In a report certain to fuel the debate over affirmative action, an extensive study of doctors trained at the University of California at Davis over a 20-year period found those admitted with special consideration for factors like race or ethnic origin had remarkably similar post-graduate records and careers to those admitted on academic merit alone.
The report, published today in the Journal of the American Medical Association, found that students receiving admissions preferences--not all of them members of minorities--performed less well in the basic science courses of the first two years of training, were less likely to graduate with honors and more likely to repeat the certification examination to become doctors.
But the two groups graduated at essentially the same high rate and, following graduation, they followed parallel paths, completing residency training at the same rate, receiving similar evaluations by residency directors, selecting their specialties in the same percentages and establishing practices with almost the same racial mixes.
The research was undertaken by two professors of medicine at the Davis campus following the California Regents decision two years ago to bar any consideration of race or ethnicity in admitting students. In its decision, the Regents cited concerns about the quality of students admitted under affirmative-action programs, a fixture in higher education since the Supreme Court's landmark 1978 Bakke case, which originated at the Davis medical school.
Advocates of affirmative action praised the findings as proof that those who were given admission preferences have careers similar to those who were not.
"This is a highly significant study, what I would call a landmark study, which shows we should do more with applicants from special circumstances who are not quite optimal tickets in their grade point averages and test scores," said Dr. William Jacott, head of the family practice department at the University of Minnesota medical school and a trustee of the American Medical Association.
Opponents of affirmative action remained unimpressed, pointing out that if the two graduating groups ended up practicing on a similar ethnic mix, one major argument put forward in favor of affirmative action--that minority populations will be better served by such graduates--loses its power.
The study was conducted by Dr. Robert C. Davidson of the Department of Family and Community Medicine at the Davis campus and Dr. Ernest L. Lewis, associate dean for student affairs and a member of the department of urology at Davis. Both have served for many years on the school's admissions committee and were granted access to school records for the admissions in question; those for students who began their studies between 1968 and 1987. They also wrote to the graduates' residency programs and directors as well as to the graduates themselves to assess post-graduate careers.
Their data contain several ambiguities because of the circumstances of admission over the years. For example, in the group admitted under special consideration, only 53.5 percent were members of minority groups. The rest were beneficiaries of such consideration because of experiences like volunteering in the community or serving in the Peace Corps, or previous careers like teaching or nursing. These students were admitted even though their undergraduate grades and test scores were below the standard required by the medical school.
In addition, 4 percent of the students admitted without preferences were members of minority groups.
"The thrust of the article is to blur the distinction between racial differences and special consideration," remarked Stephan Thernstrom, a professor of history at Harvard and co-author, with his wife, Abigail, of a new book, "Black and White: One Nation Indivisible" (Simon and Schuster)." It is sloppy or slippery of them to suggest that this program has been highly successful without making a distinction between the population that receives special consideration for racial as opposed to nonracial reasons."
The study coincides with growing concern over the value, effectiveness and fairness of affirmative action nationwide. This is especially true in California, where, two years ago, the Board of Regents banned the use of race and ethnic origin in university admissions and where last year a referendum, Proposition 209, barred race and gender considerations in state hiring and promotion.
It was a 1978 case from the Davis medical school, Regents of the University of California v. Bakke, that laid out the United States Supreme Court's criteria for taking race into account in admissions.
In that case, Alan Bakke, a white medical school applicant, was denied admission because the school kept certain slots for minority members. The court ruled that such a policy was unconstitutional but added that race could be one of a number of factors considered for in admissions.
The Regents' 1995 decision effectively invalidated the Bakke ruling for California schools.
An editorial in today's issue of the Journal of the American Medical Association commenting on the study hailed the data as evidence that medical schools across the country must not be affected by the current political climate and should pursue affirmative action in their admissions. The author of the editorial, Dr. Michael J. Scotti Jr., a vice president of the American Medical Association, said that medical schools had agreed through a partnership program to enroll 3,000 minority medical students by 2000, and had been making progress toward that goal. But since 1994, there has been a regression, he said, because of the climate created by legal challenges and the fear of further challenges. Dr. Davidson, the study's co-author, said that part of the problem was a perception among those applying to medical school that California campuses are no longer receptive to them since the 1995 Regents decision. He said that applications to Davis from minority group members plummeted in 1996, recovering only slightly last year.
He said he was certain that he would find that higher percentages of minority graduates were serving underserved populations when he undertakes a study to break down the special admissions beneficiaries between minorities and others.
Dr. Davidson and Dr. Lewis acknowledged that their study will not stop the debate over affirmative action, but stated, "We have shown that a special consideration admissions process with a major emphasis on cultural diversity in the student population at one school of medicine has been very successful in selecting students with the academic capability to succeed in medical school and provide a student population with broad cultural diversity."
(Note: The charts that accompanied this article have not been posted.)
Bronner, Ethan. 1997. "Study of Doctors Sees Little Effect of Affirmative Action on Careers." New York Times, October 8, 1997:A1, C26.