OPINION: The privilege of becoming a physician

The field of medicine lacks diversity because applying to medical school is inaccessible

CW: ableism, racism, classism

Coming into university, I thought I was going to be a doctor. I got accepted into health sciences and thought that health was something I wanted to pursue. While I am still passionate about health care, I’ve come to many realizations during my undergraduate degree — with one of them being that I am unable to apply to medical school due to my disabilities.

It’s hard to face the reality that some things might be unattainable for you when there is this mindset pushed that if you work hard enough, you can achieve anything. I agree that it’s good to work hard and set goals for yourself, but becoming a doctor is a bit more complicated than simply “working hard.”

It’s hard to face the reality that some things might be unattainable for you when there is this mindset pushed that if you work hard enough, you can achieve anything. I agree that it’s good to work hard and set goals for yourself, but becoming a doctor is a bit more complicated than simply “working hard.”

The first barrier I came across was the lack of accessibility surrounding the application process. For most Canadian medical schools, you have to write the Medical College Admission Test in order to apply. The MCAT is a multiple choice examination that covers a wide variety of subjects such as physics, chemistry and biology, and assesses your critical thinking and problem solving skills. 

Typically, the MCAT is a seven hour and 30 minute-long test where you are not allowed to access water or food except for during the scheduled breaks. To allow for things such as extra time, a separate testing area or even water or food during the testing period, you have to apply for accommodations.

Accommodations for the MCAT are known to be notoriously difficult to access according to many applicants. You need to submit a profile, your condition, history, a personal statement that talks about your experiences and a comprehensive evaluation by a qualified professional. The problem with this is that many people with disabilities may not always have a “proper” diagnosis since many conditions are hard to diagnose and may even take years — it took five years and several doctors to diagnose my rare knee condition. In addition, folks may face barriers in accessing healthcare services due to long wait times, racism, classism or other forms of discrimination. 

The Association of American Medical Colleges, which administers the MCAT, is known to be strict on accommodations. Even if you have extensive documentation for your disability, you may be denied accommodations. Many have shared such experiences on platforms such as Reddit, detailing the hardships of accessing accommodations. If you’re given accommodations, it could not be what you requested for. As a result, many people decide to “power through” instead of applying for an accommodation. In addition, up until 2015, MCAT accommodations used to be flagged for being administered in a non-standard setting, which could have an impact on your medical school applications.

Even amidst a pandemic, the MCAT is still running in-person — they have shortened the test from seven hours and 30 minutes with two 10 minute breaks and one 30 minute break to five hours and 45 minutes with three 10 minute breaks. It’s ironic that MCAT testing is in-person and could potentially put test takers at risk, while other standardized tests like the Law School Admission Test is online to accommodate for the pandemic. 

It’s ironic that MCAT testing is in-person and could potentially put test takers at risk, while other standardized tests like the Law School Admission Test is online to accommodate for the pandemic. 

Ableism isn’t the only barrier people face in applying to medical school. A recent study found that McMaster University Medical School applicants often come from upper-class families, with the median income of $98,816 being almost $30,000 higher than the average Canadian. From those who were accepted into McMaster, the median income was $105,959. This creates a huge disparity in healthcare: low-income patients will often lose out on the opportunity to have a physician that can empathize with their experiences or fully understand conditions that disproportionately affect low-income people. 

Applying to medical school is difficult, but low-income students have it even harder because the cost of applying to medical school is high. Maintaining a high grade point average requires hard work and lots of studying, but when you’re juggling two or three jobs on top of that, it can be exceedingly difficult. Not to mention that while low-income students often have to work jobs, students that are more well-off can spend their time doing volunteer work or extracurricular activities that can boost their resume. Upper-class students can also pay for MCAT prep courses to help boost their scores, which can cost up to $2000. If you’ve received a medical school interview, you may also need to book a bus, train or plane ticket for the in-person interview depending on where the school is located.

Another disparity that has been very visible this year is the lack of Black and Indigenous medical students in Canada. Very few Black students have been admitted to McMaster Medical School for the past five years and other Canadian medical schools historically haven’t done much better with admitting Black and Indigenous students either.

Very few Black students have been admitted to McMaster Medical School for the past five years and other Canadian medical schools historically haven’t done much better with admitting Black and Indigenous students either.

In the class of 2020, I was the only Black medical student in my class! And my class was super amazing but I think it could of been better. Sign our open letter to the McMaster MD program to make huge improvements towards diversity and inclusion! https://t.co/GCJChL9kk6

— Oluwatobi Olaiya (@tobiolaiya_) June 20, 2020

https://twitter.com/Alavian_S/status/1274457232680378373

Although there have been some changes, such as Queen’s University changing their accelerated medical school route so that it is reserved for Black and Indigenous students only, many people have criticized these changes, as Black and Indigenous students will be entering an environment that may not be supportive. 

Although I appreciate the approach Queen's has begun to take, I do wish more was addressed on how these Black and Indigenous students will be properly supported at a school that is known to have blatant issues with racism especially for undergrads: https://t.co/Xy5SR4DSHb https://t.co/tVcg1bOfm4

— Iku Nwosu, MD (@IkuNwosu) July 24, 2020

I’ve always found it ironic that medical school is inaccessible in many facets — the fact that people with disabilities, low-income individuals and Black and Indigenous folks are disadvantaged when applying highlights the lack of doctors who belong to these identities. The best doctors that I’ve had are ones that can empathize with my experiences. But if the majority of doctors are abled, upper-class and not Black or Indigenous, you alienate a large group of people.