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Ebert on Davis

THE MAIL

To the Editors of The Crimson:

Judith Kogan, Diane Sherlock and other members of the Crimson editorial staff, over the past few days, have written a series of in depth articles dealing with a critique of medical school admissions and medical student evaluations. The Crimson also has commented editorially on the critique.

An article by Dr. Davis, entitled "Academic Standards in Medical Schools," published in the New England Journal of Medicine, precipitated the issue. What may not be generally known is that Dr. Davis was criticizing the Harvard Medical School specifically, since his published article was based on an internal document written by Dr. Davis for presentation to the Faculty Council. It is for this reason that I feel it is incumbent upon me to rebut the charge that the Harvard Medical School may be granting the M. D. degree on a "charitable basis" or that any of our graduates, whether minority or non-minority, many endanger the public because of inadequate preparation. Here are some facts.

1. Identical standards are used for judging all students at the Harvard Medical School. The chairmen of all of the preclinical departments have issued a signed statement to the effect that all students who graduate from the Harvard Medical School have received intensive training in the biological basis of medicine and all have been evaluated by the same academic standards. Similarly, there is no evidence to suggest that dual standards are used in the clinical clerkships.

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2. Dr. Wealt, Senior Associate Dean for Clinical Affairs and internship advisor, reviewed in its entirety each record of each medical student graduating in the Class of 1976 and interviewed each student. Not only did he judge that all were highly qualified, but he was unable to distinguish between minority and non-minority students on the basis of their records.

3. The Harvard Medical School uses a pass-fail system of grading in the preclinical portion of the curriculum and does not calculate class standings. Grades are given, however, in the clinical years, and the grades A and B are considered honor grades. Since students do not take all of the same clinical courses, it is difficult to compare overall performance. However, all students are required to take "core" clerkships in medicine and surgery. The Registrar has reviewed the records of all students graduating in 1974 and 1975 and has calculated the percentage receiving honor grades in both medicine and surgery. For the Class of 1974, 66 per cent of the total class received honor grades in both clerkships, and 50 per cent of minority students received honor grades in both. For the Class of 1975, 79 per cent of the total class and 74 per cent of the minority students received honor grades in both clerkships.

4. One measure of quality of medical students is internship selection. I have personally reviewed the results of the Internship Matching Plan for Harvard medical students in the Class of 1976 and I am unable to distinguish any differences in the quality of the internship appointments for minority and non-minority students. Minority students have been appointed to a variety of high quality internships, including the Massachusetts General Hospital (medicine), Los Angeles County Harvor General Hospital (medicine and surgery), University of California Hospital, San Francisco (medicine), Presbyterian Hospital, New York City (medicine), University of Texas Southwestern Affiliated Hospitals, Dallas (medicine), Yale-New Haven Medical Center, New Haven, Connecticut (surgery), Children's Center University Hospital, Seattle, Washington (pediatrics), Standford University Hospital, California (medicine), Bronx Municipal Hospital Center, New York City (pediatrics), Peter Bent Brigham Hospital, Boston (medicine).

5. Dr. Davis used the example of a student who had failed Part I of the National Boards five times and yet was granted his M. D. degree as proof of his point that Harvard (by implication) was irresponsible in protecting the public interest. What he neglected to state, because he had not bothered to inform himself of the facts, was that the student in question was granted the M. D. degree only after a year of highly satisfactory clinical performance on the wards of a distinguished hospital, documented by letters from all of the chiefs of service under whom he served. Nor did Dr. Davis mention that the student had passed Part II of the National Boards. There is nothing to suggest that this man will be anything but a fine physician. To consider that he might be a danger to patients is ludicrous.

Harvard Medical School takes pride in the quality of all of its graduates and reaffirms that all have completed a rigorous medical education. It rejects the notion that any of its graduates might be a danger to the public because of inadequate preparation. And, finally, the Medical School reaffirms its commitment to the education of able minority students. Robert H. Ebert, M.D.   Dean of the Harvard Medical School

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