When Race Trumps Merit: How the Pursuit of Equity Threatens Lives. Heather Mac Donald

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The Pursuit of Equity Sacrifices Excellence, Destroys Beauty, and Threatens Lives Hardcover – April 18, 2023

by Heather Mac Donald (Author)

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Heather Mac Donald is the Thomas W. Smith fellow at the Manhattan Institute and the author of When Race Trumps Merit: How the Pursuit of Equity Sacrifices Excellence, Destroys Beauty, and Threatens Lives.

Does your workplace have too few black people in top jobs? It’s racist. Does the advanced math and science high school in your city have too many Asians? It’s racist. Does your local museum employ too many white women? It’s racist, too.

After the Black Lives Matter protests of 2020, prestigious American institutions, from the medical profession to the fine arts, pleaded guilty to “systemic racism.” How else explain why blacks are overrepresented in prisons and underrepresented in C-suites and faculty lounges, their leaders asked?

The official answer for those disparities is “disparate impact,” a once obscure legal theory that is now transforming our world. Any traditional standard of behavior or achievement that impedes exact racial proportionality in any enterprise is now presumed racist. Medical school admissions tests, expectations of scientific accomplishment in the award of research grants, the enforcement of the criminal law—all are under assault, because they have a “disparate impact” on underrepresented minorities.

When Race Trumps Merit provides an alternative explanation for those racial disparities. It is large academic skills gaps that cause the lack of proportional representation in our most meritocratic organizations and large differences in criminal offending that account for the racially disproportionate prison population.

The need for such a corrective argument could not be more urgent. Federal science agencies now treat researchers’ skin color as a scientific qualification. Museums and orchestras choose which art and music to promote based on race. Police officers avoid making arrests and prosecutors decline to bring charges to avoid disparate impact on minority criminals.

When Race Trumps Merit breaks powerful taboos. But it is driven by a sense of alarm, supported by detailed case studies of how disparate-impact thinking is jeopardizing scientific progress, destroying public order, and poisoning the appreciation of art and culture. As long as alleged racism remains the only allowable explanation for racial differences, we will continue tearing down excellence and putting lives, as well as civilizational achievement, at risk.

The following is an excerpt from Heather Mac Donald's new book, When Race Trumps Merit: How the Pursuit of Equity Sacrifices Excellence, Destroys Beauty, and Threatens Lives, published by DW Books.

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The post–George Floyd racial reckoning hit the field of medicine like an earthquake. Medical education, medical research, and standards of competence have been upended by two related hypotheses: that racial disparities in the demographics of the medical profession and racial disparities in health outcomes are the products of systemic racism. Questioning those hypotheses is professionally suicidal. Vast sums of public and private research funding are being redirected from basic science to political projects aimed at dismantling white supremacy. The result will be a declining quality of medical care and a curtailment of scientific progress.

Virtually every major medical organization—from the American Medical Association (AMA) and the American Association of Medical Colleges (AAMC) to the American Association of Pediatrics (AAP)—has embraced the idea that medicine is an inequity-producing enterprise. The AMA's 2021–2023 Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity is virtually indistinguishable from a black studies department mission statement. The plan plunges the reader into a thicket of social-justice maxims: Physicians must "confront inequities and dismantle white supremacy, racism, and other forms of exclusion and structured oppression, as well as embed racial justice and advance equity within and across all aspects of health systems." The country needs to pivot "from euphemisms to explicit conversations about power, racism, gender and class oppression, forms of discrimination and exclusion." (The reader may puzzle over how much more "explicit" current "conversations" about racism can be.) We need to discard "America's stronghold of false notions of hierarchy of value based on gender, skin color, religion, ability and country of origin, as well as other forms of privilege."

A key solution to this alleged oppression, according to the AMA, is identity-based preferences throughout the medical profession. The AMA strategic plan calls for the "just representation of Black, Indigenous and Latinx people in medical school admissions as well as . . . leadership ranks." The lack of "just representation," according to the AMA, is due to deliberate "exclusion," which will end only when we have "prioritized and integrated the voices and ideas of people and communities experiencing great injustice and [those who are] historically excluded, exploited, and deprived of needed resources such as people of color, women, people with disabilities, LGBTQ+, and those in rural and urban communities alike."

According to medical and STEM leaders, to be white is to be racist per se; apologies and reparations for that offending trait are now expected. In June 2020, the journal Nature identified itself as one of the culpably "white institutions that is responsible for bias in research and scholarship." In January 2021, the editor-in-chief of Health Affairs lamented that "our own staff and leadership are overwhelmingly white." The AMA's strategic plan blames "white male lawmakers" for America's systemic racism.

And so medical schools and medical societies are discarding traditional standards of merit in order to alter the demographic characteristics of their profession. As with all disparate impact analyses, that demolition of standards rests on an a priori truth: that there is no academic skills gap between whites and Asians, on the one hand, and blacks and Hispanics, on the other. Therefore, any test or evaluation on which blacks and Hispanics score worse than whites and Asians is biased and should be eliminated.

The United States Medical Licensing Exam (USMLE) is a prime offender. At the end of their second year of medical school, students take Step One of the USMLE, which measures knowledge of the body's anatomical parts, their functioning, and their malfunctioning; topics include biochemistry, physiology, cell biology, pharmacology, and the cardiovascular system. High scores on Step One predict success in a residency; highly sought-after residency programs, such as surgery and radiology, use Step One scores to help select applicants.

Black students are not admitted into competitive residencies at the same rate as whites because their average Step One test scores are a standard deviation below those of whites, representing, in statistical terms, a massive gap. (Standard deviation measures how dispersed data are from a mean.) Step One has already been modified to try to shrink that gap; it now includes nonscience components such as "communication and interpersonal skills." But the standard deviation in scores has persisted. In the world of anti-racism, that persistence means only one thing: The test is to blame. It is Step One that, in the language of anti-racism, "disadvantages" underrepresented minorities, not a lesser degree of medical knowledge.

The Step One exam has a further mark against it. The pressure to score well inhibits minority students from what has become a core component of medical education: anti-racism advocacy. A fourth-year Yale medical student describes how the specter of Step One affected his priorities. In his first two years of medical school, the student had "immersed" himself, as he describes it, in a "student-led committee focused on diversity, inclusion, and social justice." The committee lobbied the administration for changes in the curriculum, the admissions process, and research funding. The student ran a podcast about health disparities. All that political work was made possible by Yale's pass-fail grading system, which meant that he didn't feel compelled to put studying ahead of diversity concerns. Then, as he tells it, Step One "reared its ugly head." Getting an actual grade on an exam might prove to "whoever might have thought it before that [he] didn't deserve a seat at Yale as a Black medical student," the student worried.

The solution to such academic pressure was obvious: abolish Step One grades. Since January 2022, Step One has been graded on a pass-fail basis. The fourth-year Yale student can now go back to his diversity activism without worrying about what a graded exam might reveal. Whether his future patients will appreciate his focus is unclear.

Medical school bureaucrats cheer on this reorientation to advocacy. A career advisory dean at the George Washington University School of Medicine & Health Sciences describes a conversation she had with a student who had done so poorly on her Step One test that she would have a hard time "matching" (med-school argot for landing) her preferred residency in obstetrics and gynecology. The advisor insisted that the student's test scores were less important than her "passion for social justice." (How that passion might help a doctor treat a uterine rupture during delivery is also unclear.) In the career advisor's view, the student's "feelings of incompetence" were arbitrary and unjustified. Yet they were "impacting" the student's clinical performance. Arguably, it was the student's struggles with core science concepts that were impacting her clinical performance. No matter. Making Step One pass/fail will help students more "effectively tell their stories to residency programs," since it is apparently a student's "story" that hospitals should use in selecting interns.

Every other measure of academic mastery has a disparate impact on blacks and thus is in jeopardy.

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See When Race Trumps Merit: How the Pursuit of Equity Threatens Lives

There are people in every society who are honest, trustworthy, reliable, dependable, competent and hardworking. They are people you can depend on. You can trust them. They are deserving. Then there are other people who are not honest, not trustworthy, not very hardworking, and you can’t trust them or depend on them. They are not deserving. We live in a competitive society. The number of good jobs, good positions, are limited. Who will get them? Who should get them? What should decide that question? Personal merit or some other criterion? What happens if a society by its policies, for whatever its reasons, promotes the undeserving and incompetent above the deserving and competent? Lifts up the lazy, untrustworthy, incompetent types placing them above the honest, reliable, hardworking, competent types? Answer: The honest, competent and trustworthy become angry and the dishonest, incompetent and undeserving become even more incompetent, dishonest and undeserving. It is all about justice and how people respond to injustice. If the criterion for promotion becomes something other than simple merit (like, for example, race) then the consequences for a society are going to be highly negative. It will result in the society becoming ever more dysfunctional. We live in a society of organizations and personal incompetence in organizations produces organizational dysfunction. This seems like an obvious fact but it is something that liberals don’t seem to understand. If low achievers in our education system are, because of their race, promoted in ways they don’t deserve, if their defects and inadequacies are deliberately masked, and high achievers (such as orientals) are down ranked, what do you think will be the consequence? If a society promotes the inferior at the expense of the superior what do you think will be the consequence? What dysfunctions will result? What will be the consequence in areas like medicine, science, technology, industry, military, national competitiveness, etc.?

Underneath all of this is a false assumption on the part of liberals. It is the false narrative that there is an unfair systemic bias against Blacks in this country. There is no doubt in my mind that the vast majority of biases that might exist against Blacks in this country are the fault of the Blacks themselves. Just like with the Gypsies, there are perceptions about Blacks that are not without basis. Why might a policeman carry an unfavorable opinion of Blacks? Could it have something to do with the Black man’s propensity towards crime and violence? The Blacks do a lot more poorly in school than Whites and Asians. Could the reason simply be that the Whites and Asians work harder? The reason must either be that they work harder or that the Whites and Asians are smarter. I think it is simply a matter of working harder. Either way, there is no excuse for depriving the White and Asian of the acknowledgment and rewards that he has worked for and deserves. I believe that the reason Blacks tend to do poorly in school has to do with Black home environment, single parent households, low household income, and Black culture, Black mentality (and the incentives of our welfare system has a lot to do with all this). The reason oriental children do so well has to do with oriental culture and mentality.

It is not systemic racism that is responsible for low percentages of blacks in various vocations. It is educational and intellectual lack due to poor education, poor scholastic performance, that is responsible. The root of the disparity problem lies in personal intellectual achievement, personal mental competence. And that is closely connected to performance in the school system.

See

Intellectual disparities among people and the power in good habits

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