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U.S.|With End of Affirmative Action, a Push for a New Tool: Adversity Scores

https://www.nytimes.com/2023/07/02/us/affirmative-action-university-of-california-davis.html
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AFFIRMATIVE ACTION

 * Supreme Court Deems Practice Unlawful
 * Read the Decision
 * Highlights From the Ruling
 * How Admissions Could Change
 * Other Key Rulings

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WITH END OF AFFIRMATIVE ACTION, A PUSH FOR A NEW TOOL: ADVERSITY SCORES

To build a diverse class of students, the medical school at U.C. Davis ranks
applicants by the disadvantages they have faced. Can it work nationally?

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The medical school at the University of California, Davis, is one of the most
diverse in the country.Credit...Jim Wilson/The New York Times


By Stephanie Saul

July 2, 2023, 5:00 a.m. ET
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For the head of admissions at a medical school, Dr. Mark Henderson is pretty
blunt when sizing up the profession.

“Mostly rich kids get to go to medical school,” he said.

In his role at the medical school at the University of California, Davis, Dr.
Henderson has tried to change that, developing an unorthodox tool to evaluate
applicants: the socioeconomic disadvantage scale, or S.E.D.

The scale rates every applicant from zero to 99, taking into account their life
circumstances, such as family income and parental education. Admissions
decisions are based on that score, combined with the usual portfolio of grades,
test scores, recommendations, essays and interviews.

The disadvantage scale has helped turn U.C. Davis into one of the most diverse
medical schools in the country — notable in a state that voted in 1996 to ban
affirmative action.



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With the Supreme Court’s ruling last week against race-conscious admissions, the
medical school offers a glimpse of how selective schools across the country
might overhaul their admissions policies, as they look for alternative ways to
achieve diversity without running afoul of the new law.

Last week, President Biden called adversity scores a “new standard” for
achieving diversity.

Word has gotten out about the U.C. Davis scale. Dr. Henderson said that about 20
schools had recently requested more information. And there are other
socioeconomic measurements, including Landscape, released in 2019 from the
College Board, the nonprofit that administers the SATs. That tool allows
undergraduate admissions offices to assess the socioeconomic backgrounds of
individual students.

But skeptics question whether such rankings — or any kind of socioeconomic
affirmative action — will be enough to replace race-conscious affirmative
action. And schools that use adversity scales may also find themselves wandering
into legal quagmires, with conservative groups promising to fight programs that
are simply stand-ins for race.

Over the years, medical schools have made some progress in diversifying their
student bodies, with numbers ticking up. But just like undergraduate admissions,
wealth and connections continue to play a determining role in who is accepted.
More than half of medical students come from families in the top 20 percent of
income, while only 4 percent come from those in the bottom 20 percent, according
to data from the American Association of Medical Colleges.

There is also a family dynamic. Children of doctors are 24 times more likely to
become doctors than their peers, according to the American Medical Association.
It’s hard to know why the profession passes down from generation to generation,
but the statistic drove the association to adopt a policy opposing legacy
preferences in admissions.



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“That’s a staggering economic gap between medical students and the general
public,” said Dr. Henderson, who comes from a working-class upbringing and now
serves as associate dean of admissions.

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As a consequence, the number of Black doctors remains stubbornly low: About 6
percent of practicing doctors in the United States are Black, compared with 13.6
percent of the American population who identify as Black.


Image

Dr. James E.K. Hildreth, president of Meharry Medical College, left, says the
Supreme Court’s decision will lower the number of Black doctors. Credit...Travis
Loller/Associated Press


With the Supreme Court decision, “that number is likely to go down,” said Dr.
James E.K. Hildreth, the president of Meharry Medical College, formed in 1876 in
Nashville to train Black health care providers.

Leaders in medicine say training more Black and Hispanic doctors could help
bridge the vast divides in American health care. Research shows that doctors
from underrepresented racial and ethnic groups are more likely to work in
primary care or in locales where doctors are scarce.



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And patients have better outcomes when treated by doctors from similar
backgrounds, said Dr. Jesse M. Ehrenfeld, president of the American Medical
Association.



The U.C. Davis scale has drawn attention because of its ability to bring in
diverse students using what the schools says are “race-neutral” socioeconomic
models.

In its most recent entering class of 133 students, 14 percent were Black and 30
percent were Hispanic. Nationally, 10 percent of medical school students were
Black and 12 percent were Hispanic. A vast majority of the U.C. Davis class — 84
percent — comes from disadvantaged backgrounds, and 42 percent are the first in
their family to go to college.

The overall acceptance rate has been less than 2 percent.

In the Davis scale, first used in 2012, eight categories establish an adversity
score for each candidate. Factors include family income, whether applicants come
from an underserved area, whether they help support their nuclear families and
whether their parents went to college.

The higher an applicant rates on the disadvantage scale, the bigger the boost.

There is no set formula on how to balance the scale with the academic record,
Dr. Henderson said, but a simulation of the system revealed that students from
underrepresented groups grew to 15.3 percent from 10.7 percent. And the share of
economically disadvantaged students tripled, to 14.5 percent of the class from
4.6 percent.



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At the same time, scores from the MCAT, the standardized test for medical school
applications, dropped only marginally.

Still, it’s not easy to persuade medical schools to upend admissions standards,
particularly anything that undermines the value of test scores and grades. Dr.
Henderson said he had received pushback from his own colleagues.

“Doctors say their kids got into medical school elsewhere, and they didn’t get
in here,” he said.

As the children of doctors, he said, those applicants earned an S.E.D. score of
zero.

A number of scholars, including Richard D. Kahlenberg, have promoted using
class-conscious preferences, which they say could address racial inequities in
education without fostering the resentment often prompted by racially based
diversity plans.

And President Biden said on Thursday that his administration would develop a
“new standard for colleges taking into account the adversity a student has
overcome.”



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“The kid who faced tougher challenges has demonstrated more grit, more
determination,” Mr. Biden told reporters at the White House, “and that should be
a factor that colleges should take into account in admissions.”


Image

Dr. Mark Henderson said other schools had reached out for more information about
the U.C. Davis disadvantage rankings. But skeptics questioned whether they could
make up for race-conscious admissions. Credit...Jim Wilson/The New York Times


He might be talking about someone like Eleanor Adams, a member of the Choctaw
Nation, who said that she did not think medical school was an option for her.

“I didn’t grow up with a lot of money,” she said.

But she found mentors who encouraged her, and today she is in her third year of
medical school at U.C. Davis, which is in Sacramento. She plans to become an
Indian Health Service doctor in Oklahoma — fulfilling one of the school’s goals,
Dr. Henderson said, which is to train doctors who will return to their
communities.

At schools in other states without affirmative action, such as the University of
Michigan, admissions officials have complained that enrolling more
socioeconomically disadvantaged students has not significantly increased the
share of Black, Hispanic and Native American students.



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“Those tools certainly have utility, but they fall short of accomplishing what a
race-conscious admission practice does,” said Dr. Ehrenfeld of the American
Medical Association.

The socioeconomic rankings could also be legally challenged. Chief Justice John
G. Roberts Jr., in his majority opinion on affirmative action, wrote that
colleges could consider how race had affected an applicant’s life. But he also
warned against using proxies for race.

The Pacific Legal Foundation, a libertarian activist group, has already sued a
selective school, Thomas Jefferson High School for Science and Technology in
Alexandria, Va., for using economic factors as stand-ins for race in admissions.

Joshua P. Thompson, a lawyer for the foundation, said the legal questions
surrounding these disadvantage indexes were complex.

“I think the devil is going to be in the details,” Mr. Thompson said. “The
Supreme Court was pretty clear that what can’t be done directly can’t be done
indirectly.”



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Should it come to that, Dr. Henderson said that his school’s disadvantage scale
would be defensible in court.

“Am I worried about it? Yes,” Dr. Henderson said of a lawsuit. “Is it going to
stop me? No.”



Stephanie Saul is a national education reporter based in New York. @stefsaul

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