As my colleagues and I entered the residency application cycle my medical school announced it would be joining a number of other prominent institutions in suspending the election of medical students to AOA the medical school honors society. I cannot fault this decision as it was taken based on the consensus opinion of the medical student body. Acceptance does not preclude frustration however with the process. In this piece, I would like to reflect on these considerations of how the decision may have been better taken.
Firstly, this close to the residency application season the loss of such an honor many of my colleagues have worked hard towards and deserve is highly unfair. It is my opinion and one shared by other advocates of separating from AOA that this is not the type of decision to be rushed particularly when those on the threshold of residency applications bear the brunt of potential consequences while those making them are established in their careers. At the earliest, it is my view that this type of decision should be done if at all in the spring with ample time to explore alternatives and implications to the loss of a well-understood commendation. What frustrates me more is the seeming hypocrisy of ceasing student nominations while maintaining school affiliation. To me, this looks like little more than paying lip service to reforms towards equity in AOA while precluding the school from paying any cost in terms of access to grants, the reflected glory of students who receive them or faculty honors the AOA may bestow. If the national AOA is such a problematic institution that we no longer trust its processes to honor students how do we justify giving it more decision-making authority with even less representation? I have enormous trust in my colleagues and so perhaps too much faith in the nomination process but as it stands now all AOA-associated decisions regarding my school is in the hands of strangers.
With regards to AOA, I have no dog in the fight as the likelihood of my nomination was quite low and my receipt of the full honor still lower. In addition, I am well aware of the uncomfortable reality that much of medicine inextricably meshed with discrimination and inequity, it is in fact one of the central focuses of my academic life. What frustrates me is that my school failed to take a full stance. Had we chose to stay then we retain the opportunity to induct person by person the best among us and move the flawed and reactionary elements within the AOA and medicine more generally in the right direction. To leave fully would send a clear message that we believe the data on racial bias within AOA recipients is irreconcilable with the culture and beliefs of our school. To leave with the liminality we have is to diminish our voices from the discussion and opportunity to be the change we would like to see while also offering, at best, a lukewarm rebuke so realities allegedly so concerning that a group of students on the cusp of one of most significant moments of their career was made to forcibly sacrifice a key marker of their years of effort and accomplishment.