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Underneath the Davis Affair

BRASS TACKS

If liberals are to keep the programs so necessary to quickly increase the number of black doctors for black communities, they must be willing to debate their conservative colleagues on the question of standards of excellence, instead of simply trying to isolate or slur their opponents.

In an era when opponents of vigorous affirmative action programs are not "rednecks" unabashedly out to deny minorities their fundamental rights but social scientists armed with evidence purporting to show the damaging effect quotas many have on blacks who have made it, liberals must be prepared to counter, not berate.

How can those in favor of maintaining these recruitment programs defend them to those who say that some standards of excellence will be compromised? One way is to refute the traditional criteria that those who holler "foul" go by. For instance, the National Examination Board which tests mostly memorized material rather than clinical ability, seems to be outmoded at a time when clinicians for poor, especially black areas, are in seriously short supply. The notion that scientific knowledge given during the first two years of med school is more difficult for some blacks than it is for some whites may be true, and if so, then both sides should be candid about it. After all, if blacks are admitted from schools thought to be disadvantaged, or if the students are thought to be disadvantaged themselves, why should administrators expect that they should be on par with other students immediately?

And, more important, what does it matter as long as they perform excellently in their clinical education, as is the case right now? Despite Davis's assertion, no one has proven that there is a direct link between performance by a doctor and tests like the National Boards. To the contrary, William P. Craget, from the Stanford University School of Medicine, noted in an informative letter to the New England Journal of Medicine this summer that he has found a much higher correlation with attitudinal behavior than lack of scientific knowledge among poor internship performances he has analysed.

Critics of this argument are always quick to cite the Health, Education and Welfare administrator who, when he heard that blacks weren't taking religious studies because they did not have a strong knowledge of Greek and Hebrew, two prerequisites, told the school to get rid of the two languages and include more modern languages. The analogy is too easily and inconsiderately applied. If there is no clear link between the scientific knowledge and clinical performance, then what is so outrageous about making the curriculum fit today's present need for more doctors in impoverished areas?

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And then there is the simple, most-direct explanation for recruiting more and more black candidates: as most liberals and conservatives agree, there is no genetic difference between the races, therefore as long as there is an income disparity and an educational disparity the medical schools must be willing to extend their services to minimize these differences. Only when the disparity is cancelled should these programs be abolished.

But in order to persuade, it is first important to admit that there are two sides to the discussion of admissions. Crying racist and claiming that Davis's supporters are attacking all minority students' competence duck the conservatives' insistence on maintaining standards of excellence in the first two years' academic work for all students, an argument that must be challenged. What is needed is an honest attack pointing up the limited link that these standards have with providing better distribution of health care in America.

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