Uché Blackstock’s Jan. 28 Opinion essay, “How thousands of Black U.S. doctors simply vanished,” valuably synthesized how modern medicine was founded on racist thinking, policies and practices. The discrimination embedded in medicine’s early framework — escalated after the 1910 Flexner Report — endures today in the disproportionate burden of disease and early death in our Black and Brown neighborhoods and diminished access to medical school.
Most U.S. medical schools rely heavily on MCAT scores and grade point averages in their regular admissions processes. The City University of New York School of Medicine has never used the MCAT and never will. Instead, we have a holistic applicant review process through which we get to know whole candidates, including lived experiences, challenges they’ve overcome and what they uniquely bring to our school, and we don’t discredit those who worked to help support their siblings or took on extra responsibilities as translators and navigators for parents who don’t speak English. We look at transcripts but understand that myriad factors can thwart even the brightest student’s path.
Our process is designed to illuminate promise, innate talent and a deep commitment to community. With this approach to inclusive excellence, we’ve trained generations of diverse physicians who are underrepresented in medicine — 40 percent of our current medical students are Black, and 22 percent are Latinx — most of whom come from and go on to work in underserved communities that need compassionate, person-centered and excellent health care the most, with a focus on addressing the social determinants of health.
Carmen Renée Green, New York
The writer is dean of the City University of New York School of Medicine.
In her Jan. 28 essay, Uché Blackstock maintained that economic inequality rooted in the legacy of Jim Crow and persistent racism is one of the major barriers to entry for Black medical students. She reminded readers that Black students don’t have the same financial resources as their White peers because of the lack of generational wealth.
Dr. Blackstock stated that it is our nation’s duty to rectify centuries of injustice, and she was correct.
Passage of H.R. 40, which would establish a commission to study and consider a national apology and proposal for reparations for the institution of slavery, would begin to address this duty.
H.R. 40 was first introduced in 1989 and has been introduced in every Congress since. Now is the time for our legislators to support H.R. 40. Reparations in the form of education grants and scholarships for Black students are in the best interest of our entire nation.
Elaine Shea, Catlett, Va.
Uché Blackstock’s Jan. 28 essay referenced the 1910 Flexner Report. The report did cause the closing of five of seven Black medical schools, but it caused the closure of 82 of 148 medical schools across the country. The report did not target Black schools. Before the report, medical schools were predominantly for-profit institutions without standards for admission and graduation, and without adequate exposure to patients or educational resources for students. The doctors produced were woefully undertrained and frequently incompetent and dangerous. The massive reform after Flexner led the United States to become the world leader of scientific medical advances, medical education and advanced complex medical care.
Medical schools have worked hard in recent years to increase the proportion of Black students, which will ultimately increase the percentage of Black physicians. The percentage of Black applicants accepted into medical schools is nearly the same as for other racial groups. The proportion of Black students in many schools is now near or above the 13 percent of Black people in the general population. At Duke, for example, 20 percent of students were Black in the entering class in 2021. According to the Association of American Medical Colleges, Black enrollment in medical schools increased by 10.5 percent from 2019 to 2020 and 51.6 percent from 2013.
Dr. Blackstock derided the importance of the MCAT test in medical school admissions, but data clearly show that this test is predictive of performance in medical school.
Sadly, our society has not yet fulfilled the dream of judging people by the content of their character and not by the color of their skin. We have much work to do.
Daniel Ein, Washington
The writer is a clinical professor emeritus of medicine at George Washington University.
