ASTRO has gone full woke

[scarbrtj]

Mais bien sûr I am a GQ subscriber. First I'd heard of the dude.

---

Members don't see this ad.

 

[elementaryschooleconomics]

Mais bien sûr I am a GQ subscriber. First I'd heard of the dude.

Wow...what...what is this...

 

[scarbrtj]

Wow...what...what is this...

The way.

 

[Ray D. Ayshun]

The way.

I read the definition of antiracist. It involves actions. Iow, you can't say anything, unless Twitter outrage is now an action. Kinda like gender. Words are now actions, human sacrifice, dogs and cats living together...mass hysteria. It's not enough to not like racists.

 

[scarbrtj]

I read the definition of antiracist. It involves actions. Iow, you can't say anything, unless Twitter outrage is now an action. Kinda like gender. Words are now actions, human sacrifice, dogs and cats living together...mass hysteria. It's not enough to not like racists.

May rad oncs and academic centers may shocked to find out that that Ibram Kendi is totally against billing multiple IMRT plans w/ MRIgRT!

 

[Ray D. Ayshun]

May rad oncs and academic centers may shocked to find out that that Ibram Kendi is totally against billing multiple IMRT plans w/ MRIgRT!

Does hating all of mankind equally = antiracist?

 

[RadOncMegatron]

May rad oncs and academic centers may shocked to find out that that Ibram Kendi is totally against billing multiple IMRT plans w/ MRIgRT!

What if Kendi feels conventional fractionation is a racist tool used by capitalist and we must all use SBRT? Is he a secret agent for APM and bundling?

 

[Ray D. Ayshun]

What if Kendi feels conventional fractionation is a racist tool used by capitalist and we must all use SBRT? Is he a secret agent for APM and bundling?

Commies call it SABR.

 

[OTN]

May rad oncs and academic centers may shocked to find out that that Ibram Kendi is totally against billing multiple IMRT plans w/ MRIgRT!

...and there it is. This is about collectivism as much as (I would say more than) race

 

[thecarbonionangle]

when the breadlines come, and they are, i wonder how folks will feel about “capitalism”. Crooked expansion by unscrupulous chairs and thieving mysoginistic execs: Capitalism or cummunism at its best? You be the judge folks!

 

[RadOncMegatron]

Commies call it SABR.

That's too funny.

 

[OTN]

when the breadlines come, and they are, i wonder how folks will feel about “capitalism”. Crooked expansion by unscrupulous chairs and thieving mysoginistic execs: Capitalism or cummunism at its best? You be the judge folks!

The mixing of state power (the state picking winners and losers via selectively paying some entities much more for the same service) with capitalism is not free-market capitalism, it’s neo-facism.

 

[medgator]

The mixing of state power (the state picking winners and losers via selectively paying some entities much more for the same service) with capitalism is not free-market capitalism, it’s neo-facism.

I think statism might be a more accurate term,

 

[scarbrtj]

FWIW, anybody that talks about anti-capitalism (anti-standard-fractionism??? pro-hyper-residentism??? anti-private-practiceism???) should acknowledge things like this. Someone on twitter arguing "hey, we need less linacs with hypofx, no biggie" and I'm thinking... that will kill tech innovation right? And where would we be without tech innovation in rad onc? Back in a cave in front of a viewbox with a china marker and everybody in the waiting room with G2 desquamation or worse and a death row inmate changing out the cobalt source that's where!

Capitalism is the greatest anti-poverty program the world has ever known

 

[Lamount]

“Greed is good” - so long as it doesn’t let giant hospital systems buy PPs and turn them into low-paying autonomy-crushing satellites, or inspire big academic centers to charge much more than community practices... then we need to break out the Chez Guevara shirts, right?

Well regulated capitalism probably favors society, but mostly favors big fish at the expense of small ones.

 

[seper]

is this lecture free to anyone? will registration be needed?

 

[hbosch]

It's not capitalism when the state chooses to pay MSK and MD Anderson more for the exact same service and these people don't even serve under represented minorities. It is immoral is what it is. Flat out immoral, and the state is in cahoots with them.

ASTRO hiring Kendi to speak is dumb not necessarily because they are being "woke" but because they are being massive disingenuous hypocrites. Kendi's book (Which I have not read but looked into) does have valid criticisms (meaning it should be criticized) but many of the people listed as Obama supporters are actually fairly conservative compared to a progressives- there are however progressives that will not espouse everything Kendi writes in his book...but staying on topic relative to radiation oncology- maybe they actually picked him because he has cancer and he will speak of his experience getting treatment (though he did not get radiation)....who knows...nevertheless it is facetious for this specialty to trick anyone regardless of ethnicity or skin color to coming into this field until they fix the job market and they stop hypocritical pricing of services...

For the people who keep writing I treat all my patients the same, that is decent and expected of you. There are however doctors I have worked with that actively "other" and stereotype in particular black patients "oh you know how they are!" "oh they're loud" "oh they're stubborn" and "oh that's their culture." And I have had patients who vocally complain to me that they "had to see a black doctor" and "oh the surgeon has a name I can't pronounce-why didn't they send me to someone with a name I can pronounce." I have had lots of patients vocalize without hesitation their bigotry, biases and racism...and I still treat them just as I would treat a not racist patient (or less racist, because everyone is a bit racist)...but let's not deny that it is much harder for black doctors than it is for the rest of us and while you specifically may not treat your black patients worse- other people do and I have seen it happen so...

 

[theradiator]

It's not capitalism when the state chooses to pay MSK and MD Anderson more for the exact same service and these people don't even serve under represented minorities. It is immoral is what it is. Flat out immoral, and the state is in cahoots with them.

ASTRO hiring Kendi to speak is dumb not necessarily because they are being "woke" but because they are being massive disingenuous hypocrites. Kendi's book (Which I have not read but looked into) does have valid criticisms (meaning it should be criticized) but many of the people listed as Obama supporters are actually fairly conservative compared to a progressives- there are however progressives that will not espouse everything Kendi writes in his book...but staying on topic relative to radiation oncology- maybe they actually picked him because he has cancer and he will speak of his experience getting treatment (though he did not get radiation)....who knows...nevertheless it is facetious for this specialty to trick anyone regardless of ethnicity or skin color to coming into this field until they fix the job market and they stop hypocritical pricing of services...

For the people who keep writing I treat all my patients the same, that is decent and expected of you. There are however doctors I have worked with that actively "other" and stereotype in particular black patients "oh you know how they are!" "oh they're loud" "oh they're stubborn" and "oh that's their culture." And I have had patients who vocally complain to me that they "had to see a black doctor" and "oh the surgeon has a name I can't pronounce-why didn't they send me to someone with a name I can pronounce." I have had lots of patients vocalize without hesitation their bigotry, biases and racism...and I still treat them just as I would treat a not racist patient (or less racist, because everyone is a bit racist)...but let's not deny that it is much harder for black doctors than it is for the rest of us and while you specifically may not treat your black patients worse- other people do and I have seen it happen so...

we often trash retrospective reviews here but for those who have experience with them:

was race included in your dataset (among countless other variables) and how often was that an independenly significant predictor of an important outcome as opposed to radiation dose, tumor biology, systemic therapy etc?

perhaps that is why this forum is skeptical of the overarching importance of race as the sole prognostic variable.

could race be independently predictive of access to MSKCC or MDACC? possibly or even probably but that wouldn’t advance anyone’s agenda or increase anyone’s chance of promotion

 

[thecarbonionangle]

we often trash retrospective reviews here but for those who have experience with them:

was race included in your dataset (among countless other variables) and how often was that an independenly significant predictor of an important outcome as opposed to radiation dose, tumor biology, systemic therapy etc?

perhaps that is why this forum is skeptical of the overarching importance of race as the sole prognostic variable.

could race be independently predictive of access to MSKCC or MDACC? possibly or even probably but that wouldn’t advance anyone’s agenda or increase anyone’s chance of promotion

of course it would be predictive because these places are total scam “nonprofits” with state funding (fascist?) who do not treat the poor, uninsured, and only take cadillac plans. Plenty of valet parking as well.

 

[OTN]

of course it would be predictive because these places are total scam “nonprofits” with state funding (fascist?) who do not treat the poor, uninsured, and only take cadillac plans. Plenty of valet parking as well.

Correct. UT (with whom MDACC is associated) states that it is NOT part of their mission to treat the poor or uninsured. How a state-funded institution gets to say that is beyond me.

 

[w00tz]

To be fair, MDACC in Houston does cover LBJ hospital with medical oncology (and not sure about radiation oncology? in the works?), which is a county/safe net hospital. Maybe those patients are decently-funded through the county medical insurance plan? But yes, I agree that, in general, the prices they charge are ridiculous. If they really wanted to end cancer, they would make their care more affordable/accessible.

 

[theradiator]

To be fair, MDACC in Houston does cover LBJ hospital with medical oncology (and not sure about radiation oncology? in the works?), which is a county/safe net hospital. Maybe those patients are decently-funded through the county medical insurance plan? But yes, I agree that, in general, the prices they charge are ridiculous. If they really wanted to end cancer, they would make their care more affordable/accessible.

The ultimate question is how to best call out this hypocrisy below SDN and Twitter and get this into mainstream media as an investigative report.

 

[DoctwoB]

Very weird situation. I'd love to hear Kendi speak though am on the fence about his views (some points are reasonable, some are a stretch). It's just weird that it would happen at a medical society meeting and I can certainly understand the frustration that they are ignoring the real issues with Rad Onc and directing energy towards this.

To put out my view in the racism/systemic inequality/biology view, I'd say its damn complicated and anyone offering an overly reductionist view is probably wrong. To look at a single issue. Do African Americans get diabetes at higher rates because of poor individual choices? Biologic susceptibility? Poverty resulting from areas of systemic racism in housing, school, jobs, justice system, etc? Capitalistic aspects of our society that led to promotion of carbs over other foods? IMO the answer is yes to all.

 

[hopelezwanderer]

UT Houston definitely has it in the mission to treat the poor and uninsured, it is affiliated with LBJ the other county hospital . MDACC radiation oncology has no association with LBJ . Baylor covers that site

 

[thecarbonionangle]

UT Houston definitely has it in the mission to treat the poor and uninsured, it is affiliated with LBJ the other county hospital . MDACC radiation oncology has no association with LBJ . Baylor covers that site

Meanwhile plenty of money to build proton centres with the Chinese. Can’t give a poor person XRT. Nothing to see here folks!

 

[scarbrtj]

Meanwhile plenty of money to build proton centres with the Chinese. Can’t give a poor person XRT. Nothing to see here folks!

The gator right as usual.

Black children less likely to receive proton therapy than white children

 

[RickyScott]

The gator right as usual.

Black children less likely to receive proton therapy than white children

its not just children- the discrepancy in adults should be much worse: . Several proton centers (like Harvard and Penn) anecdotally are great when it comes to kids of any economic background, but this wont be extended to adults. Not going to spot many black patients in proton center waiting rooms at MSKCC or MDACC,
Twitter RaRas somehow feel good about delivering 5 fractions of radiation at insane prices which will only be paid by cadillac insurances not accessible to most people. Almost like the hypofractionation serves as some sort of psychological defense mechanism for the high prices that exclusivize their treatment and harm society.

 

[RadOncMegatron]

its not just children- the discrepancy in adults should be much worse: . Several proton centers (like Harvard and Penn) anecdotally are great when it comes to kids of any economic background, but this wont be extended to adults. Not going to spot many black patients in proton center waiting rooms at MSKCC or MDACC,
Twitter RaRas somehow feel good about delivering 5 fractions of radiation at insane prices which will only be paid by cadillac insurances not accessible to most people. Almost like the hypofractionation serves as some sort of psychological defense mechanism for the high prices that exclusivize their treatment and harm society.

These are very real problems with very complicated solutions. No easy answers. I re-iterate with many on here the gross hypocrisy of it all. When you go woke and start virtue signalling, how will these issues not come up? One of the issues this movement has is that the leaders are prominently bourgeoisie univ. professors (like Kendi himself) and now rich, affluent, (not to mention white - I don't care, but they do!), academic physicians are pretending to be not part of the problem. I DONT THINK SO. Dirty laundry is now coming out...

 

[Chartreuse Wombat]

its not just children- the discrepancy in adults should be much worse: . Several proton centers (like Harvard and Penn) anecdotally are great when it comes to kids of any economic background, but this wont be extended to adults. Not going to spot many black patients in proton center waiting rooms at MSKCC or MDACC,
Twitter RaRas somehow feel good about delivering 5 fractions of radiation at insane prices which will only be paid by cadillac insurances not accessible to most people. Almost like the hypofractionation serves as some sort of psychological defense mechanism for the high prices that exclusivize their treatment and harm society.

Adults the same disparities are evident

A Population-Based Assessment of Proton Beam Therapy Utilization in California

This population-based analysis of patients with cancer in California found significant differences in proton beam therapy use by health insurance type, race/ethnicity, and socioeconomic status.

www.ajmc.com

Proton Versus Intensity-Modulated Radiotherapy for Prostate Cancer: Patterns of Care and Early Toxicity

Proton radiotherapy (PRT) is an emerging treatment for prostate cancer despite limited knowledge of clinical benefit or potential harms compared with other types of radiotherapy. We therefore compared patterns of PRT use, cost, and early toxicity among ...

www.ncbi.nlm.nih.gov

The inevitable conclusion based on critical race theory is that people that provide proton therapy are racist.

 

[RadOncMegatron]

Adults the same disparities are evident

A Population-Based Assessment of Proton Beam Therapy Utilization in California

This population-based analysis of patients with cancer in California found significant differences in proton beam therapy use by health insurance type, race/ethnicity, and socioeconomic status.

www.ajmc.com

Proton Versus Intensity-Modulated Radiotherapy for Prostate Cancer: Patterns of Care and Early Toxicity

Proton radiotherapy (PRT) is an emerging treatment for prostate cancer despite limited knowledge of clinical benefit or potential harms compared with other types of radiotherapy. We therefore compared patterns of PRT use, cost, and early toxicity among ...

www.ncbi.nlm.nih.gov

The inevitable conclusion based on critical race theory is that people that provide proton therapy are racist.

Hilarious, but sad. When you look at fat studies, they talk about how the narrative of fat medicine is oppressive and that those scientific studies are biased.

It really is one stone throw away to say that from a critical race point of view, advanced technology is a fruit of white privilege and it is no wonder that white people have more access to the tools they invented.

 

[scarbrtj]

Adults the same disparities are evident

A Population-Based Assessment of Proton Beam Therapy Utilization in California

This population-based analysis of patients with cancer in California found significant differences in proton beam therapy use by health insurance type, race/ethnicity, and socioeconomic status.

www.ajmc.com

Proton Versus Intensity-Modulated Radiotherapy for Prostate Cancer: Patterns of Care and Early Toxicity

Proton radiotherapy (PRT) is an emerging treatment for prostate cancer despite limited knowledge of clinical benefit or potential harms compared with other types of radiotherapy. We therefore compared patterns of PRT use, cost, and early toxicity among ...

www.ncbi.nlm.nih.gov

The inevitable conclusion based on critical race theory is that people that provide proton therapy are racist.

Dr. Curtiland Deville works at a proton center. Here are his thoughts...

August 31, 2020
The Suffocating State of Physician Workforce Diversity
Why “I Can’t Breathe”
Curtiland Deville Jr, MD1

It is a difficult time to witness the outrage of the ravaged and disenfranchised communities of color and the long-standing, systemic oppression of Black people in the US. I find my clinical day job as a radiation oncologist exceptionally fulfilling—supporting, advocating for, and treating men with prostate cancer. What led me to this specialty and disease-site specialization was the firsthand observation that Black men in the US suffer the highest incidence of prostate cancer globally and have a death rate twice that of White men,1 and the apparent ignorance of or apathy about these disparities that I perceived during my training. Yet, the recent health disparities and inequities during the coronavirus disease 2019 (COVID-19) pandemic and the blatant racial and social injustices that have caused multiple Black lives to be unnecessarily killed before our eyes have also affirmed my passion and call to workforce diversity as a means to address health equity.
Despite decades of calls to improve physician workforce diversity, my field, radiation oncology, ranks among specialties that can and must do better with respect to racial, ethnic, and gender diversity.2 In 2018, Black full-time faculty3 and residents4 in the US comprised 6442 of 178 543 (3.6%) and 7430 of 136 028 (5.5%) positions in their respective workforces, compared with 32 of 1842 (1.7%) and 26 of 744 (3.5%) in radiation oncology. The peak of representation for Black residents in radiation oncology was 6.4% in 1998 when there were also 26 Black residents and fewer residents overall.5
I view this disproportionate underrepresentation of Black physicians as complicit exclusion or gross negligence. Moreover, it is perpetuated in many other fields, clinical environments, and health care organizations, particularly on the path to career advancement and leadership. This lack of inclusion and representation is oppressive and takes my breath away.
I can’t breathe when I walk into a room and am the only person who looks like I do, particularly in places of power and achievement. Sadly, I have known this otherness the majority of my lifetime, despite living in diverse, urban environments. Yet the further I advance within my specialty and academic medicine, the more uncomfortable and suffocating it becomes to think that I am the only voice of color or historically underrepresented minority perspective in most meetings and decision-making environments. More perturbing is thinking about the rooms that I have not yet entered and the consequential decisions being made within them, knowing that no one like me may have ever had a seat at that table despite their clear deservedness, competence, and unique insights. On a daily basis, it is defeating and discouraging to realize that structural barriers to health equity may persist owing to a lack of representation of all members of our society at the highest levels. It is an oppressive weight like the knees of the police officers crushing the back and neck of George Floyd. This is not hyperbole. It is the unprivileged, cumulative sum of decades of macroaggressions and microaggressions, stereotype threats, overt and implicit biases, isolationism, and exclusion. It is the need to cry out, “Black Lives Matter!”
And still, I have been fortunate to have an indomitable upbringing and trusted mentors, colleagues, and leaders from a variety of demographic backgrounds who have holistically acknowledged my distance traveled, diverse perspective, and potential to contribute in nontraditional ways, and who without hesitation encouraged me along my educational and professional career. I am eternally grateful for the confidence of these individuals who went beyond their immediate duties to ease the proverbial systemic knee of racism from my neck. I am excited by the diversity of allies emerging during this revolutionary period who are similarly compelled to dismantle the centuries of disenfranchisement that they encounter in their daily lives, as well as the disproportionate underrepresentation in their board rooms, medical specialties, and other places of power and achievement.
I hope this period of change brings meaningful and sustained action behind words. The innumerable statements of solidarity and acknowledgment are ground zero in this conversation, the bare minimum, like “thoughts and prayers” in response to mass shootings. Without a strategic vision, an action plan, well-delineated policies, transparent resources, collective buy-in, and shared accountability, hollow statements risk hypocritically perpetuating the ineffectual systems they profess to change. Together, the local, national, and global demonstrations for racial justice are demanding more than lip service.
Organizational leaders, chairs, and program directors need a period of self-reflection and confession around the paucity of Black trainees and physicians entering their programs. Many may have never trained or hired a Black physician nor created or participated in a pipeline program to actively recruit one. Successful diversity efforts are intentional and explicit, not happenstance or osmotic, as demonstrated by a cardiovascular fellowship program, which developed a recruitment initiative facilitating transition from having never trained an underrepresented minority in 2007 to 25% representation in 2013.6 Similarly, the American Society for Microbiology leadership implemented strategic education—with direct questioning of all male rosters—to achieve gender equity in representation of their annual meeting speakers.7
Structural barriers should be dismantled. For example, Black medical students are less likely to attend schools with affiliated radiation oncology residency programs,8 yet an analysis found nearly 30% of medical students going into radiation oncology matched at their home institution and 80% matched from schools with affiliated programs.9 Where they do not currently exist, specific partnerships and recruitment/pathway programs should be created, funded, and sustained. The same vigor and accountability with which institutions prepared for the COVID-19 pandemic or more routinely prepare for accreditation surveys and other organizational initiatives will be required to facilitate implementation of effective strategies such as holistic admissions and recruitment, training against bias, pipeline expansion and retention, and accountability among leadership.
Ultimately, I am forever encouraged on the path toward improving physician workforce diversity to benefit our patients and society by the words of Frederick Douglass in his 1857 West India Emancipation address, “If there is no struggle there is no progress. Those who profess to favor freedom and yet deprecate agitation are men who want crops without plowing up the ground; they want rain without thunder and lightning. They want the ocean without the awful roar of its many waters.”10

 

[RadOncMegatron]

Dr. Curtiland Deville works at a proton center. Here are his thoughts...

August 31, 2020
The Suffocating State of Physician Workforce Diversity
Why “I Can’t Breathe”
Curtiland Deville Jr, MD1

It is a difficult time to witness the outrage of the ravaged and disenfranchised communities of color and the long-standing, systemic oppression of Black people in the US. I find my clinical day job as a radiation oncologist exceptionally fulfilling—supporting, advocating for, and treating men with prostate cancer. What led me to this specialty and disease-site specialization was the firsthand observation that Black men in the US suffer the highest incidence of prostate cancer globally and have a death rate twice that of White men,1 and the apparent ignorance of or apathy about these disparities that I perceived during my training. Yet, the recent health disparities and inequities during the coronavirus disease 2019 (COVID-19) pandemic and the blatant racial and social injustices that have caused multiple Black lives to be unnecessarily killed before our eyes have also affirmed my passion and call to workforce diversity as a means to address health equity.
Despite decades of calls to improve physician workforce diversity, my field, radiation oncology, ranks among specialties that can and must do better with respect to racial, ethnic, and gender diversity.2 In 2018, Black full-time faculty3 and residents4 in the US comprised 6442 of 178 543 (3.6%) and 7430 of 136 028 (5.5%) positions in their respective workforces, compared with 32 of 1842 (1.7%) and 26 of 744 (3.5%) in radiation oncology. The peak of representation for Black residents in radiation oncology was 6.4% in 1998 when there were also 26 Black residents and fewer residents overall.5
I view this disproportionate underrepresentation of Black physicians as complicit exclusion or gross negligence. Moreover, it is perpetuated in many other fields, clinical environments, and health care organizations, particularly on the path to career advancement and leadership. This lack of inclusion and representation is oppressive and takes my breath away.
I can’t breathe when I walk into a room and am the only person who looks like I do, particularly in places of power and achievement. Sadly, I have known this otherness the majority of my lifetime, despite living in diverse, urban environments. Yet the further I advance within my specialty and academic medicine, the more uncomfortable and suffocating it becomes to think that I am the only voice of color or historically underrepresented minority perspective in most meetings and decision-making environments. More perturbing is thinking about the rooms that I have not yet entered and the consequential decisions being made within them, knowing that no one like me may have ever had a seat at that table despite their clear deservedness, competence, and unique insights. On a daily basis, it is defeating and discouraging to realize that structural barriers to health equity may persist owing to a lack of representation of all members of our society at the highest levels. It is an oppressive weight like the knees of the police officers crushing the back and neck of George Floyd. This is not hyperbole. It is the unprivileged, cumulative sum of decades of macroaggressions and microaggressions, stereotype threats, overt and implicit biases, isolationism, and exclusion. It is the need to cry out, “Black Lives Matter!”
And still, I have been fortunate to have an indomitable upbringing and trusted mentors, colleagues, and leaders from a variety of demographic backgrounds who have holistically acknowledged my distance traveled, diverse perspective, and potential to contribute in nontraditional ways, and who without hesitation encouraged me along my educational and professional career. I am eternally grateful for the confidence of these individuals who went beyond their immediate duties to ease the proverbial systemic knee of racism from my neck. I am excited by the diversity of allies emerging during this revolutionary period who are similarly compelled to dismantle the centuries of disenfranchisement that they encounter in their daily lives, as well as the disproportionate underrepresentation in their board rooms, medical specialties, and other places of power and achievement.
I hope this period of change brings meaningful and sustained action behind words. The innumerable statements of solidarity and acknowledgment are ground zero in this conversation, the bare minimum, like “thoughts and prayers” in response to mass shootings. Without a strategic vision, an action plan, well-delineated policies, transparent resources, collective buy-in, and shared accountability, hollow statements risk hypocritically perpetuating the ineffectual systems they profess to change. Together, the local, national, and global demonstrations for racial justice are demanding more than lip service.
Organizational leaders, chairs, and program directors need a period of self-reflection and confession around the paucity of Black trainees and physicians entering their programs. Many may have never trained or hired a Black physician nor created or participated in a pipeline program to actively recruit one. Successful diversity efforts are intentional and explicit, not happenstance or osmotic, as demonstrated by a cardiovascular fellowship program, which developed a recruitment initiative facilitating transition from having never trained an underrepresented minority in 2007 to 25% representation in 2013.6 Similarly, the American Society for Microbiology leadership implemented strategic education—with direct questioning of all male rosters—to achieve gender equity in representation of their annual meeting speakers.7
Structural barriers should be dismantled. For example, Black medical students are less likely to attend schools with affiliated radiation oncology residency programs,8 yet an analysis found nearly 30% of medical students going into radiation oncology matched at their home institution and 80% matched from schools with affiliated programs.9 Where they do not currently exist, specific partnerships and recruitment/pathway programs should be created, funded, and sustained. The same vigor and accountability with which institutions prepared for the COVID-19 pandemic or more routinely prepare for accreditation surveys and other organizational initiatives will be required to facilitate implementation of effective strategies such as holistic admissions and recruitment, training against bias, pipeline expansion and retention, and accountability among leadership.
Ultimately, I am forever encouraged on the path toward improving physician workforce diversity to benefit our patients and society by the words of Frederick Douglass in his 1857 West India Emancipation address, “If there is no struggle there is no progress. Those who profess to favor freedom and yet deprecate agitation are men who want crops without plowing up the ground; they want rain without thunder and lightning. They want the ocean without the awful roar of its many waters.”10

Counter points from one of my favorite black thinkers, Dr. Walter E. Williams, prof. of econimcs, at GMU.

Selected Syndicated Columns

Articles by Week

walterewilliams.com

Clearly there is diversity of thought on this issue even in the black community, but as Water Williams, Thomas Sowell, and other conservative black intellectuals note they are called some pretty nasty names for daring to disagree.

 

[RickyScott]

I read the definition of antiracist. It involves actions. Iow, you can't say anything, unless Twitter outrage is now an action. Kinda like gender. Words are now actions, human sacrifice, dogs and cats living together...mass hysteria. It's not enough to not like racists.

Dr. Curtiland Deville works at a proton center. Here are his thoughts...

August 31, 2020
The Suffocating State of Physician Workforce Diversity
Why “I Can’t Breathe”
Curtiland Deville Jr, MD1

It is a difficult time to witness the outrage of the ravaged and disenfranchised communities of color and the long-standing, systemic oppression of Black people in the US. I find my clinical day job as a radiation oncologist exceptionally fulfilling—supporting, advocating for, and treating men with prostate cancer. What led me to this specialty and disease-site specialization was the firsthand observation that Black men in the US suffer the highest incidence of prostate cancer globally and have a death rate twice that of White men,1 and the apparent ignorance of or apathy about these disparities that I perceived during my training. Yet, the recent health disparities and inequities during the coronavirus disease 2019 (COVID-19) pandemic and the blatant racial and social injustices that have caused multiple Black lives to be unnecessarily killed before our eyes have also affirmed my passion and call to workforce diversity as a means to address health equity.
Despite decades of calls to improve physician workforce diversity, my field, radiation oncology, ranks among specialties that can and must do better with respect to racial, ethnic, and gender diversity.2 In 2018, Black full-time faculty3 and residents4 in the US comprised 6442 of 178 543 (3.6%) and 7430 of 136 028 (5.5%) positions in their respective workforces, compared with 32 of 1842 (1.7%) and 26 of 744 (3.5%) in radiation oncology. The peak of representation for Black residents in radiation oncology was 6.4% in 1998 when there were also 26 Black residents and fewer residents overall.5
I view this disproportionate underrepresentation of Black physicians as complicit exclusion or gross negligence. Moreover, it is perpetuated in many other fields, clinical environments, and health care organizations, particularly on the path to career advancement and leadership. This lack of inclusion and representation is oppressive and takes my breath away.
I can’t breathe when I walk into a room and am the only person who looks like I do, particularly in places of power and achievement. Sadly, I have known this otherness the majority of my lifetime, despite living in diverse, urban environments. Yet the further I advance within my specialty and academic medicine, the more uncomfortable and suffocating it becomes to think that I am the only voice of color or historically underrepresented minority perspective in most meetings and decision-making environments. More perturbing is thinking about the rooms that I have not yet entered and the consequential decisions being made within them, knowing that no one like me may have ever had a seat at that table despite their clear deservedness, competence, and unique insights. On a daily basis, it is defeating and discouraging to realize that structural barriers to health equity may persist owing to a lack of representation of all members of our society at the highest levels. It is an oppressive weight like the knees of the police officers crushing the back and neck of George Floyd. This is not hyperbole. It is the unprivileged, cumulative sum of decades of macroaggressions and microaggressions, stereotype threats, overt and implicit biases, isolationism, and exclusion. It is the need to cry out, “Black Lives Matter!”
And still, I have been fortunate to have an indomitable upbringing and trusted mentors, colleagues, and leaders from a variety of demographic backgrounds who have holistically acknowledged my distance traveled, diverse perspective, and potential to contribute in nontraditional ways, and who without hesitation encouraged me along my educational and professional career. I am eternally grateful for the confidence of these individuals who went beyond their immediate duties to ease the proverbial systemic knee of racism from my neck. I am excited by the diversity of allies emerging during this revolutionary period who are similarly compelled to dismantle the centuries of disenfranchisement that they encounter in their daily lives, as well as the disproportionate underrepresentation in their board rooms, medical specialties, and other places of power and achievement.
I hope this period of change brings meaningful and sustained action behind words. The innumerable statements of solidarity and acknowledgment are ground zero in this conversation, the bare minimum, like “thoughts and prayers” in response to mass shootings. Without a strategic vision, an action plan, well-delineated policies, transparent resources, collective buy-in, and shared accountability, hollow statements risk hypocritically perpetuating the ineffectual systems they profess to change. Together, the local, national, and global demonstrations for racial justice are demanding more than lip service.
Organizational leaders, chairs, and program directors need a period of self-reflection and confession around the paucity of Black trainees and physicians entering their programs. Many may have never trained or hired a Black physician nor created or participated in a pipeline program to actively recruit one. Successful diversity efforts are intentional and explicit, not happenstance or osmotic, as demonstrated by a cardiovascular fellowship program, which developed a recruitment initiative facilitating transition from having never trained an underrepresented minority in 2007 to 25% representation in 2013.6 Similarly, the American Society for Microbiology leadership implemented strategic education—with direct questioning of all male rosters—to achieve gender equity in representation of their annual meeting speakers.7
Structural barriers should be dismantled. For example, Black medical students are less likely to attend schools with affiliated radiation oncology residency programs,8 yet an analysis found nearly 30% of medical students going into radiation oncology matched at their home institution and 80% matched from schools with affiliated programs.9 Where they do not currently exist, specific partnerships and recruitment/pathway programs should be created, funded, and sustained. The same vigor and accountability with which institutions prepared for the COVID-19 pandemic or more routinely prepare for accreditation surveys and other organizational initiatives will be required to facilitate implementation of effective strategies such as holistic admissions and recruitment, training against bias, pipeline expansion and retention, and accountability among leadership.
Ultimately, I am forever encouraged on the path toward improving physician workforce diversity to benefit our patients and society by the words of Frederick Douglass in his 1857 West India Emancipation address, “If there is no struggle there is no progress. Those who profess to favor freedom and yet deprecate agitation are men who want crops without plowing up the ground; they want rain without thunder and lightning. They want the ocean without the awful roar of its many waters.”10

would love to

Counter points from one of my favorite black thinkers, Dr. Walter E. Williams, prof. of econimcs, at GMU.

Selected Syndicated Columns

Articles by Week

walterewilliams.com

Clearly there is diversity of thought on this issue even in the black community, but as Water Williams, Thomas Sowell, and other conservative black intellectuals note they are called some pretty nasty names for daring to disagree.

would love to hear someone in the black community address diversity in the setting of poor job prospects in radonc. A black doctor is a valuable resource- is it best used in radonc?

 

[seper]

Curt is suffocating? Classic Ivy League career. I know him a bit from training. He is very comfortable with the system.

 

[KHE88]

Is ASTRO paying ibram kendi and if so, how much? Serious question.

I am honestly glad that they have succumbed to the woke mob and allowed this to happen. Because I truly believe that most of us, even if you are not conservative-leaning like I am, are moderate or classically liberal (i.e., non-insane people), and are going to immediately become nauseated with this repulsive fiction.

Ibram kendi and the like (Nikole Hanna Jones, Robin DiAngelo, etc) preach Marxism/collectivism and use race-baiting tactics to achieve their goals. The game is fairly obvious. They use phrases that seemingly everybody would agree with to hide their agenda. They seek to destroy America, because the fundamental premise of America is equal opportunity. They seek equal outcome, which requires heavy-handed government intervention/socialism/restriction of freedom and individual liberty. And often they seek more than equal outcome in the form of attempting to right previous injustices by punishing some identity groups/re-distributing. It's disgusting. And what this all ultimately is doing is make race relations in this country far worse by propagating this lie that America is a deeply racist place, that innocent blacks are being gunned down in the streets en masse, and that any place an racial imbalance exists that it MUST be due only to systemic racism and not other factors.

So along those lines, I am very glad that ASTRO has chosen to do this because apparently some of us didn't already know who this person is. We all need to know who this person is and we all need to listen very carefully to what he is arguing for. We need to understand this evil and where it is coming from.

These people have learned that there is a LOT of money to be made with this scam. You go to organizations and companies and peddle your diversity seminars knowing that if they don't pony up the cash, they can scream racism. Al Sharpton and his organization is most notorious for this. No company wants negative press, so if a group with a clever tagline comes to your company and promotes things that don't involve the apparent mission their tagline suggests, then well you just go along with it because you don't want your company labelled racist by a prominent public figure. Your primary responsibility is to your shareholders. And the books become number one best sellers.

TL;DR: Good job ASTRO. Anybody who had any doubts about where your heads are will now be convinced.

 

[solitarius]

Critical race theory in one sentence:

If you are not anti-racist, then you are racist.

 

[theradiator]

Counter points from one of my favorite black thinkers, Dr. Walter E. Williams, prof. of econimcs, at GMU.

Selected Syndicated Columns

Articles by Week

walterewilliams.com

Clearly there is diversity of thought on this issue even in the black community, but as Water Williams, Thomas Sowell, and other conservative black intellectuals note they are called some pretty nasty names for daring to disagree.

Thanks for sharing. Dr. Williams' 9/2/20 post directly addresses the issue of diversity in professions that is applicable to radiation oncology.

He also cited an article by Rav Avora that I thought was well written.

The fallacy of white privilege — and how it’s corroding society

Last month, I retweeted a comment by a contrarian writer who questioned whether racism was to blame for the spread of the coronavirus, and a close (white) friend responded to me with a well-meaning…

nypost.com

Very important to point out that immigrants from Cuba, Nigeria, Barbados, Trinidad and Ghana all have higher median incomes than the American average to attack the intellectually lazy narrative being promulgated.

The United States is not perfect but remains the shining bastion of freedom. I personally reject racism and have previously argued that oncologists are among the least racist people because we have a common enemy - cancer. No question the United States currently has a problem with poverty, drug addiction and violence that need to be addressed. By embracing BLM and their "solutions", the mainstream media and celebrities have elevated a formerly fringe ideology and ASTRO appears to be jumping on the bandwagon.

 

[medgator]

. By embracing BLM and their "solutions",

Is there a problem?

 

[communitydoc13]

I’m fine with ASTRO doing this. I don’t belong to ASTRO and can fully understand frustrations with the organization, the quality of research in general in radiation oncology and the impact that overtraining has on everyone in the field.

People are excited or at least passionate about the talk. It resonates much like grievance threads on this board or grievance in general. How many talks at ASTRO are people really interested in? How common are practice changing presentations given? We should not indulge in logical fallacies equating the public embrace or traction of things like disparity research or pushes for equity with the lack of real and exciting basic and translational scientific or general clinical research in our field. These things are almost certainly not related. (Of course, health care disparities are real and should be studied scientifically.)

This did not occur in a vacuum. As mentioned above, ASTRO is a political organization. It plays an important role in presenting our profession to the public and lawmakers. In principle, it should aim to present us as a high value and principled group. It should advocate for reasonable remuneration and protect us from creep from outside specialties. The cynical person would say that it should ensure our continued regulatory capture and is a classic special interest group. ASTRO’s public image matters.

The most famous radiation oncologist today is Steve Hahn, who was on the board of directors of ASTRO. He is the head of the FDA, a miraculous regulatory body tracing its roots to the first progressive president (Teddy Roosevelt). I call it miraculous because I have little confidence that the market alone would guarantee the safety, efficacy or even identity of food or medicine delivered to the public. I doubt that anyone on this board believes that the public trust in the FDA has increased under Steve Hahn’s tenure. He is the political appointee of Donald Trump. I will let Trump’s rhetoric, including his cultivation of far right social capital by attacking a black, moderate democrat’s citizenship, speak for itself. But the relationships between Steve Hahn, Trump and the public’s perception of radiation oncology in general is important and I suspect that ASTRO leadership is aware of this and open to narratives far from that represented by the Trump Administration.

I have never been victimized by critical race theory in particular or critical theory in general. I am sure that there have been some victims. I am aware of contentious faculty meetings and frustrations with trying to rectify disparities at a very downstream point where upstream talent is not diverse. I am sure that Bret Weinstein was victimized by radical proponents of critical theory at Evergreen State, an institution not very reflective of our country in general. But, how many of you have been victimized by critical theory? It is a theoretical framework. Like all theoretical frameworks it should be considered and not censored. Bret Weinstein is by the way a much more public intellectual now than he ever was before he was victimized.

I know that systemic racism is real. I know because I am white and middle aged and have heard all the whites only conversations over the years. These conversations now routinely occur in mixed company online forums. When there is anonymity and no upvoting, what is the dominant narrative online? Is it that disparities are complicated and are undoubtedly related to social structures and upbringing and history or is that they are the product of inherent differences?

When I recruit for my red county practice, representative of where the opportunities are and where I was able to land a job, I am aware of color, and the question of whether an applicant of color could be happy there crosses my mind. Mainly because the dominant narrative that I hear from patients and the friends of my teen children is one of white grievance.

 

[Chartreuse Wombat]

I’m fine with ASTRO doing this. I don’t belong to ASTRO and can fully understand frustrations with the organization, the quality of research in general in radiation oncology and the impact that overtraining has on everyone in the field.

People are excited or at least passionate about the talk. It resonates much like grievance threads on this board or grievance in general. How many talks at ASTRO are people really interested in? How common are practice changing presentations given? We should not indulge in logical fallacies equating the public embrace or traction of things like disparity research or pushes for equity with the lack of real and exciting basic and translational scientific or general clinical research in our field. These things are almost certainly not related. (Of course, health care disparities are real and should be studied scientifically.)

This did not occur in a vacuum. As mentioned above, ASTRO is a political organization. It plays an important role in presenting our profession to the public and lawmakers. In principle, it should aim to present us as a high value and principled group. It should advocate for reasonable remuneration and protect us from creep from outside specialties. The cynical person would say that it should ensure our continued regulatory capture and is a classic special interest group. ASTRO’s public image matters.

The most famous radiation oncologist today is Steve Hahn, who was on the board of directors of ASTRO. He is the head of the FDA, a miraculous regulatory body tracing its roots to the first progressive president (Teddy Roosevelt). I call it miraculous because I have little confidence that the market alone would guarantee the safety, efficacy or even identity of food or medicine delivered to the public. I doubt that anyone on this board believes that the public trust in the FDA has increased under Steve Hahn’s tenure. He is the political appointee of Donald Trump. I will let Trump’s rhetoric, including his cultivation of far right social capital by attacking a black, moderate democrat’s citizenship, speak for itself. But the relationships between Steve Hahn, Trump and the public’s perception of radiation oncology in general is important and I suspect that ASTRO leadership is aware of this and open to narratives far from that represented by the Trump Administration.

I have never been victimized by critical race theory in particular or critical theory in general. I am sure that there have been some victims. I am aware of contentious faculty meetings and frustrations with trying to rectify disparities at a very downstream point where upstream talent is not diverse. I am sure that Bret Weinstein was victimized by radical proponents of critical theory at Evergreen State, an institution not very reflective of our country in general. But, how many of you have been victimized by critical theory? It is a theoretical framework. Like all theoretical frameworks it should be considered and not censored. Bret Weinstein is by the way a much more public intellectual now than he ever was before he was victimized.

I know that systemic racism is real. I know because I am white and middle aged and have heard all the whites only conversations over the years. These conversations now routinely occur in mixed company online forums. When there is anonymity and no upvoting, what is the dominant narrative online? Is it that disparities are complicated and are undoubtedly related to social structures and upbringing and history or is that they are the product of inherent differences?

When I recruit for my red county practice, representative of where the opportunities are and where I was able to land a job, I am aware of color, and the question of whether an applicant of color could be happy there crosses my mind. Mainly because the dominant narrative that I hear from patients and the friends of my teen children is one of white grievance.

I hope you feel better after this confession

 

[Ray D. Ayshun]

I’m fine with ASTRO doing this. I don’t belong to ASTRO and can fully understand frustrations with the organization, the quality of research in general in radiation oncology and the impact that overtraining has on everyone in the field.

People are excited or at least passionate about the talk. It resonates much like grievance threads on this board or grievance in general. How many talks at ASTRO are people really interested in? How common are practice changing presentations given? We should not indulge in logical fallacies equating the public embrace or traction of things like disparity research or pushes for equity with the lack of real and exciting basic and translational scientific or general clinical research in our field. These things are almost certainly not related. (Of course, health care disparities are real and should be studied scientifically.)

This did not occur in a vacuum. As mentioned above, ASTRO is a political organization. It plays an important role in presenting our profession to the public and lawmakers. In principle, it should aim to present us as a high value and principled group. It should advocate for reasonable remuneration and protect us from creep from outside specialties. The cynical person would say that it should ensure our continued regulatory capture and is a classic special interest group. ASTRO’s public image matters.

The most famous radiation oncologist today is Steve Hahn, who was on the board of directors of ASTRO. He is the head of the FDA, a miraculous regulatory body tracing its roots to the first progressive president (Teddy Roosevelt). I call it miraculous because I have little confidence that the market alone would guarantee the safety, efficacy or even identity of food or medicine delivered to the public. I doubt that anyone on this board believes that the public trust in the FDA has increased under Steve Hahn’s tenure. He is the political appointee of Donald Trump. I will let Trump’s rhetoric, including his cultivation of far right social capital by attacking a black, moderate democrat’s citizenship, speak for itself. But the relationships between Steve Hahn, Trump and the public’s perception of radiation oncology in general is important and I suspect that ASTRO leadership is aware of this and open to narratives far from that represented by the Trump Administration.

I have never been victimized by critical race theory in particular or critical theory in general. I am sure that there have been some victims. I am aware of contentious faculty meetings and frustrations with trying to rectify disparities at a very downstream point where upstream talent is not diverse. I am sure that Bret Weinstein was victimized by radical proponents of critical theory at Evergreen State, an institution not very reflective of our country in general. But, how many of you have been victimized by critical theory? It is a theoretical framework. Like all theoretical frameworks it should be considered and not censored. Bret Weinstein is by the way a much more public intellectual now than he ever was before he was victimized.

I know that systemic racism is real. I know because I am white and middle aged and have heard all the whites only conversations over the years. These conversations now routinely occur in mixed company online forums. When there is anonymity and no upvoting, what is the dominant narrative online? Is it that disparities are complicated and are undoubtedly related to social structures and upbringing and history or is that they are the product of inherent differences?

When I recruit for my red county practice, representative of where the opportunities are and where I was able to land a job, I am aware of color, and the question of whether an applicant of color could be happy there crosses my mind. Mainly because the dominant narrative that I hear from patients and the friends of my teen children is one of white grievance.

What's white grievance?

 

[communitydoc13]

I hope you feel better after this confession

Ha! I feel a little bit better and look forward to more clinical threads. I have confidence in this forum and the obvious talent present. Anonymity provides value in discussing clinical issues.

What's white grievance?

Feeling that things are stacked against you. That your privilege is overestimated or that your white identity makes it harder for you than for a racial minority. Maybe I should have said "white victimization". I agree that identifying as a victim is not helpful for anyone.

 

[RadOncMegatron]

Ha! I feel a little bit better and look forward to more clinical threads. I have confidence in this forum and the obvious talent present. Anonymity provides value in discussing clinical issues.


Feeling that things are stacked against you. That your privilege is overestimated or that your white identity makes it harder for you than for a racial minority. Maybe I should have said "white victimization". I agree that identifying as a victim is not helpful for anyone.

I think it’s good to come here with your point of view. We disagree here and there, but appreciate your willingness to engage. What I think is not appreciated is the self-silencing due to fear of retaliation. Real or not, it someone should say “it’s ok to disagree with us on diversity issues.” This is most certainly not the case. You and a I disagree, but sounds like you want to hear me out, unfortunately it is not like that with those espousing these views (in fact it’s part of their ideology). Did you see what happens to Dr. Norman Wang? He wrote a standard opposing view to affirmative action and was vilified nationally not just on Twitter and the media, but by PITT and the American Heart Association. He lost his position as the EP fellowship director. First Amendment scholars troubled by Pitt’s demotion of professor for saying affirmative action harms students | The College Fix

This “cancel culture” is real and we all are concerned their can be no debate on whether Prof. Kendi should speak. I encourage more posts from those who do agree Prof. Kendi should speak at ASTRO and for a lack of a better term our “woke” colleagues to have dialog here. It will be heated but we all need it.

 

[deleted605854]

I just wanted to zap cancer. Use tech to zap cancer. I like it. I truly enjoy it. It brings both purpose and escapism into my life.

First the prospects go up in smoke and then the escapism is whisked away.

Oh well.

It is what it is.

 

[2021Doctor]

What exactly is ASTRO doing about the job market situation?

 

[communitydoc13]

I think it’s good to come here with your point of view. We disagree here and there, but appreciate your willingness to engage. What I think is not appreciated is the self-silencing due to fear of retaliation. Real or not, it someone should say “it’s ok to disagree with us on diversity issues.” This is most certainly not the case. You and a I disagree, but sounds like you want to hear me out, unfortunately it is not like that with those espousing these views (in fact it’s part of their ideology). Did you see what happens to Dr. Norman Wang? He wrote a standard opposing view to affirmative action and was vilified nationally not just on Twitter and the media, but by PITT and the American Heart Association. He lost his position as the EP fellowship director. First Amendment scholars troubled by Pitt’s demotion of professor for saying affirmative action harms students | The College Fix

This “cancel culture” is real and we all are concerned their can be no debate on whether Prof. Kendi should speak. I encourage more posts from those who do agree Prof. Kendi should speak at ASTRO and for a lack of a better term our “woke” colleagues to have dialog here. It will be heated but we all need it.

I appreciate your reply.

You won't hear from me that there isn't a tyranny on the left. There absolutely is. Now in terms of "cancel culture", I think it is important to clarify what that means. Norman Wang was absolutely cancelled because punishment was met out. The punishment is a critical part of cancelling. Disagreeing, unfriending on social media, unfriending in person or insulting are in my mind not cancelling (nor is quitting ASTRO because Kendi was invited to speak). I would say that a boycott is not cancelling. I think it is fair to say that today right leaning people in academia reasonably feel threatened by the prospect of cancelling. Of course, left leaning people have been cancelled in the past and Marxism is used as a dirty word in this thread.

I strongly believe in free speech and would hopefully not cancel anyone outside of criminality, cruelty or negligence.

I don't know Kendi's work well but agree that the proposal for a government department with vast powers and no political oversight is bad and can be described as totalitarian. I also think Wang shouldn't have been cancelled.

I like the Smithsonian's definition of antirascism. Doesn't seem so onerous. Not sure how you would criticize someone who earnestly tries to do this.

There is so much we could discuss. I'll lead with some somewhat propositional logic. Help me fill in the connectors.

Premise 1. There are no meaningful differences in intrinsic potential regarding the subtle human qualities of intelligence, work ethic or character between large groups of people assigned to traditional racial groups.

Premise 2. There are marked disparities in wealth, educational achievement and healthcare outcomes between these groups.

I'll ask you to connect these two honestly.

I contend that if you hold premise 1 to be true, actionable factors that lead to premise 2 must be present. (Prove me wrong.) I also contend that it is society's responsibility to address these. (This may be a matter of taste. Maybe "wokeness" is defined by this second contention.)

I doubt many on this board would deny premise 2.

I contend that when people acknowledge (even privately) premise 2, but are morally opposed to studying or emphasizing actionable factors that could connect premise 1 to premise 2, they are usually denying (even privately) premise 1. (I may be wrong, and am open to arguments about why these actionable factors should not be addressed).

I acknowledge that you can accept both Premise 1 and Premise 2, feel that it is morally right to address actionable factors that lead to Premise 2, and still not support particular programs such as affirmative action.

I'll accept any connector.

 

[Chartreuse Wombat]

Long answer to be found in this book

Amazon product

Discrimination and Disparities gathers a wide array of empirical evidence to challenge the idea that different economic outcomes can be explained by any one factor, be it discrimination, exploitation, or genetics.

 

[Lamount]

Premise 1. There are no meaningful differences in intrinsic potential regarding the subtle human qualities of intelligence, work ethic or character between large groups of people assigned to traditional racial groups.

Premise 2. There are marked disparities in wealth, educational achievement and healthcare outcomes between these groups.

When it comes to access to healthcare, treatment of disease, and outcome measures, I agree that equity between races is a reasonable goal. Absent a specific and verifiable biological cause for a disparity ( I.e. SS disease being more prevalent in African and Middle eastern populations), there is no reason we should accept worse outcomes for one group, and should work to rectify any deficiencies that lead to differences.
The case for Racial/gender/ethnic equity among students at a given school or doctors in a given specialty is more dubious, in my opinion.

Between premise 1 and 2 is an assumption: all groups want the same things. When it comes to health, it is safe to assume that all groups would prefer to be healthy, given the opportunity. But you can’t necessarily ASSUME that the desire to go to med school is flat between all races, religions, cultures and genders... let alone a specific specialty. Maybe women tend to prefer doing OB/Gyn whereas men prefer rad onc. Maybe the opposite is true. Before I could ever entertain affirmative action, I would like to see GOOD data showing me that differences exist DESPITE equal desire. Do these data exist?

btw I am huge fan of having this discussion... appreciate you starting it

 

[Mandelin Rain]

A people should be able to fully overcome 400 years of enslavement, systemic discrimination, education denial, wealth denial, power denial, and incarceration in two generations even while most of those factors still exist.

If they can’t, it’s their problem, imo. And if I have to hear about it, in most ways, that makes me the biggest victim of them all.

 

[Mandelin Rain]

1. African Americans have always been treated equally in this country (since they were brought on slave ships) and where we stand currently is an entirely just outcome.

2. Historically, African Americans were treated poorly in America, but that all ended instantly in 1968 and in the interim 52 years they should have just bootstrapped themselves to equals.

3. Historically, African Americans were treated poorly and currently they are treated less poorly. That should be good enough.

4. I don’t care, because the current system works well for me and mine and I’m afraid to see it changed.


Those are really the 4 options that you can take. Unfortunately, I think most people are #4.