Lily🍒

I understand why many Asian families feel frustrated in elite admissions systems. In intensely competitive environments, there is a real perception — and sometimes evidence — that exceptional academic performance still does not guarantee admission. That feeling should not be dismissed. But admissions committees also confront another reality: if you have 100 applicants from privileged, high-performing educational pipelines with nearly identical scores, resumes, research access, tutoring, and opportunities, it is not irrational to also value the applicant who achieved similar academic success despite poverty, instability, underfunded schools, family hardship, or lack of institutional advantages. That is not abandoning merit. It is recognizing that achievement exists in context. And medicine especially is not merely selecting expert test takers. It is selecting future physicians who will care for human beings across every class, culture, language, and circumstance in society. The irony is that many people who defend “objective merit” often become deeply uncomfortable the moment merit is evaluated in anything broader than a percentile ranking.

As a fellow surgeon, you should know better than most that medicine eventually exposes the limits of standardized metrics. Yes, MCAT and GPA help identify people capable of surviving cognitively demanding training systems. Nobody disputes that. But surviving training is not synonymous with becoming the best physician or surgeon. You and I have both seen residents with extraordinary scores struggle under pressure, collapse when uncertainty enters the room, communicate poorly with families, or lack operative judgment. And we have both seen others with less dazzling paper metrics become superb clinicians whom nurses trust, patients adore, and colleagues rely upon at 2 AM. Surgery especially has a way of humiliating simplistic theories of merit. The body does not care about your percentile ranking when the anatomy is distorted, the bleeding starts, and the room becomes quiet. At some point experience should teach us that medicine is evaluating human beings, not sorting calculators. oh and we have the literature to show this by the way -- and yes, the smartest doctors are surgeons but don't tell. MCAT predictive validity: • Donnon et al. Acad Med. 2007 PMID: 17198300 () • Callahan et al. Acad Med. 2010 PMID: 20068426 () • Saguil et al. Mil Med. 2015 • Hanson et al. Acad Med. 2022 • Harvey et al. JNMA. 2025 Structural bias & admissions: • Lucey & Saguil. Acad Med. 2020 • Faiz et al. JAMA Health Forum. 2023 • Davis et al. Acad Med. 2013 • Nakae & Subica. JNMA. 2021 Physician diversity & outcomes: • Snyder et al. JAMA Netw Open. 2023 • Hill et al. J Health Econ. 2023 • Xu et al. AJPH. 1997 • Vichare et al. Ann Fam Med. 2024 Medical school diversity outcomes: • Saha et al. JAMA. 2008 • Morris et al. NEJM. 2021 • Ly et al. Ann Intern Med. 2022 • Florescu et al. JAMA Netw Open. 2025

The deflection is thick with this one. The issue isn't diversity but lowering standards and choosing applicants based on race is illegal and you can try to twist that any way you want but the DOJ enforces those laws of the Court. Patients need/should have the best qualified.