A Brief History
Brief History of Admissions Discrimination From Ludmerer's Book, A Time
to Heal, Chapter on Fulfilling Medicine's Social Contract, pages 63 - 65
I guess it should not be surprising that we still discuss some of these
issues even now on this list serve - children of alumni, older, second
career, geographic, minority, religious, etc.
Era of 1920 - 1940 Admissions Preferences and Discrimination
Prestigious colleges held in favor - odds of one in 3 or 4 vs one in 7 - 8
for applicants from non-prestigious
Geographic preference - Public institutions - state residents only
Private institutions - diverse quality national applicants preferred
Children of alumni - various schools preferred
Older applicants - frowned on
Those who could pay given preference
African-Americans - many obstacles due to discrimination, cost of school,
cost of application fee, justifications given include concerns of dropout
rates. Flexnerian reforms resulted in many school closures, particularly 3
of 5 black medical schools. Discrimination persisted long after WWII when
other discriminations eased.
Women - one medical school for women in 1850. Not many women in others. As
time went by all but 2 schools open by 1946 to women, but limitations and
quotas existed. These were justified by claims of potential waste of
education, less time in medical career, etc. Studies demonstrated
significant contributions of women however. Slow steady increases in recent
decades.
Nativist climate of 1920s saw prejudice and legislation vs Catholics,
Italians, Jews, and other ethnic or religious minorities. The Jews faced
the most severe quotas:
"The fact that most Jewish applicants were Eastern European Jews rather
than German Jews as before was not lost on medical school admissions
committees as frightened of the "new" immigration as the rest of American
society. In the early 1920's a backlash began. The first manifestation was
the creation of quotas at many elite private colleges. Soon quotas appeared
in medical schools and other areas of professional and graduate training
(numerous references page 418). By the late 1930s and early 1940s, rigid
quotas were found throughout medical education. In the early 1940s, 3 out
of every 4 non-Jewish students were accepted, in contrast to 1 out of 13
Jewish students." p 64 The text goes on to note that even the Women's
Medical College of Pennsylvania discriminated vs Jews. On the bright side
New York University and Tufts resisted these quotas despite great pressure.
Poor students also out of running with high tuition, books, fees and living
expenses - p 64 and 65
It is important to realize that this era housed a national attitude of
discrimination as well. Celebrated trials of immigrants and anarchists and
labor unions captured the media attention. During the height of Nazi
atrocities the US and nearly all of North and South America did not open
the doors to oppressed Jews (except for the Dominican Republic and one
other West Hemisphere nation - Holocaust Museum data). Don't even ask how bad it was for
Native Americans, Appalachian people, and minorities in poorer areas of the
country at these times. (Note that women in Appalachia were among the most
literate and educated women in the world prior to the civil war. After the
war and the resultant 3 generations of education and economic disaster
locally they lost out greatly - according to Appalachian State University
experts). Talk to some Afghanis if you want to try to understand how bad
things can become in a relatively short time. Ponder what would have
happened to post WWII Japan and Germany had these nations been forced into
the economic and education disasters that were usual after losing a war or
choosing to support the losing side and suffering the consequences for
decades and generations.
Would love to see a US study of changes in the socioeconomic status of
matriculants over the past 50 years. Suspect that it would be similar to
the study in Toronto showing major declines in those coming from the lowest
quartile.
I find it interesting that nearly all of these biases would tend to
decrease the numbers of doctors choosing underserved urban and rural
populations.
Robert Bowman
rbowman@unmc.edu
Robert - thanks for the ref. to the book about med. school discrimination. The latest group to suffer discrimination is Asian-American applicants, whose situation is similar to that of Jewish applicants in the middle decades of the 20th century, although not as severe. I wrote about this in an article "Admission of Asian Americans to U.S. medical schools," Academic Medicine, vol. 73 (March 1998), pages 226-7. The same article is reprinted in "The Advisor," Vol. 18 (Summer 1998) pp 13-14. I can send you a copy if you're interested.
Sincerely,
Steve George (Chair, Health Professions Committee, Amherst College)
Prof. Stephen George Phone: 413-542-2477
Biology Dept. and Neuroscience Program FAX: 413-542-7955
Amherst College sageorge@amherst.edu
Amherst, MA 01002-5000 http://www.amherst.edu/~sageorge
More at Discrimination and Vice Versa
Education - the entire pipeline