The Edge of the Abyss
This is not a drill.....
A few weeks ago, I published an opinion essay on the Brownstone website, entitled Medicine in the Wilderness:
https://brownstone.org/articles/medicine-in-the-wilderness/
While I stand by everything I wrote in that essay, I have been forced to add to it. For you see, the events of October 7, 2023 have changed everything. The blinders are now off and I see we are not just in “the wilderness”, but we are sliding down a glacier. Our crampons have slipped and we are hurtling towards a cliff. We madly try to dig in our ice axe to arrest the fall. I don’t yet know if we will be successful.
The world was exposed to unspeakable barbarity as terrorists gleefully tortured and killed hundreds of Israeli civilians in the worst attack against Jews since the days of The Holocaust. Far from attempting to hide their actions, they reveled in uploading the sadistic videos for the world to see.
One would hope that anybody seeing those videos and the laughing perpetrators would be filled with revulsion. Unfortunately, that is not the case….The BLM Chicago tweeted their support of the murderers with an illustration on a tweet (since deleted because of the uproar) showing solidarity with the paragliding terrorists who attacked a music festival:
https://nypost.com/2023/10/11/blm-chicago-admits-it-isnt-proud-of-deleted-post-of-hamas-paraglider/
There were huge numbers of pro-terrorist rallies at college campuses across the country. Make no mistake, these were not rallies in support of the Palestinian people, as portrayed by most of the media. It was solidarity with the terrorist as these students at the University of Wisconsin shouted, “Glory to the martyrs (or murders—it is unclear on the audio):
https://www.campusreform.org/article?id=24160
Typically, although they condemned the terrorist butchery itself, the University refused to condemn this blatant display of hate speech:
https://themessenger.com/news/wisconsin-university-refuses-to-condemn-pro-hamas-demonstrators
Instead, they pontificated on free speech and academic freedom although they looked the other way while allowing a conservative speaker to be hooted off the podium:
Despite the video evidence of the most depraved actions, many student groups were offended that the perpetrators were called “terrorists”:
https://alphanews.org/u-of-m-student-group-calls-hamas-terror-the-only-option/
One would hope that the future physicians of the United States exhibited more critical thinking, ethics and integrity…but sadly, that was not the case:
https://twitter.com/donoharm/status/1712927324146991271?s=20
According to this tweet, an organization chartered by the University of Minnesota appears to also stand in solidarity with the brutal murder of over a thousand Jews…
How is this possible? Well, it unfortunately is not the first time physicians have been on the forefront of such actions:
https://www.tabletmag.com/sections/history/articles/fernandes-doctors-who-became-nazis
There must be something…some factor “X”… that is present in my profession to allow this. It is clear to me that academic medicine cannot by itself reform what is now this mad slide down the glacial chute to the cliff. It is beyond wandering in The Wilderness. It is critical now.
We need to reform the criteria upon which we admit students to the health professions, and, more importantly, the criteria we employ in advancement within academic and corporate medicine. To be sure, the American Association of Medical Colleges has published Core Competencies for Entering Medical Students:
https://students-residents.aamc.org/applying-medical-school/article/core-competencies
Although at first glance this appears a great start, I am concerned about the actual meaning of some of the elements. In particular, the second competency states the student should:
Demonstrates knowledge of socio-cultural factors that affect interactions and behaviors; shows an appreciation and respect for multiple dimensions of diversity; recognizes and acts on the obligation to inform one’s own judgment; engages diverse and competing perspectives as a resource for learning, citizenship, and work; recognizes and appropriately addresses bias in themselves and others; interacts effectively with people from diverse backgrounds.
In theory, the key elements of Diversity, Equity and Inclusion seem laudable. However, in practice they seem to devolve into Orthodoxy, Inequality and Exclusion. Look at the actions of the medical student organization at the University of Minnesota in support of Hamas. What definition of “Diversity” are they actually using?? Have they addressed “bias” in themselves?
We have seen that the integrity of science and medicine has taken an exponential nosedive. Publications seem to be more dependent upon proper ideology than honesty and the good of patients and society. Just today it was announced that after a seven-month ethics investigation Dr. Mark Skidmore was cleared of any violation in his landmark study on the prevalence of significant side effects of the mRNA COVID agents. His original study was retracted due to an anonymous complaint that was found to be without merit. The original journal did not reverse the retraction, but it has been published by another journal (COVID-19 Illness and Vaccination Experiences in Social Circles Affect COVID-19 Vaccination Decisions):
https://www.publichealthpolicyjournal.com/copy-of-clinical-and-translational-re
Readers of this substack will know I have long advocated for fostering critical thinking, ethics, courage, integrity and moral reasoning in students, faculty and leaders in medicine. If our medical educational system is incapable of producing physicians who fail to recognize the barbarity of the butchers of October 7, 2023 or attempt to inject some sort of moral equivalence of their actions and the existence of the State of Israel, it has utterly failed. Reform must be imposed from the outside and must be initiated early on in the education of the healthcare professionals of the future. Professional school is too late.
That slide down the glacial chute is accelerating. Unless the ice axe holds we will shoot into the Abyss…and it is fast approaching. We don’t have much more time.
Russel, Sadly it is the external forces that have already killed medical education. As a many decade medical educator (and admissions committee attendee) I can tell you with assurance that the criteria for admission have shifted radically. We used to admit students based on their ability to learn the difficult profession and strong desire to help humanity be healthier. Today we ignore both of these (MCATs deprecated, GPA's nuanced by your race, etc.) and admit people based on their demographics, social justice warrior score, and "distance traveled" -- as if living in your car for a month qualifies you to be a doctor.
This is all BECAUSE of the external AAMC organization -- most of us at the grassroots hate every component of this. But wait...it gets worse.
Because underqualified students are routinely admitted, the standards just keep slipping. First, we did away with grades because some students did better than others (and because the flunk rate by number was profound -- many schools remediating 25-30% of their students. You had better hope that is not going to be YOUR doctor.) Pass/fail allows you to put the cutoff anywhere and just pass everyone about 3% irrespective of whether they grasp the material or not. Of course, we have also been required to dumb down the course materials to help a few more look better and to help with the absurdity of "work/life balance" which is all about no work. Of course, now that people are demonstrably less qualified, we have now removed the scoring from part 1 of the National Boards -- a testament to the fact that pass rates for this national test based on discernable numbers were cratering. Again, once it is pass fail, one can just pass the top 95% irrespective of scores. Easy solution until you are the patient.
But wait...there's more. Because we now have NO data on medical students vis-a-vis quality, no one has any idea about which residents will be better than any others. This used to be a really selective process...now it is a crapshoot based on one test (Part II of the boards is still scored, but who knows for how much longer) and interviews/recommendations which tell you nothing for practical purposes.
It is not that no good students go to medical school. Many still do. But the government/bureaucracy has made it almost impossible to tell. It is why I know no one of my cohort that will see any physician under 40. (And some use 50 as their cutoff.)
Be warned.
Since you routinely accent semantics, I feel comfortable discussing language with you. In current context, of course.
(While we're here, to "the Arab street," is there any practical difference in meaning between "Islamic Jihad-misfired, wayward rocket" and fictitious "Israeli bomb" --- despite the absence of any effective crater at the purported bomb-explosion (pre-hospital) site, and the assumed aim and release of said explosive armament in an intentional, murderous, systematic manner by one of Israel's piloted warplanes --- when attempting to explain its riotous and destructive impulses? Not enough, evidently and obviously.)
Your characterization of how DEI devolves constantly and everywhere into UIE captures/summarizes all your observations, concisely and precisely so.
There are certain causes present --- deception, untruthfulness, racial bias and discrimination (a/k/a "hellish payback"), tyranny --- when such ill-gotten acronyms devolve, rather than to systematically grow, bring positive, needed, overdue modification; adapt, while interacting with a modified-constructive environment, and, thus, evolve.
You get it, Professor.