Six in 10 medical school applicants end up with nothing more than a pile of rejection letters after pouring their hearts and souls into studying, volunteering, researching, and more. A few understand that their quest was a long shot. Many others start looking for reasons why they didn’t get in. Was it low test scores? Not enough volunteer time? Or was affirmative action the culprit?

Lively — and often bitter — threads on studentdoctor.net and Reddit condemn the use of affirmative action in medical school applications, usually with claims that black or Hispanic students got in while white students, with the same or higher scores, were rejected. Despite the social, capital, and educational advantages of growing up white, these gripers seem to believe that the world has suddenly flipped and being white is holding them back.

Many look past the importance of hard-to-quantify factors for getting into medical school like research, volunteering, recommendations, essays, and interviews and instead fixate on how minority applicants have lower scores on the Medical College Admission Test (MCAT) and lower grade point averages (GPAs).

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The assumption that minority applicants are “stealing seats” in medical schools bothered me. So I put it to the test. Using publicly available data from the Association of American Medical Colleges (AAMC), I compared the odds of getting into medical school between 2013 and 2016 for white applicants and black applicants with the same MCAT scores and GPAs. (At the time, the top score on the MCAT was 45. The scoring system has since changed, and the top score is now 528.)

I compared only white and black applicants because underrepresentation in medicine is most clearly defined for these two groups. However, it is likely that the results would also apply to other underrepresented minorities.

As shown in Figure 1, at nearly every comparison, black applicants were, on average, preferentially admitted to medical school over their academically similar white peers. For example, a black applicant with an MCAT score of 31 (the median for all individuals accepted to medical school) and a GPA of 3.7 (the median for all individuals accepted to medical school) had, on average, a 30.7 percent higher chance of getting into medical school than a white applicant with a similar MCAT score and GPA.

I can almost hear the anti-affirmative-action readers saying, “I told you so. Why should we be giving such a massive boost to black applicants?”

In addition to righting the decades-long structural and historical factors that have limited opportunities for black students to enroll in medical school, there are many benefits to having diversity in the medical profession. A diverse physician population encourages innovation, promotes cultural competence to reduce health disparities, and shows minority youths that there are places for them in science and medicine. And physicians of color help society at large, not just minority communities.

But convincing readers that affirmative action is important and necessary isn’t my goal. I want to demonstrate how little affirmative action hurts white applicants, how few medical school spots black applicants get, and who is most likely to lose a spot to a black applicant with lower scores.

To start, realize that today there are only about seven black medical students in a class of 100. Affirmative action opponents somehow seem to think those seven take more spots from qualified white applicants than the other 93 white applicants do.

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Let’s set the acceptance rate of black and white applicants equal to each other. If 63 percent of white applicants with a 31 MCAT score and 3.7 GPA are accepted, then 63 percent of black applicants with the same stats are accepted. This essentially takes away the advantages seen in Figure 1. By holding black applicants to the “same standards” as white applicants, we would expect about 750 fewer black applicants accepted to medical school each year, effectively halving the number of blacks who get into medical school.

Now let’s give all of those 750 spots to white applicants. (Of course, that’s not what would happen in the real world.) Figure 2 shows the outcome: Those who get the biggest bump in their odds of getting into medical school are the ones who are already most likely to get into medical school — applicants with high MCAT scores and GPAs. Those who have little to gain are already on the edge of not getting in anyway. By opening up 750 medical school seats to white applicants, those with a 26 on the MCAT and a 3.6 GPA probably still aren’t getting in.

Reducing the number of black applicants admitted to medical school by 750 and giving all those seats to white applicants would increase the acceptance rate of white applicants from 45.15 percent to 47.97 percent, a 2.82 percent increase. But as I learned from my analyses, that small increase is negligible when compared to the impact of increasing MCAT scores on applicants’ chances of admission. Though I do not show the analysis for GPA here, small increases in a white applicant’s GPA (maybe getting a B+ instead of a B in one class) improves his or her chances much more than reducing the number of accepted black applicants.

As shown in Figure 3, an increase of one to three points on the MCAT score does more to improve a white applicant’s odds of getting into medical school than would eliminating affirmative action. With a median 3.7 GPA, going from a 29 on the MCAT to a 32 increases the odds of getting into medical school by 17.38 percent — far more than the “equal acceptance” scenario posed above.

From the perspective of the AAMC, though such an increase in the MCAT score is relatively meaningless. A 3-point higher score on the MCAT could mean answering correctly just three more of the 230 questions, perhaps getting 75 percent of the questions right instead of 73 percent. Given that some guesswork is involved, and that applicants would likely get slightly different scores if they took the test multiple times, the AAMC reports MCAT scores with a 4-point range. If an applicant scores a 29 on the MCAT, the AAMC reports that his or her true MCAT score is somewhere between 27 and 31. In other words, a white applicant with a 3.7 GPA and 29 MCAT who correctly guesses the answer to one more question, simply by chance, is better off than if we “level the playing field” by holding black applicants to the same score-based admission standard.

Some of those who contend that affirmative action is what kept them out of medical school argue that some low-scoring black applicants are in the med school seats they should have gotten. I did the math to see how likely that is.

Figure 4 shows that it’s far more likely a white applicant “stole a spot” than a black applicant. For a white applicant with a 31 MCAT score and a 3.7 GPA, for every black applicant who scored lower and was accepted there are, on average, 4.11 white students who also scored lower and were accepted.

It’s only low-scoring white applicants (less than a 26 on the MCAT and a GPA less than 3.2) who are more likely to have “their” seats offered to black students than to white students. Yet at that end of the statistical spectrum, the chance of getting into medical school is less than 5 percent for both whites and blacks. But look at the average number of low-scoring black students accepted each year (132) and the total number of white applicants accepted each year (26,420). The chance that a low-scoring white medical school applicant will “lose” a spot to a low-scoring black applicant is 0.5 percent. How unlikely is that? It’s even less likely as the applicant dying in a car accident.

White applicants with low scores should realize that their MCAT scores and GPAs are holding them back far more than their black colleagues.

These analyses didn’t surprise me. When I interviewed at 11 medical schools last year, I saw no more than 10 black applicants among the 100-plus applicants I met. How could such a small group — blacks make up 9 percent of medical school applicants — be usurping so many white applicants medical school seats? The answer is that they aren’t.

My message to those who whine that minority students took their spots in medical school: Think about the five other white applicants who got in with the same statistics as each minority student. Then notice the amazing minority students who did cutting-edge research and incredible volunteer work just like you. Notice the obstacles that many of them have faced every day because of the color of their skin yet have excelled as students and as people in and out of the classroom. Think about how many more amazing doctors we could have if we had equality of opportunity earlier in the educational system.

Increasing the number of blacks and other minority students in medical schools can change the trajectory of the medical field for the better. And it isn’t costing white applicants a thing.

Spencer Dunleavy is a Rhodes Scholar at the University of Oxford. He will begin medical school at the Columbia University College of Physicians and Surgeons in the fall of 2019.

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  • I understand it is good to have diversity in med schools, but tell that to my son who had excellent grades and top 2%mcat, but didn’t get in. He is a kind compassionate person. Neither he, his father (me) or his grandfather is a racist.

    Now I know how black people felt in the 1950’s when they were told they were not as good as whites, and saw fewer opportunities.

    We were moving to a color blind society, where “they will not be judged by the color of their skin, but by the content of their character”.

    Not getting into med school will not define my son, he is remarkable and will succeed in life. I know this snub is so much less than what blacks have endured. But racism has denied my son his dream.

  • Why are you saying that minority students did more cutting-edge research and volunteer work? Personally, for me, I did 4,000 hours of volunteer work, I was a research assistant in 2 labs, and I achieved a 3.85 GPA and 512 Mcat. Yes, it is not top-notch, but come on, I should still get into a medical school. I was rejected from 8 schools my first time applying and luckily, got in my second year. I have better qualifications than most of my friends that are seen as “minorities”. How is it fair to discriminate against whites? When did “reverse racism’ become common and acceptable. It is definitely more acceptable than racism. Honestly, I understand that minorities may be presented with fewer opportunities, therefore, they may end up with lower qualifications, but what if your white friends (me) also grew up poor, then my mom remarried right as I was entering college so I got no assistance even though I had no help. Now, I am suffocated in debt upon my entrance to med school with still no help? Do you think it is fair? Am I at a disadvantage? You don’t know the full story. Qualifications should not be based on race, but about how well you did during undergrad.

    • Maybe they didn’t consider you personable the first attempt? More goes into selection than raw stats. You could have the best stats ever and not be a good doctor. You could also have bad stats and be an amazing doctor. Your story matters a lot. A person with a bad Undergrad GPA could have been going through some real hardships like a death in the family which could affect anyone. That said, there are specific hardships that are more common in the minority communities. Like having to take care of your siblings because your mother is on drugs (this is becoming more common overall). It could even be something as simple as never learning how to study because there was never anyone there to guide you and you never had a stable life or having to learn to consider yourself a human being when the rest of the world sees you as less than nothing. Maybe you should have spent some of those volunteer hours in urban communities like I did. You may find that many of the things you take for granted, you should be thankful for. You can’t break down an entire persons ability by looking at their performance in one or two areas at any one point in time. You have to look at the whole picture. What I do know is that if you had time to for 4000 hours of volunteer work, your life hardships were minimal. I was working 3 jobs and taking care of my family (siblings) when I was in undergrad. As well as trying to volunteer and study. Should my GPA be as high as yours?

      I have found that GPA is 50% luck of birth, 50% hard work. The luck of birth aspect is something that has been well studied and understood but not well publicized. It is the understanding that our upbringing plays the most significant factor in our GPA. A supportive family or a family which provides for their children leads to a higher probability of high GPA. That upbringing is based on luck of being born into that type of family. Being born into that type of family is half the battle of getting a good GPA. You don’t have to worry about basic necessities like food, shelter, medicine, etc. and have the opportunity to focus on other factors like studying which leads to learning how to study and get good grades (something with parents support and something without). That’s where the hard work comes in. But, the luck part is still the most important part because it’s the only part out of your control. It adds a significant number of hardships that you will have to overcome to even get to the same starting line as the others. These hardships are significantly more common (percentage wise) in black and, to a lesser extent, hispanic communities. That probably leads to their stories being a lot more compelling than someone who grew up in a middle class household with food in the fridge, a room to study in, significant violence, etc.

      Something to think about: I ate only once a day for most of the days a week growing up and that was at school. If I wanted more, I had to go do some work to get some money and buy some food for myself. I didn’t have my own room until I was 18 and had to become the head of the family which led to me working 3 jobs. Before then, I lived in a garage with my whole family. I could go own but i’m not going to share my life story here. I had no idea how to study when i started college. I just knew my goals and my dreams. By your standards, I should have given up on becoming a doctor because I wasn’t qualified by your GPA standards. People like me should have just became welders, right? Look at me now. Helping pre-med and med students understand their materials after they deemed me unworthy.

      If you are trying to take the human factor out of becoming a doctor, do everyone a favor and stop becoming a doctor. The human factor is the essence of being a doctor.

  • “Affirmative action doesn’t hurt white medical school applicants”

    – That’s right. It hurts ASIAN applicants. Asian applicants have a much harder time getting in than even white applicants. Moreover, pigeonholing a large number of Indian, Pakistani, Afghan, Chinese, Korean, Japanese, Thai and other applicants all into one general “Asian” demographic is unfair to all of them. They suffer the penalty of being the traditionally highest achieving students, and are set unfairly high standards to get in.

    Strange how there was no mention of Asians at all in the article.

  • The point isn’t that most white students who were rejected for medical school would still be rejected. Right now any white student who was rejected can claim that, but for affirmative action, he would have been admitted. Once affirmative action is ended, no student will be able to make this claim. In addition, with the elimination of affirmative action, black students will no longer be looked on as “dummy quota admits.”

  • What I saw on the interview trail was that many white students who WOULD have been competitive for MD seats, but for the fact of affirmative action policies, were displaced into osteopathic schools. No one has examined the impact of this–displacing white students out of MD schools and into DO schools. DO schools struggle to matriculate minorities because the admission policies at MD schools favor them so strongly. Are DO schools, by default, turning into a “white ghetto?”

  • Mr Dunleavy shows his algebraic prowess by performing sensitivity analysis on white student acceptance rates as a function of MCAT and GPA. I will trust his math regarding those 750 excess African Americans admitted with lower scores than rejected white peers. His comparisons of race to GPA and MCAT scores however are facile and simply a matter of arbitrarily comparing unrelated numbers. And those 750 acceptances persist with presumably no explanation but race.
    Personally I’m a bit on the fence about affirmative action. But if one favors it, discuss its justification and benefits to society, what makes it worthwhile and all those it will help. The present article just doesn’t stand up.
    I wonder how an admissions committee would view this- a clear lapse in reasoning supporting a politically correct conclusion?

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