Tracking Affirmative Action

Affirmative action students admitted to UC Davis Medical School with below-standard grades and test scores had to play catch-up during their first years in school but turned out to be just as competent doctors as regularly admitted students, according to a study released today.

The study, conducted by two UC Davis medical professors who support using race in admissions, examined the performance of medical students over two decades.

Their conclusion: Giving preference to ethnicity and other special qualities “yields powerful effects on the diversity of the student population and shows no evidence of diluting the quality of the graduates.”

But the study, which appears today in the influential Journal of the American Medical Assn., drew immediate criticism from affirmative action foes, who accused the authors of statistical “sleight of hand.”

Gail Heriot, a University of San Diego law professor and a former campaign leader for Proposition 209--last year’s state ballot measure that banned racial preferences--complained that the report lumped minority students with white students who also were admitted under special circumstances, thereby “diluting the differences of affirmative action students . . . who wouldn’t have been admitted except for their race.”

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Dr. Robert C. Davison, who co-authored the study with Dr. Ernest L. Lewis, defended the project as an accurate look at “a group of students who were offered admissions despite lower grades and [Medical College Admission Test] scores.”

Their report points out that 46.4% of those students who entered through special admissions were white. They were admitted despite lower grades or test scores, the study said, because of qualities such as leadership ability or fluency in multiple languages, or because they had overcome poverty or physical disability.

Such special admissions criteria also won entrance for the vast majority of “underrepresented minority students,” defined as blacks, Latinos and Native Americans.

The minority students made up 42.7% of the special admittees, but only 4% of regularly admitted students during the study period spanning 1968 to 1987. During that time, 356 of 1,784 students--an average of 20% of each incoming class--were admitted because of special considerations.

Such special admissions hit a low in 1977, the study noted, because of the landmark case that ensued when a white student denied admission, Alan Bakke, sued the university. The U.S. Supreme Court subsequently ruled that the school’s practice of reserving a certain number of seats for minorities was unconstitutional.

That forced the University of California and other schools to drop such set-asides and switch to a system that simply included ethnicity along with other criteria in admissions decisions--until last year.

Under a 1995 decision by the UC Board of Regents, the university’s five medical schools, three law schools and other graduate programs now are barred from using race, ethnicity or gender in admissions. That policy has caused dramatic drops in the enrollment of blacks and Latinos at some professional schools, but not Davis. Its 93 incoming medical students this fall include five blacks, four Latinos and three native Americans.

The study published today reported that, over the two decades, the “special considerations” students were only slightly less likely to survive medical school than others. About 94% for those admitted under special considerations graduated, compared to 98% of the other students.

Among other findings:

* The medical students admitted because of special considerations had considerably lower college grade-point averages and scores on the Medical College Admission Test than other medical students. Specially admitted students had average GPAs of 3.06, compared to 3.5 for other students, and a mean score of 9.0 on the test, contrasted with 11.0 for regular admissions. The test is graded on a scale of 1 to 15.

* While the specially admitted students lagged behind in the basic sciences courses in the first two years of medical school, they began to catch up in medical and surgical clinical courses in their third year.

* The special-admissions students had a higher failure rate on the National Board of Medical Examiners test taken in medical school--which doctors must pass to obtain a license--and more often repeated the exam before passing.

* But after graduation, both types of students had similar experiences in residency training programs and were “equally likely to receive honors evaluations.”

An accompanying editorial in the AMA Journal praised the authors for demonstrating that “the number of fully qualified individuals in the applicant pool is much larger than formerly was thought.” While “some specially admitted students have not been successful,” it said, “the count is small compared with their overall numbers and their potential to increase medical care to patients most in need.”

Dr. Randall Morgan, past president of the National Medical Assn. in Washington, which represents more than 22,000 African American physicians, said the study supports the group’s views that medical schools should consider a person’s race and other qualities in picking whom to train as doctors.

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“We have not seen distinct correlation between grade-point average and medical tests with the performance as a physician,” Morgan said. “More attention should be paid to the type of person, one’s level of dedication and human sensitivity.”

But Jennifer Nelson, executive director of the American Civil Rights Institute in Sacramento, which opposes affirmative action, latched onto one finding of the Davis study that failed to support other surveys, which have suggested that training more minority doctors helps fill the needs of poor communities. The Davis study said the “specially admitted” students went on to “nearly identical” practices as others.

When asked to estimate the ethnicity of their patients, those who got into medical school through special admissions said 55% of their patients were white and that 17% did not speak English--compared with a patient group that was 59% white and 13% non-English speaking for those who had been regularly admitted to medical school.

“It’s illogical to think that letting someone in on the basis of their skin means they are going to work in the inner city,” Nelson said.

“The much more logical way to attract medical students to work in inner cities is to do what the Army does: Ask them to commit to working in the inner city for a certain number of years for a break on their tuition.”

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Different Paths, Similar Careers

A study of medical students at UC Davis over two decades found that black and Latino students almost always were admitted under “special consideration” criteria-but so were many white students. The affirmative action students got lower grades in medical school than did those who entered by regular admissions, but went on to similar medical careers.

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What sort of medical career they pursue

Private practice

Special consideration graduates: 48%

Other graduates: 46%

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Health maintenance organization

Special consideration graduates: 17

Other graduates: 13

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Academic medicine

Special consideration graduates: 13

Other graduates: 11

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Military or Veterans Affairs

Special consideration graduates: 1

Other graduates: 2

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Community clinic

Special consideration graduates: 6

Other graduates: 5

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Hospital-based medicine

Special consideration graduates: 3

Other graduates: 6

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Medical administration

Special consideration graduates: 3

Other graduates: 1

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Continued training

Special consideration graduates: 3

Other graduates: 6

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Other

Special consideration graduates: 6

Other graduates: 9

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Course grades

Molecular and cell biology

Special consideration admissions: 2.65

Regular admissions: 3.21

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Pathology

Special consideration admissions: 2.81

Regular admissions: 3.24

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Surgery

Special consideration admissions: 2.73

Regular admissions: 3.13

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Medicine

Special consideration admissions: 2.66

Regular admissions: 3.07

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Special Consideration Admissions

Native American: 2.2%

Asian: 10.9%

Black: 16.0%

Latino: 24.5%

White: 46.4%

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Regular Admissions

Native American: 0.1%

Black: 0.7%

Latino: 3.4%

Asian: 14.7%

White; 81.1%

Source: UC Davis Medical School