Quick hit: Men, Medicine, and Meritocracy vs Affirmative Action

2010 October 26
by Terri

It was those very numbers that made me start to look at the breakdown of the applicant pool, in terms of the ratio of male to female, and the discovery of what was, I think, an over-emphasis on grade point average.

Normally we hear words like this when we’re talking about low female enrollment, but in the case of medicine, it seems that meritocracy is failing the men.

The Globe and Mail article asks, “Is affirmative action for men the answer to enrolment woes?” and the article talks about how they’ve broadened the selection criteria so the focus is less on marks so that more men meet the cutoff.

Some other choice quotes:

[Some] universities across [Canada] have been tinkering with admissions to boost the number of men in medical school – looking beyond marks to give male applicants, in particular, credit for things like community service.
While women apply to medical school in record numbers – and make up nearly 60 per cent of students admitted – men still stand a better chance of being accepted in every province but three, according to data from the entering class of 2007. They were Alberta, Quebec and Prince Edward Island.

The notion of a stealth policy of affirmative action for men is not new. It first surfaced south of the border in 2006. That year, the dean of Kenyon College wrote an op-ed in The New York Times lamenting that she had to pass over “glorious stacks of girls” in favour of less qualified boys in order to keep some semblance of a gender balance at the school. She said the trend is widespread in postsecondary schools in order to keep themselves marketable.

Dr. Cappon says it’s an image issue here too: “If it looks like a woman’s program, you’ll have trouble attracting both men and women.”

What do you think of stealth affirmative action? I’ve definitely had many a bitter male student rant that it’s happening for women in CS, but to be completely honest it’s largely been the less successful students who wouldn’t have made the grade anyhow and just wanted a scapegoat. However, this is the first I’ve heard a public admission of universities doing this sort of thing and I’m curious now if it’s been done for other faculties for any other groups other than men in medicine.

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This post was written by terri.

Terri is a web security researcher, open source developer, teacher, amateur photographer, naturalist, geek, gamer, musician, and woman in technology. She blogs/tweets under the name terriko, and maintains a web security blog at WebInsecurity.net.

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21 Responses
  1. Mary permalink
    October 26, 2010

    This is a bit of a tangent from gender issues, but there was a watershed in Australia about 10 years back and the majority of medical schools switched to interview+aptitude measurements from pure grades (and sometimes to postgrad when before they’d had direct entry from high school). A big part of this was talk about dropping grades to low on consideration in favour of empathy, people skills and so on.

    However, there have been concerns since that the interviews criteria for “empathy” and “people skills” actually were basically People Like Us criteria.The race balance of accepted students shifted to white students, the income levels of students’ families became even higher and so on.

    Some medical schools either seriously considered or did switch to a pure aptitude+lottery: you had to achieve such a rank on a test of academic aptitude, and then you were admitted or not at random.

    I sometimes wonder about how this would compare with affirmative action more broadly. However Australian universities are really now moving to the model of selecting “life skills” students (ie, people with extracurriculars on their resumes) rather than high grades students, so I don’t see a widespread move to a lottery happening here.

  2. Mary permalink
    October 26, 2010

    Re your CS discussion, I wonder if CS is different in Canada? In Australia, since about 2003, it’s been a low demand major and primarily one students are hoping to transfer out of into something more prestigious or (perceived) higher income. So I’d be surprised to see such complaints here.

  3. Eivind permalink
    October 27, 2010

    I don’t like secrecy in the selection-process. I prefer transparency. Partly for the reason Mary states: more subjective “People skills” criteria, tend to in practice boil down to “People Like Us”, and it’s damn hard to argue with what boils down to, basically, “we don’t like you”.

    The other reason is that once a decision-process is secret, it opens it up to all sorts of abuse and corruption. If there’s no clear, objective, transparent set of criteria for you to follow; then there’s also nobody who can stop you from picking candidates based on your own secret set of criteria. (“His dad is in my golfclub”)

    If you -do- want to give credit for other stuff than grades, by all means, do so, but do it openly, and with objectively quantifiable criteria. That way, people can critique your criteria too, something that can’t easily happen as long as the criteria are secret.

    In some schools here in Norway you *do* get a bonus for being the rarer sex in that education. And you may get bonuses for other stuff (example: applicants who want to become nurses gets a modest bonus for each 6 months they where working full-time with taking care of old, sick or disabled, up to a max of 18 months)

  4. October 27, 2010

    I used to attend Mary Washington College in Virginia and it was always rumored that the school was doing that in order to get guys to attend the school. At the time, it was very hard to get into the school as a freshman, usually requiring over a 4.0 GPA and a ton of afterschool activities, volunteer work, etc. However, a number of the guys in our classes had much lower GPAs in high school. In the long run, I don’t think it really benefited the men though. Those who didn’t have the necessary skills didn’t make it to graduation; most of them dropped out or transferred in their freshman year.

  5. Restructure! permalink
    October 27, 2010

    Personally, I get suspicious when admission criteria are switched from pure numbers to something that involves a person’s subjective opinion. I support affirmative action to counteract implicit bias in things like interviews, recommendation letters, statements of intent, the evaluation of extracurricular activities and community service, etc. However, switching from pure numbers to something that involves more subjective opinion, where the applicant’s gender and ethnicity are not masked, invites bias.

    I read somewhere that U.S. universities used to admit students based on only GPA and/or standardized test score, but because there were too many Jews getting in, they introduced recommendation letters. I found a link that talks about this: The Hidden History of Admission and Exclusion at Harvard, Yale and Princeton:

    The problem, of course, was that while many at Harvard genuinely prized good character, it required willful blindness (especially in view of Lowell’s explicit acknowledgment) to believe that admissions officers were going to try to measure good character fairly and honestly. It was all a ruse. Furthermore, there was a good reason that Harvard had not attempted to take character into account in the past except in the rare case of demonstrably bad character: It is devilishly difficult to do so. Efforts to employ objective measures can always be circumvented. Subjective measures will become too subjective, since admissions officers will tend to pick their personal favorites. In practice, “good character” at the Ivy League of the 1920s meant a diploma from one of the “right” prep schools and letters of recommendation from the “right” people. It meant being good with a football. It even meant being tall and handsome. Most of all, it meant not being Jewish.


    The Jewish quotas lasted many years, and remnants of their existence—letters of recommendation, emphasis on sports, and, to a lesser degree, other extracurricular activities—are still in place today, although presumably they are no longer unfairly administered to benefit WASPs relative to Jews. Once they are instituted, such requirements are difficult to terminate—as racial preference advocates will find out if diversity requirements ever become an unnecessary or unwanted means of keeping up minority numbers.

  6. Meg permalink
    October 27, 2010

    What gets me is that men still have a better chance of being accepted than women, and their enrollment doesn’t seem to have declined. Instead, women’s enrollment has increased and capacity has expanded (http://www.cmaj.ca/cgi/content/full/161/8/983), and yet this is seen as men loosing. If we keep thinking about these things as a zero-sum game when they are obviously not, we will all loose.

    “Stealth affirmative action for men” sounds like the same thing we usually call “the old boys network”. Often it seems that those areas where men are disadvantaged they have additional societal privilege (like college presidents that look like them) to push back and re-establish privilege (like having a better chance of being accepted into medical school). It isn’t as though I’ve seen any evidence of systematic bias against men in Chemistry 101 leading them to be given worse grades than women for the same level of achievement, which are the cases where I believe Affirmative Action is encouraged. It does sound like the systematic biases against women may have declined, in which case the scholarships may have already served their purpose (and could perhaps be redirected to other, intersecting oppressions, like single parents or socioeconomic class.) The supportive atmosphere, however, has probably benefited the men who are there as well as the women.

    I am curious about the sociology that has led so many highly-qualified women to want to go into medicine. Do they have fewer inviting options than similarly-qualified men? I don’t know very much about Canada, though, so I couldn’t say. If this were the US I would assume that the rising pay in the financial sector and the ever-expanding military-industrial complex and related research provide attractive alternatives for men that are less attractive to women.

    Plus, if, say, sexual harrassment isn’t tolerated in medical school, I know that would discourage some of the doctors I met when I worked at a hospital. One of the perks of medicine when they had gone to school was the opportunity to convince nurses to sleep with you, or at least ogle them while you worked. They were none to pleased by diversity training, electronic medical records or having to justify treatment decisions. While the number of male applicants may have remained the same we have no way of knowing if they are the same men who would have been interested ten years ago

    Another factor that might be at work is that, unlike research-based graduate programs, medical school and law school do appear to base admission more on “blind” criteria like grades or test scores. It’s easier for women to compete on those grounds than get into competitive and potentially-hostile grant-funded positions that require individual professors to want to work with you. When given an equal playing field with well-defined rules women perform well (and sometimes excel, because they are used to having to outperform their peers in order to be given the same level of recognition.) Men who go into those fields are forgoing some level of privileged admissions, and probably know it (at least, until these policies come about.)

  7. Nick permalink
    October 27, 2010

    This is precisely the wrong way to go about fixing this issue, and always has been. Although I doubt we’ll hear a peep from the “men’s rights” groups who’ve been decrying affirmative action for decades, except to express a vindictive hurrah.

    We’ve allowed a culture to form in which academic achievement is “unmanly” and immasculine, and of course because we only have a gender binary model, immasculine *has* to be feminine. So high scholastic performance is “for girls”. And while I celebrate the fact that we now accept that women are allowed and even expected to perform well in school, we are failing our boys as surely as we fail our girls.

    This is why I’m feminist, precisely this. Not only because it’s ethically right–it is–but also because living in a patriarchal society is damaging for men, for me. It is simple pragmatic self-interest. The current societal understanding of gender is bad for women, but it’s also bad for nearly all men. It is bad for others, but it is also bad for me, and leaves this world worse than it could be, and should be.

    • Jayn permalink
      October 27, 2010

      “We’ve allowed a culture to form in which academic achievement is “unmanly” and immasculine,”

      I do wonder sometimes if there’s a mote of necessity going on here. Skilled trades that pay well are generally considered masculine, so there’s less need for boys to work towards the grades needed for a university education. I saw this in high school–most of the top students were girls. Not that we didn’t have boys who could have earned the same grades, but many of them were planning to become fishermen like their fathers, which doesn’t require any post-secondary education. These boys started learning their trade in high school–the first week of lobster season saw a noticeable drop in male attendance. Yet I have never known of a female fisherman (the closest thing was ‘candy pots’, where money earned from that trap went to a child), so for even a chance of making the same type of money, girls needed those high grades.

      • Terri permalink*
        October 27, 2010

        And then we’ve got the culture where academic achievement is unfeminine, in that girls are sometimes told to act less smart or they’ll never attract a boy. (Yes, I was told this and ignored it as a young teenager.)

        So basically, academic achievement is just uncool?

        • Nick permalink
          October 27, 2010

          Well, sure. Although I’d argue that the subtle difference is that boys are “supposed” to be smart and girls are “supposed” to be good at school (or that neither are supposed to be any of this, messages kids get are confusing). But being bookish and scholastic, at least when I was a kid, was definitely considered the realm of girls; smart boys were all competing to be the biggest underachiever.

          Either way, the gendered messages that we’re getting about this stuff is problematic for everyone at school. As in the example above, where the fact that many men are fishermen gets translated into both an idea that women shouldn’t be fisherman (or in similar professions) and that men *should* be fisherman (or in similar professions). Not enough men recognize that the second is just as damaging to them as the former is to women, or we’d all be feminists.

  8. Valerie Aurora permalink
    October 27, 2010

    Nice post!

    As for how long this has been going on, at least since 1997 in the U.S., according to admissions data collected by U.S. News and World Report:

    Using undergraduate admissions rate data collected from more than 1,400 four-year colleges and universities that participate in the magazine’s rankings, U.S. News has found that over the past 10 years many schools are maintaining their gender balance by admitting men and women at sometimes drastically different rates.

    From Many Colleges Reject Women at Higher Rates Than for Men – published in 2007.

  9. Ames permalink
    October 27, 2010

    Med school is an interesting focus for this discussion. Medical education is one of the most hide-bound among all the professions and assumptions about the knowledge, skills, and abilities needed to be either a “good” medical student or a “good” medical doctor have undergone precious little change over the entire existence of the MD degree. Changes have started to happen though, but it’s at a glacial pace, mostly due to the staunchly conservative nature of the profession itself, and those in it who are fighting mightily to maintain the status quo. Med schools admitting more women, as well as considering criteria other than prodigious ability to memorize and regurgitate, are examples of such changes and the backlash is predictable.

    • Restructure! permalink
      October 27, 2010

      Med schools admitting more women, as well as considering criteria other than prodigious ability to memorize and regurgitate, are examples of such changes and the backlash is predictable.

      Did you read the post?

      • Ames permalink
        October 28, 2010

        And your point is? I know it’s amazing to imagine, but perhaps there are wider perspectives than yours. If you have a comment to what I said, by all means make an effort. Snark does not a conversation make.

        • Terri permalink*
          October 28, 2010

          Well, I admit I was wondering the same thing, since the article was about how med schools are finding they can’t recruit enough MEN, which is actually a pretty big shift from when women weren’t even allowed to study medicine. But your comment is talking about how medicine hasn’t changed.

          So are you trying to say that despite the lack of changes regarding what makes a good doctor, women have turned out to be the best candidates, and this is an unpleasant revelation for the staunch conservatives?

        • Restructure! permalink
          October 28, 2010

          I apologize for the flippant response.

          Why do you group “med schools admitting more women” together with “considering criteria other than prodigious ability to memorize and regurgitate” as if these two actions are moving in the same direction of change? In reality, “considering criteria other than prodigious ability to memorize and regurgitate” causes “med schools admitting more men“, which goes against the direction of “med schools admitting more women”.

  10. namae nanka permalink
    October 27, 2010

    “This is precisely the wrong way to go about fixing this issue, and always has been. Although I doubt we’ll hear a peep from the “men’s rights” groups who’ve been decrying affirmative action for decades, except to express a vindictive hurrah.”


  11. ConFigures permalink
    October 28, 2010

    Speaking of meritocracy, if anyone goes to “Hierarchy in Meritocracy: Community building and code production in the ASF” at the Apache conference next week, I’d be interested in a write-up. It looks interesting: “The ASF explains the success of its communities and the software they produce by claiming to have instituted a meritocracy that brings contributors together into communities in a way that significantly influences code production. The claim is that ‘community-over-code’ distinguishes the Apache communities from other open source projects like those found in Sourceforge or Google code. The relevance of these claims, and therefore of institutions like meritocracy, can be explained and better understood by analyzing them through an organizational model of open source. Such a model was developed by Van Wendel de Joode (2005): “The model is intended to serve as input to discussion and reflection and as a guide for further research on the subject.” There are eight design principles in the organizational model of open source and for this project the principles of collective choice arrangements, conflict resolution mechanisms and multiple layers of nested enterprise were chosen for their relevance on decision-making. In this session we will explore the role of institutional instruments and self-organizational mechanisms in code production. We will discuss how to model and measure these phenomena, and their influence in code production, in social networks of file co-authorship (an idea inspired by Apache Agora). ” — http://na.apachecon.com/c/acna2010/sessions/557

    • Mary permalink
      October 28, 2010

      ConFigures: we have open threads for tangents as tangential as this one.

  12. David permalink
    October 30, 2010

    I question the need for enrollment statistics across all racial, gender, and socioeconomic groups having to be balanced at all times. I think we should demand fair, objective, rigorous standards of achievement for potential applicants to any higher ed program, standards that are transparent and do not mention or favor any one group simply because of background, race, sex, religion, ethnicity/whatever.

    It’s not the responsability of anyone to demand that qualified women should give up their spots in a med program because men are not or do not want to apply in as great numbers as women. Likewise, it’s not anyone’s responsability, for any program, to have to give up their spot because “we already have enough of that type of person”.

    If we want to combat inequality in admissions, the best way I see to do it is to change the culture of who wants to apply and to encourage minorities who are not applying in as great numbers. The answer is not to just bend the admissions curve, the answer is to provide more targeted private scholarships and encouragement in the effected communities and subcultures.

    Anyway, I’d also like to address Nick’s Comment
    “This is precisely the wrong way to go about fixing this issue, and always has been. Although I doubt we’ll hear a peep from the “men’s rights” groups who’ve been decrying affirmative action for decades, except to express a vindictive hurrah.”

    Agreed, but did you have to throw in a “take that” toward the men’s rights movement? From my standpoint (I’m not a member of either the feminist or men’s rights movements) people come off as hypocritical when they support one type of affirmative action, and not another.

    • Terri permalink*
      November 1, 2010

      I agree that sometimes the focus on exactly proportional representation of all groups is perhaps not the best or most achievable goal, but I think when you’re seeing one group rise or fall rapidly, or know that some are consistently not well-represented, it makes sense to take some time to re-evaluate how you do your recruitment. So if you’re noticing that most of your new applicants are female, asking why and considering adjustments seems perfectly reasonable to me.

      What I’m curious about is whether the re-evaluation is leading to stopgap measures to balance the program, or whether it’s also leading towards more serious thought into what makes a good doctor. It seems like some of the things they suggest, like more focus on community service, might be good criteria that they’ve wanted to use for other reasons but haven’t had reason to make the change without the impetus of misbalanced genders.

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