The Diversity question.

08/03/2024

Every year, around springtime, I find myself speaking with people where choosing my words carefully is part of the problem. Students aspiring to become healthcare professionals ask me for advice about the how-to’s of the fast-approaching starting line of the application cycle. The obscene demands institutions place on young people—both before and during school—is a discussion for another time but in that moment years of work to prove our dedication to the enterprise of healing is about to be turned into something tangible. Words that another can interpret, and determine if the author ought to be welcomed into the hallowed corridors of academia.

Applicants start forming an image of the competition at this stage more than any other. A fear starts settling in whereby our limited explorations of the world seem to be dwarfed by the infinite possibilities of experiences someone else might bring to the judges’ table. Students vacillate between stretches of amorphous discomfort as they navigate the dizzying, seemingly endless number of steps that lead to the successful submission of an application. This fear of the unknown can lead to paralysis, and my task becomes manifold. I begin by giving the students a general lay of the land and importing the significance of every deadline. I listen, try to understand their strengths and weaknesses, assess potential, and then attempt tailored advice. My goal is to inspire confidence while also offering a clear picture of the daunting task ahead. A big chunk of this work is done through writing—a task that is misunderstood both in the how and why.

It benefits no one to point out the laziness of admissions committees in asking poorly thought-out questions. An example of this callousness is the invariable question about ‘Diversity.’ Though not always explicitly asked, the question that can take surreptitious forms is a source of confusion and distress especially when put forth with deception. In attempting to address this seemingly touchy subject we stumble and dive into our tangible experiences—the ones we think set us apart. Places traveled or moments spent with sick or dying family members are common starting points. Fortunately, this is followed by recognition of the mundane in everything we’ve done. We subsequently beat ourselves up and quickly start losing conviction as the broken snippets of our lived stories meet dead ends.

So how do we overcome the ensuing paralysis?

I used to struggle when this problem eventually presented itself, not knowing how to help those I was offering guidance. Having spent decades of my life trying to convince the gatekeepers of professional degrees with chains of overlapping activities, I felt there was no other way but to spin a convincing narrative of it all. It took me some time but I realized the question of diversity was never about our experiences. It never mattered if you were born in an impoverished mountain village or an affluent suburban neighborhood. A probable explanation for the indolent questioning started emerging. The healthcare system in the United States (and many other places) requires obedience. It needs people who could be placated with the promise of a life filled with material sufficiency. What better than a satisfied, well-fed servant of the system? The questions the overlords want to ask should offer insight into an individual’s potential for obedience, and if they could ask in a sweet, innocuous way then more power to them.

Now without bringing you too far down this depressing sewage of thought, let me give you my take on how to answer this question about diversity so you can quickly move on to answering the other questions in your supplemental/secondary application. Instead of prose let’s take the banal approach of bullet points.

  • It is not about your experiences.

  • It is not about how your value system or personality aligns with the mission statement of the school—no matter how convincingly they seem to make that claim.

  • It is about whether you can work with others who occupy distinct, unfamiliar niches.

  • It is about your ability to have an open mind, be patient, and ignore the biases you inadvertently hold on to due to circumstance or choice.

  • It is about your ability to project an amenable and functioning persona in the face of things you might have opinions about.

  • It is about you.

The diversity question does not require some fancy interpretation. It is the plain and simple acknowledgment that while we see differences, we are capable of accepting them as differences of culture, circumstance, or choice. One has to draft an agreement of how their open-mindedness will overcome those challenges that possess potential for conflict. Behind the implied nobility of the query is a nefarious and dirty lie—that this is about the health of the people. The statements we make about our understanding of the pillars of medicine—Beneficence, Non-Maleficence, Autonomy, and Justice—are both wonderful and disgusting

The American system of providing healthcare is founded on the exploitation of both the provider and the recipient. I learned this while I was a medical student at Thomas Jefferson University’s Sidney Kimmel Medical College in Philadelphia. Like many other institutions in America, this place taught me how profit and greed crafted a system that was brutally weighed down by legal traps. Empathy is not an attitude to cultivate but a requirement to avoid litigation. Speaking honestly is not a priority, speaking carefully is. This place that I spent 30+ years trying to get to, ended up being one of the most disappointing experiences of my life. A place where I encountered some good people but many horrible ones, and it all started by beating into me this belief that the system was designed to care.

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