Smart but Slow, or Med School Gets Dumbed Down

Author Virginia Postrel recently pointed out (in Forbes (not free), and on her website) ongoing efforts to get special accomodations for students with the ‘disability’ that they aren’t good test takers, and whether what applies to students in grade schools should carry over into this nations’ professional schools:

Over the past decade students with learning disabilities have gotten used to having extra time on tests and, in some cases, separate rooms to reduce distraction. In many cases that makes sense. Giving a dyslexic third grader extra time on a standardized test makes it more likely that his answers will show what he knows rather than how fast he reads.

But a sensible accommodation for little kids can create a misleading double standard for adults. How much you know isn’t the only thing that matters in school–especially when you’re training for a demanding professional job. What patient wants a genius doctor who can’t focus in a distracting environment, reads so slowly that she can’t keep up with medical journals or tends to misspell drug names on prescriptions?

There are, of course, excellent physicians with learning disabilities. But they succeeded the hard way, without special accommodations. They demonstrated that they could work around their problems.

I would agree with that. Not all docs are geniuses; in fact, probably most are of above average intelligence, but not genius-range. They got through school and residency by working really hard and applying themselves, not necessarily through stupefying brilliance.

Of course, these disabled are represented by lawyers:

That’s not fair, argue disability activists, and it’s not legal.

In a class action filed in California state court in July, he and other attorneys argue that medical school admissions tests unfairly discriminate against applicants with disabilities like dyslexia. The Association of American Medical Colleges, argues the suit, is too stingy about giving learning-disabled students the accommodations they’ve depended on throughout their academic careers.

I’m going to re-arrange one paragraph from the esay, to complete the legal argument against the “this is a test of their ability to perform under pressure”:

Irrelevant, says Tollafield. “The MCAT is not a test that’s designed to predict how you would do as a doctor. It’s designed to predict how you’ll do on other tests in medical school and the grades that you’ll earn.”

The MCAT is many things, but any med school admissions director will tell you those scores do not correlate with success or class rank in med school, but they’re really handy to weed out people who who have no business being there in the first place.
Ms. Postrel continues, and gets it exactly right:

The lawsuit ignores the nature of medical training, which is notoriously grueling for a reason. Patients’ lives depend on physicians’ ability to perform under pressure. If learning-disabled students can’t do well on a timed test, maybe they aren’t suited to be doctors.
(excerpted paragraph above)
That argument denies the fundamental reality of professional schools. No matter how theoretical their classes, these programs aren’t about learning for learning’s sake. They’re trade schools that prepare and certify people for demanding jobs. In those jobs, performance–not intelligence or knowledge–is what matters.

If taking the MCAT is gruelling for these applicants, it’ll take them about 30 years to get through medical school, which is non-stop high-volume education. It’s hard as heck if you read and test well, and would be impossible for those with significant learning disabilities.
Then, in an interesting twist I hadn’t even considered, the author points out that this effort is, indeed, discriminatory against the not-too-bright:

Besides, the disability rights people have no objection to the most blatant form of educational discrimination: the prejudice against people who, thanks to the genetic lottery, aren’t exceptionally bright.

For an aspiring doctor, average intelligence is a far greater handicap than dyslexia or attention deficit/hyperactivity disorder. Why do some brain attributes matter more than others? Why, to use the trendy jargon, should we “privilege” intelligence?

“Wow,” says Tollafield. “That’s a big policy question. I don’t know that I’m capable of answering it.”

Looks like I’m not the only one who didn’t think of that.

via Overlawyered


  1. Wow, thanks for this post. Now let’s see if I’m lucky [privileged] enough to have my application get me into med school!

  2. It might be good if you had a conversation with Toby Cosgrove about dyslexia and medicine.

    Cosgrove struggled in public schools in his hometown of Watertown, N.Y., and studied hard for D’s in college French at Williams College in Williamstown, Mass., his father’s alma mater. He did so poorly on the standardized tests required for medical admission that he credits special circumstances for getting into the University of Virginia’s medical school, the only one of 13 schools that accepted his application.

    He’s now the head of the Cleveland Clinic.


  1. Make Way For Stupids?

    On accomodative testing and medical school