics the combined rate was 8% and among Asians, 2%.

From this data, the authors of the study concluded that, "Individuals with lower MCAT scores were more likely to fail Step 1 of the licensing exam. This explains the differential pass rates for blacks and Hispanics relative to whites and Asians."

These figures are especially stark when one considers that the scores reported by Michigan State are final scores. Medical students are allowed to take Step 1 up to six times, and when a student fails several times, only the final result is reported. Thus the 14% of black students at Michigan State who are noted as failing the exam, may in fact have repeatedly failed to pass the exam and have a failure listed as their final result, and will not be able to obtain a medical license unless they are able to pass Step 1.

More disturbing than even the failure rate of minorities on the licensing exam, Clegg asserted, "is that even among the students who ultimately pass the exam it's fair to assume that they are not going to be as successful as doctors as students who are academically better qualified would have been." He continued, "You know one of the responses that we heard to our study was, well, what's wrong with racial and ethnic preferences because no one's going to be qualified to become a doctor unless they pass the exam…as far as patients are concerned, not only will there be fewer doctors, but the doctors who finally do become admitted are not going to be as good. The idea isn't simply to admit students who are able to scrape by with a passing grade after taking the medical exam several times. We should be trying to have the best possible doctors, not doctors who are simply minimally qualified."

This debate over the possible benefits of racial preferences at the nation's medical schools was most famously raised by the 1978 Supreme Court case, Regents of the University of California v. Bakke, in which the Court ruled that the use of racial quotas in admissions was unconstitutional but continued to allow for an applicant's race to "tip the balance" in his favor.

One famous beneficiary of racial preferences in admissions is Bernard Chavis, whose admission into the University of California's medical school despite his inferior academic accomplishment prompted Bakke to file suit against the university. Long upheld as an example of the success of racially biased admissions programs, Chavis made a career serving poor minority communities until the Medical Board of California suspended his license to practice medicine in 1997, warning of his "inability to perform some of the most basic duties required of a physician" after one woman died and two more suffered serious complications after receiving liposuction from Chavis.

In response to the Center for Equal Opportunity's report, admissions officials at several of the medical schools studied argued that qualifications besides grades and MCAT scores factor into a school's decision of whether to admit each applicant.

Daniel Hunt, associate dean of admissions at the University of Washington School of Medicine denied that test scores are the most important factor in the admissions process, and claimed that 50% of the school's decision is based an applicant's interview. "Clearly the things we pick up in an interview-sensitivity and compassion, for example-aren't represented by those numbers. To my knowledge there are no studies that say the MCAT and the GPA predict who's going to be a good doctor."

But Clegg argues that even consideration of other factors would not lead to the racial disparities in admissions that the researchers discovered. "It may be that the medical schools take into account things beside MCAT scores and grades," he noted, "but there's no reason to think that those other things, whatever they are, are going to favor one group or another disproportionately. You have to think that white students are at least as likely as black students to get good teacher recommendations, that Asian students are as likely as Hispanic students to do well in interviews, that whites and Asians are as likely as blacks and Hispanics to have engaged in extracurricular activities that are viewed favorably."

"I think that one of the things that is disturbing about this study is that in addition to what it shows about medical schools it also shows the extent to which the use of racial and ethnic preferences at the undergraduate level has been a failure," Clegg concluded. "The claim from the proponents of affirmative action has been you give a slight edge to African American students when they apply to undergraduate school and that's all that will be necessary….Well apparently that's not true."