Preparation and Sophistication

Best Post of Group:

I have to agree with Ed Miller (filtered for sarcasm) and Lolita. At my campus
the biggest problem is that the students are often pretty unsophisticated when
they come to us and return in the summer to rural towns or somewhat isolated
neighborhoods where they don't have ready access to the tools or the support for
facing this task. To say that "they're gonna be rich someday so they better start
acting like it now" misses the point and, in fact, sounds extremely condescending
to a group of worthy and valuable potential candidates. Let's try to remember
that some of these students are coming from a long way back in the pack and they
deserve, from us and from AMCAS, a boost rather than a kick in the chops.

Having said that, I think it serves us all to remember that email is a rather
"hot" medium and this discussion seems to be heating up more than most. We
certainly need to remind each other and AMCAS to be reflective, tolerant and
helpful, but shouldn't be shooting others here in the trenches. We're all (I
hope) trying to help solve a difficult and strongly entrenched problem not of our
making. Still, if the sixties taught me nothing else, steady pressure applied to
the right people and right organizations will ultimately effect change.

Dennis M. McNair, Ph.D. Dennis McNair <mcnair+@PITT.EDU> Department of Biology University of Pittsburgh at Johnstown

 

> >From: "Lolita A.Wood-Hill" <woodhill@SCISUN.SCI.CCNY.CUNY.EDU>
> >To: <HLTHPROF@LIST.MSU.EDU>
> >Sent: Thursday, May 31, 2001 10:45 AM
> >Subject: Re: Follow-Up
I will once again comment on this issue but in another area of
concern. Does anyone realize that although there is still a paper MCAT
application there is only the electronic method for filing for the fee
waiver!? This, to me, confirms that certain organizations are not
interested in seeing faces of the poor and of the minority community in
medical school. Of all things to make web based only, which is going to
be used by the poorest students, seems ludicrous and almost sinister!! What,
if anything, can AMCAS and AAMC respond to this new insult to a population
already facing difficulty in getting to health professions schools!!

Lolita

Edward Miller wrote:

Give everyone access to the internet immediately. Install and/or upgrade electrical circuits, install high speed phone lines, buy up-to-the-minute computers, give everyone a summer job where they don't have to work unreasonable hours and therefore can't even use the out-of-date (if it exists) computer at the local (if they have one) library!

So, now I know what to say: "Pull yourself up by your bootstraps, children! It's the American way to get ahead." Of course, if you don't have any boots, I suppose you don't have anything with which to pull yourself up. Hmmmm, maybe I should rethink this. To quote the Bard,

"Prosperity begins to mellow and drop into the rotten mouth of death."

With all due respect (I think),

 Ed

 

Dear Lolita:

I share this email in part with you, from a respected colleague. I agree with her assessment of your student population and wonder what your thoughts are?

"... I also wonder if most of the poor students Lolita serves couldn't have made plans for this particular application time to have access to decent computers.

My thinking is, yes, we have a responsibility to help our students. AND, yes, students have a responsibility to help themselves. Our responsibility is not greater than theirs, is not the responsibility to solve this problem for them.

At this point, all these students (poor or abroad or otherwise having trouble applying) need to demonstrate good judgment and the ability to solve problems. The better they are able to do this, the more confident we (letter writers) will be of their readiness for medical school."
------------------------------------------------
Quite honestly, I agree with this email. If you understand your student population so well, what are your plans to help assist, advise and encourage them during this situation? Also, what are your student's plans to overcome such obstacles? As potential physician's they will face many obstacles...

California students are some of the most diverse students applying and are consistently the highest applicant pool. USC is a private institution and reflects diversity. I've yet to have any hysterical students calling, emailing, etc. to me about the slow on-line AMCAS. They appear to be mature, responsible and capable applicants...poor and not-so- poor, and report managing things well. As a former New Yorker...California really has helped mellow me out to look at things a little less frantically I suppose.



Thanks Stefan

Awareness of the challenges is a start toward addressing them. Being disadvantaged in any of a number of ways seems to lead to a commitment to want to serve others.

The opposite is a concern as well. Children of higher income and professional parents are less likely to become generalists and serve the underserved.

Are any of you aware of studies in the US that indicate that those from the lowest quartile economically are having more difficulty getting in to medical school? I think I already posted the news article from the Toronto Star that noted this in Canadian medical schools.

When this is added to a greater potential for delays in graduation and subsequent major increase in debt, it is an enormous barrier.

Robert C. Bowman, M.D, Co-Chairman
Rural Medical Educators Special Interest Group of the National Rural Health Association
UNMC Department of Family Medicine Director of Rural Health Education and
Research
983075 Nebraska Medical Center
Omaha, NE 68198-3075
(402) 559-8873 or fax at -8118
Email:  rbowman@unmc.edu
http://www.unmc.edu/Community/ruralmeded/
 

6/1/2001

Lolita-  AMEN!  I couldn't have said it better myself.  I too deal with a population much like you describe (low income, inner-city, poor advice, poor high school preparation, ESL,  etc.).  I too am dealing with technical issues that you have described.  We have a grand total of six computer labs on campus to handle the needs of 35,000+ students, many of which did not have an opportunity to learn how to use the net in high school or before they began college, or for that matter, the opportunity to learn many of the programs we take for granted in our day- to- day work.  So, much of their time is used learning the basics of computing and how to do what we would consider very rudimentary things on a computer.  Many of them don't have a computer at home to practice what they may have learned on campus, or the resources to purchase one. Therefore they must use the computers on campus, where, because of a severe shortage of hardware, everybody is limited in how long they can use an individual computer.  Learning takes time and repetition. To assume that all colleges have equal facilities and all students have equal access is a very dangerous assumption. I could go on as well about the issues of diversity, equality, and overcoming obstacles that you have raised.  But my blood pressure is already high enough.  Suffice it to say that I agree with you 100%.

I also agree with other writers that it is time to stop telling each other how to do our jobs, and figure out a way to support each other and, more importantly, our students. We (or at least I...) preach the importance of acting professionally to my pre-health students.  Maybe we should take a page from our own book.........

C. Ferguson


 I don't have any "resources" to help except offer them the use of my own computer, which I do more often then I'd like.  I've had to ask our computer services dept. to upgrade the computer labs which they are in the process of doing.  However, I could not anticipate a year ago what the computers should have as I had no information that would allow me to make such a request in advance, nor am computer savvy enough to have made such an anticipation.  As for the students needing to learn to "demonstrate good judgment and problem solving"... these kids do this each and every @#@% day!  Did we have to add to their learning quotient by DELIBERATELY placing another roadblock!?? Or could we have assumed that if we really believe that we need more minorities and poor folks with access to medical school we need to look at how to facilitate, rather than inhibit their access.  It is increasingly clear to me that many of my colleagues pay lip service to the idea of
better access .

 I have students who have never had biology, trig, chem. etc.  Many of them
cannot survive in science.  Those that do have faced tremendous burdens and obstacles---poor schooling, poor neighborhoods, poor advise from family, if they have family, ESL issues, etc.  I give them every bit of encouragement and support and advice that I can.  I do not tell them the system is flawed; they know that.  I tell them they have to figure out how to work within it as best they can. 

I really feel for any kid that some of you are advising who does not come with their
bootstraps pulled tight.  Its no wonder our numbers are falling off, not only for minority students but for lower economically situated students as well.  Who is going to service all those poor people with limited access to healthcare? Your 35 MCAT, 3.5, mommy and daddy professional type?  I don't think so.  Wake up some of you!  As we become a more global nation the health care problems of the poor are going to be knocking on our own backdoors.  They will come in the form of maids, nannies, children bused into our "better" schools, etc.

Lolita A. Wood-Hill
Deputy Director, Program in Premedical Studies
Coordinator, Post Baccalaureate Premedical Certificate Program
J-529  138th Street @ Convent Ave.
New York, NY 10031
(212) 650-7845
woodhill@sci.ccny.cuny.edu


At 11:10 AM 5/31/01 -0700, you wrote:
Dear Lolita:

I share this email in part with you, from a respected colleague.  I agree
with her assessment of your student population and wonder what your thoughts
are?

"... I also wonder if most of the poor students Lolita serves couldn't
have made plans for this particular application time to have access to
decent computers.

My thinking is, yes, we have a responsibility to help our students. AND,
yes, students have a responsibility to help themselves. Our responsibility
is not greater than theirs, is not the responsibility to solve this problem
for them.

 At this point, all these students (poor or abroad or otherwise
having trouble applying) need to demonstrate good judgment and the ability
to solve problems. The better they are able to do this, the more confident
we (letter writers) will be of their readiness for medical school."
------------------------------------------------
Quite honestly, I agree with this email.  If you understand your student
population so well, what are your plans to help assist, advise and encourage
them during this situation?  Also, what are your student's plans to overcome
such obstacles?  As potential physician's they will face many obstacles...

California students are some of the most diverse students applying and are
consistently the highest applicant pool. USC is a private institution and
reflects diversity.  I've yet to have any hysterical students calling,
emailing, etc. to me about the slow on-line AMCAS.  They appear to be
mature, responsible and capable applicants...poor and not-so- poor, and
report managing things well.   As a former New Yorker...California really
has helped mellow me out to look at things a little less frantically
suppose.

 

Dear Listserv,

I am writing in response to Cecilia Fox's concern and Lolita Wood-Hill's helpful comments. I too, have had significant numbers of disadvantaged and minority applicants; for 6 years I directed an HCOP grant. My experience is that acceptance for the fee waiver (now the FAP process) seemed to reflect poverty or near poverty levels for the past 15 or so years, but, in the last two years, many of my poverty level students have not met the eligibility criteria--which are not published--- for the fee waver/reduction.
Two examples:
1. applicant whose parents are both unemployed where the family of 5 receives federal assistance, received the fee reduction for AMCAS in Class of 2000 application; no obvious change in financial situation (still unemployed parents, but student graduated from college) but did not receive the fee reduction for a re-application in 2001---no reason provided.
2. applicant who has no father, mother has been in a mental insitution since the applicant was a child and receives monthly government assistance that goes directly to pay her room, board and expenses--$300/month as I recall,-- applicant is married, had two children with a third due during the application process and she and her husband used grants and loans to support both of them in college. Her fee reduction request was denied in 2001 based on the $300 monthly assistance given directly to her mother--I called on the student's behalf and appealed to no avail. It made no sense. She had a hard time interviewing due to her extreme financial condition.

This year, I received an email from one of my long time minority/disadvantaged advisees who has lived for many years with a Guardian with a fixed income. There has been a recent death in her extended family and the family has re-allocated its funds so no one is helping her. Her FAP application was submitted back in March for the AMCAS and she received on 6/19 a denial of the FAP with a 6/29 deadline to appeal. She is doing so and I will assist her.

I do not believe the FAP system is supporting all those who need it. These students live at the edge of financial solvency; they are truly disadvantaged. Can we as NAAHP please address this issue with the AAMC if we espouse the concern that more minority-disadvantaged students should become doctors?
--
Cynthia Lewis, Ph.D.
Advisor, CUHRE & Founding Advisor AED, San Diego State University
Advisor, UC San Diego Pre-veterinary Club
619.308.4242; FAX 619.308.4244
Email: drlewis@lewisassoc.com
Website: www.lewisassoc.com

AMCAS is obviously not in a position to do anything about this. I understand that one of the compelling reasons for going so rapidly and totally to the on-line application was the difficulty of maintaining the extremely ancient support system for the paper application. I think it is unreasonable to expect that they can even consider trying to get that up and running when they are applying all resources in the struggle to make the new system work.

On the other hand the problem Stefan and others have described most eloquently is real, and it is disgraceful to ignore it. The only place where a short-term solution could be undertaken at the medical schools themselves. If they chose, they could certainly print out and duplicate the AMCAS application, send it to any student who requests - preferably with strong advisor backing or some other filter - that they do
so, and process it manually. I have no knowledge of the schools' contract with AMCAS. Probably there is one, and probably it precludes any seperate application, but under the present appalling circumstances, one would certainly hope that such legalities would be waived. This would obviously be more WORK and the medical schools are also going to be struggling with this new technology, as soon as it hits them. However, one should bear in mind that the numbers are not likely to be large. I don't think one would get many frivolous applications from people who are merely frustrated by delay. AMCAS on-line, working as intended, which it probably will be by the 18th, is obviously a lot more convenient than a paper application. But for those people with NO access, for financial or geographic reasons, paper could work.

It remains to be seen whether there are medical schools whose commitment to the education of the economically disadvantaged is sufficient to persuade them to overcome the major inconvenience of processing a number of paper applications. (Maybe they should take lessons from P&S and NYU, who I am sure are much too generous of spirit to be quietly chortling over this!)


On Thu, 31 May 2001, Stefan Bosworth wrote:

> I sometimes wonder how any economically deprived students be they minority
> or not ever get into medical school. I have been working as a consultant
> with economically deprived students both minority and non minority for 25
> years. These are students with incredible dedication and motivation to
> become doctors, but they are students with few resources. They often have
> to use outdated technology or no technology at all. They tend to attend
> universities with less resources and because they usually work many hours a
> week, they have little time to travel to computer centers and even less
> money to pay for them. The more we ignore the problems of this group or
> pretend they don't exist, the fewer doctors there will be to serve poor
> communities. Many of us have never been truly poor and had to go through
> the kind of struggles these students do. It may be hard for us to imagine
> a world with few computers, where students often can often hardly pay for
> books and supplies, but this is the world that some of our students, who
> will someday be great doctors if we allow them to be, live. Our job as I
> have said before is not to build obstructions to these students but to take
> them down. If paper applications is a way to do this then this is what
> should be done. It is our job as premed advisor to help make sure those
> entering medical school are truly reflective of the diversity of our
> society. So far this is an unmet goal.
>

rbowman@unmc.edu

Physician Workforce Studies

Education - the entire pipeline

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