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Health equity requires diverse workforce, dean argues
University of Miami medical school Dean Henri Ford called for holistic admissions based on more than just merit to avoid “homogenous” students in a heated debate with medical doctor Stanley Goldfarb of watchdog group Do No Harm.
The University of South Florida hosted the debate over diversity, equity, and inclusion initiatives in medical schools on Friday. The panel also included USF Health Senior Associate Vice President Jay Wolfson and Georgia public health director Dr. Bonzo Reddick.
The panelists differed over how much weight admissions committees should give to MCAT scores and GPAs compared to experience and soft skills.
Dean Henri Ford argued that academic metrics alone cannot adequately measure whether someone will become a successful physician.
He described his admissions philosophy as “inclusive excellence,” emphasizing that applicants must meet academic standards while also demonstrating qualities that contribute to effective patient care. These qualities include care, consideration, compassion, and collaboration.
Ford said his institution establishes an MCAT threshold below which applicants are unlikely to succeed. But he argued that exceeding that threshold does not automatically make someone a better candidate than another applicant with a lower score.
“If we relied strictly on MCATs and GPA … we could end up with individuals who lack those soft skills to become effective, caring, compassionate physicians,” he said.
“You could actually just rely on AI to select the class, right? And if we did that, what would happen? We would end up with a fairly homogeneous group of people,” Ford said.
He argued that a diverse medical workforce is important to achieving health equity, pointing to the historical exclusion of black physicians from professional medical organizations.
Ford also drew on his own experience as an immigrant, non-native English speaker, arguing that admissions committees should consider the circumstances in which applicants achieve their academic results, rather than just the results themselves.
Building on Ford’s ideas, Reddick advocated for what he called “mission-aligned selection,” arguing that medical schools should evaluate applicants in light of the communities they are established to serve.
He described evaluating whether applicants have meaningful connections to rural health care, rather than simply accepting claims that they want to practice in rural areas.
Dr. Reddick gave an example of an applicant who could describe a family member traveling an hour and a half to see a cardiologist and explain how that experience influenced the applicant’s interest in telehealth and rural medicine.
He said such experiences can provide admissions committees with concrete evidence that an applicant understands the needs of the communities the school intends to serve.
On the other hand, Do No Harm’s Goldfarb argued that academic performance should remain the primary consideration, as data shows that undergraduate grades and MCAT scores are the most effective predictors of success in medical school and residency training.
“Academic performance before medical school is the best predictor of success, and it should be the key metric that determines admission,” he said.
Goldfarb also argued that evidence does not show that matching the race of patients and physicians improves medical outcomes or communication.
Further, he criticized the Association of American Medical Colleges’ holistic admissions model, arguing that it has little connection to a prospective physician’s ability to provide quality care.
“…holistic admission, according to the AAMC’s model … includes a myriad of factors that appear to me unrelated to medicine or patient care, including citizenship, distance traveled, relationship status, involvement in cultural events, and sexual orientation,” Goldfarb said.
“Life experiences and leadership traits are all fine to consider,” Goldfarb said, provided academic achievement and cognitive ability remain the primary criteria.
USF’s Wolfson provided a potential middle ground, suggesting that schools should first establish an academic threshold for applicants and then evaluate additional qualities relevant to their institutional goals.
“I think we have to have some empirical basis for the initial selection,” he said.
Once schools identify a pool of applicants capable of succeeding academically, Wolfson said, admissions committees can assess other characteristics based on the institution’s mission.
The debate comes amid several findings from the U.S. Department of Justice that schools are discriminating based on race in admissions.
The department found that UCLA School of Law, George Washington University, UCSF Medical School, and Yale University, among others, all discriminated against white and Asian students.
