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Academic redlining in medicine.

Sunny Nakae1, Andrew M Subica2

  • 1Department of Medical Education, California University of Science and Medicine, 1501 Violet St, Colton, CA, 92324, USA.

Journal of the National Medical Association
|June 17, 2021
PubMed
Summary
This summary is machine-generated.

Academic redlining, using Medical College Admissions Test (MCAT) cutoffs, systematically excludes underrepresented students from medical school. This practice, driven by prestige and market pressures, exacerbates health disparities and hinders diversity in medicine.

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Area of Science:

  • Medical education
  • Health equity
  • Sociology of medicine

Background:

  • Despite diversity initiatives, U.S. medical schools show persistent gaps in applicants and enrollees from underrepresented racial and economic groups.
  • Structural racism contributes to these disparities, impacting access to medical careers for marginalized students.

Purpose of the Study:

  • To introduce and provide evidence for the theory of 'academic redlining' in medical school admissions.
  • To identify the mechanisms driving academic redlining and its impact on diversity in medicine.

Main Methods:

  • Analysis of medical school admissions practices, focusing on the role of Medical College Admissions Test (MCAT) cutoff scores.
  • Examination of institutional prestige, market competition, and market bands as drivers of academic redlining.

Main Results:

  • Evidence suggests that MCAT cutoff scores function as a mechanism for academic redlining, systematically excluding underrepresented students.
  • Three core mechanisms—institutional prestige, market competition, and market bands—drive medical schools to engage in academic redlining.

Conclusions:

  • Academic redlining, perpetuated by MCAT cutoffs, disenfranchises underrepresented students and contributes to health care disparities.
  • Structural alternatives in admissions and education are needed to dismantle academic redlining and promote diversity in medicine.