The Irony of the Ivory Tower

Everyone is welcomed into the ivory tower. You are welcomed by smiling faces. Smiling faces that nod at the list. A list you must complete before you enter the door. But, of course, you are welcome here.

And on that list, you will see clearly the seven requirements [1]. Oh, you are surprised? Requirements are necessary to enter the ivory tower. They are quite clearly listed. All the seven requirements, and there are a few fees. Fees for those requirements. Fees for applying to schools. Fees for flying. Fee for lodging. And, once you have paid the fees, then we need your fee to hold your place to attend. Everyone pays to enter the ivory tower [2]. But, of course, you are welcome here.

Let’s just say that you are like me. That you take some time off between undergraduate school and more university. Somehow, you are able to put all the fees down. When you enter the ivory tower, you will look around and see that the ivory on the outside is representative of the inner diversity. Our MCAT scores matter, they must be around 512. We also care about GPAs because we do not want anything less than 3.6 around. These might seem limiting, but we want limited life experience too; we are looking for those only a year or two out of school [3]. But, of course, you are welcome here.

Now, you might wonder, why should you care. The ivory tower is open for all those who fight to get there. Unfortunately, that is where you are wrong. For you see, I have many friends who are not here since the lists and fees are so long. Fees, lists and scores prevent my friends from entering. These items close doors. But, of course, you are welcome here.

Yet, the data shows that our monolithic ivory tower is no different than those across the country. The history of racism in the medical system is a problem with roots over 2,500-years-old and continues due to racial stereotypes perpetuated by many famous physicians, scientists and scholars [4]. Despite the initiation of the ACA, Black Americans are still less likely than their white counterparts to be covered by health insurance [5] and these economic factors alongside systemic racism within our medical system led to stark health outcomes between Black and White Americans [6].  Our recruitment and awareness of health disparities over the five-years has not correlated with an increased number of Black men in medicine; Black males entering medicine has only increased by 0.3% to a grand total of 2.9% [7]. That means there are more spots for the 512 MCAT, 3.6 GPA students who can pay to enter. So next time you decide to fight for inequity, I beg you to question how you are currently benefiting from lack of diversity. But, of course, you are welcome here.

The ivory tower is ironic in its color and the welcome signs it posts. We have an opportunity to change the narrative. Next time, pause, before you say, “all are welcome here.” Is it realistic to say you are welcome and then give a conditional list? Is this list and fees feasible for everybody? What about that 3.0 GPA who barely got by but now wants to be a MD? Change can happen but it needs to start with actions that show our words. To welcome all means to truly value more than grades, to see them as baselines, instead of great escalades. If we truly value the big and small, the life experiences, then we can say with truth in each word that, all are welcome into the University of Minnesota Medical School.

REFERENCES

1. The Office of Admission (2019). “Prerequisite Course Checklist.” University of Minnesota, Medical School. https://med.umn.edu/sites/med.umn.edu/files/prerequisite_course_checklist.pdf
2. Murphy, Brendan. (2019) “The expenses in the medical school application process can add up.” https://www.ama-assn.org/residents-students/preparing-medical-school/expenses-medical-school-application-process-can-add#:~:text=What%20it%20costs%20to%20apply,each%20additional%20medical%20school%20application.
3. “Incoming Class Profile: 2019 Twin Cities Incoming Class.” University of Minnesota, Medical School. https://med.umn.edu/admissions/how-apply/incoming-class-statistics
4. Byrd, W M, and L A Clayton. “Race, medicine, and health care in the United States: a historical survey.” Journal of the National Medical Association vol. 93,3 Suppl (2001): 11S-34S.
5. Berchick, E. R., Upton R. D., & Barnett, J. C. (2019). Health insurance coverage in the United States: 2018. Current population reports. Washington DC: US Government Printing Office
6. Imhoff, J. (2020). Health Inequality Actually Is a “Black and White Issue” Research Says. University of Michigan Health, Lifestyle. https://healthblog.uofmhealth.org/lifestyle/health-inequality-actually-a-black-and- white-issue-research- says?utm_campaign=Blog&utm_medium=email&_hsmi=89215511&_hsenc=p2ANqtz– JaOKg75JL-XhfaKSPsBo84yBnmmwfxqx–MxKxwRN1UmIYfqI7VPaBj5No7gYKBgajUayk4PGfILd_g4HrhiUiIuIBg&utm_content=8921 5511&utm_source=hs_email
7. AAMC, NMA Announce Action Collaborative on Black Men in Medicine. The AAMC and NMA announced a joint effort to convene an Action Collaborative that will address the lack of representation of African American men in medicine. https://www.aamc.org/news-insights/press-releases/aamc-nma-announce-action-collaborative-black-men-medicine