Discrimination against Asian-Americans is not an easy topic, particularly in the field of medicine. Clearly, there are a disproportionate number of Asians in medicine. Although we make up only 5.6% of the US population, we account for 19.8% of medical school graduates. That fact alone makes it easy to dismiss the idea of discrimination without giving it much thought.
From personal experience, most of the Asian doctors I know don’t perceive a problem with representation, either. Some will tell you we don’t face inequity at all. As for myself, I assumed any bias against Asian-Americans was relatively minor. I’ll admit that I was very comfortable with the status quo and shied away from conversations regarding discrimination. I reasoned that I should be satisfied with my own modicum of success, since it was and still is painfully clear that other minorities have it worse.
However, A study published in JAMA Internal Medicine has shined some new light on the subject. The findings suggest that, even today, Asians and white students are not nearly as equal as commonly assumed.
Researchers at Yale studied a simple question: does a student’s ethnicity affect their chances of becoming a member of Alpha Omega Alpha (AOA), a national medical honor society? The answer in short: yes it does, and to a surprising degree. A white student was twice as likely as an Asian student to be inducted into AOA.. This analysis took standardized test scores, leadership and community service hours, and research productivity into account. To put this into perspective: if two students scored similarly on the step I board exam and published similar number of research papers, the odds of the Asian student joining AOA was half that of the white student.
Being an AOA member won’t make or break your medical career—some school don’t even have an AOA chapter—but it’s an indisputable fact that having membership will directly impact your ability to compete for residency positions. It can even determine what field of medicine a student will eventually be able to practice. As the graph below shows, the chances of matching into any given specialty are much higher for AOA members — in some specialties, there are ZERO AOA members who are “not matched.” Finally, anyone in medicine can attest that where you do your residency training also has a lasting effect on your career in the long run.
The study is limited in its scope. It does not address where bias enters the system. Each local chapter determines its own rules for induction into AOA – making generalizations about AOA membership difficult. At my medical school, grades were assigned points, and enough points meant you qualified for AOA. However, grades are not standardized between schools. Some schools do not grade the first two years. Some don’t use grades at all. For the same reason, the Yale study was not able to take grades into consideration. So, it remains a possibility that Asian American medical students had significantly lower grades in medical school despite performing equally in other areas, and thus were not granted AOA status for that reason. Most would agree that the more reasonable conclusion is that a subtle, and perhaps unconscious, bias is keeping minority students out of AOA.