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NMA leader says black students are victims of unfair grading

[[image - black and white photograph of Emerson Walden, MD]]
[[caption]] Emerson Walden, MD [[/caption]]

Efforts to increase minority admissions to America's medical schools are being undermined, in some cases, by professors who grade students on the basis of skin color instead of achievement, according to the outgoing president of the National Medical Assn. (NMA).

Emerson C. Walden, MD, says the age-old problem of getting nonwhites into medical school is being unnecessarily complicated by the problem of keeping them there once they get in.

"The National Medical Assn. is currently looking into several cases where, for nonacademic reasons, the people who tried so hard to get into school are being forced out," says the Baltimore, Md., surgeon. "It's a national problem."

Dr. Walden says the NMA also has appointed a top-level task force to investigate reports that at least 200 black syphilitics were allowed to suffer without treatment during a 40-year study conducted in Alabama by the U.S. Public Health Service.

DISCUSSION on these issues is expected to highlight the NMA's 77th annual convention and scientific assembly, Aug. 13-17, in Kansas City, Mo., adds Dr. Walden.
 
Other items on the convention agenda include minority health manpower, national health insurance, health maintenance organization (HMO) legislation, medical school scholarships for minority students, and public education about sickle cell anemia.

On the subject of alleged discrimination against black medical students, Dr. Walden declares, "This is an unnecessary onus to add to the rigors of a medical discipline. Worse yet, the kids themselves are reluctant to complain because they don't want reprisals."

Dr. Walden declines to identify specific schools where the problem is said to exist. "But," he adds, "a typical, documented case goes like this: A black kid is doing well in relation to his peers; he's keeping up; he's studying like hell; his peers are passing and he's failing."

The NMA, he says, has succeeded in identifying individual instructors who are guilty of applying tougher standards to nonwhite students, "...and once the hot light of public opinion is aimed at them they usually back off, the problem takes care of itself."

DR. WALDEN is quick to add that many cases of academic trouble are not due to bigotry. "Our job is to uncover the facts. If a kid can't hack it or just isn't 'bringing it,' all we can do is encourage him to work harder, and we hope that tutorial or remedial services are available if needed."

Minority physicians currently comprise 4-7% of the nation's MD population, Dr. Walden estimates, noting that the NMA's goal is 12% by 1975. This underscores the importance of getting more nonwhites into medical school and keeping them there, he says.

Unanswered questions continue to cloud reports that the U.S. Public Health Service used human guinea pigs in a 40-year experiment involving syphilis, concedes Dr. Walden. "But if the reports are true, this is reprehensible, intolerable, unscientific, inhumane, and unforgivable. It smacks of genocide."

THE EXPERIMENT, initiated in Tuskegee, Ala., reportedly involved 600 black men, 200 of whom were allowed to suffer the effects of syphilis untreated—even after penicillin was discovered as a cure. Some participants were said to have died of the disease.

Dr. Walden says he cannot predict what the NMA convention's reaction will be to all of this, but he hints that it probably will be strong.

On other possible NMA convention issues:

"We think the sickle cell problem has been brought fairly well into perspective," says Dr. Walden. "Most people now realize that it is not the scourge of blacks that hypertension is."

Still, he notes, much work remains to be done in eliminating confusion and ignorance about the disease. "Our major thrust is to educate whites as well as blacks about sickle cell—namely, that it is not only a black condition...and that there is a big difference between sickle cell disease and sickle cell trait.

"SOME BLACK PEOPLE," Dr. Walden says, "are not being hired, some are not getting insurance, others are paying more for insurance, simply because of fears about sickle cell trait."

This is why mass sickle cell screening programs can do more harm than good if they are not coupled with effective counseling and public education programs, adds the Baltimore physician. 

With several HMO bills being considered by Congressional committees, the NMA has been lobbying for 100 support—grants or loans—of HMO projects in low-income areas, Dr. Walden says. The medical association, he adds, is also urging a policy of reciprocity between new HMOs and established health providers.

"We don't want entrepreneurs bringing HMOs into capital-starved areas and driving out or absorbing the minority practitioners who might be there. We've already seen this sort of thing in a few cases," Dr. Walden reports.

"WE THINK THAT, by law, the existing practitioner should be allowed to remain independent, and should be able to see the HMO's patients under some kind of equitable reimbursement plan."

The outgoing NMA president adds that his association continues to view the HMO as an unproven concept, one that must be given careful trial over a period of time.

This year's NMA convention follows 12 months of organizational progress during which the association has raised its membership dues and established a new headquarters in Washington, D.C.

The number of dues-paying members is unclear, though it is believed that virtually all of the nation's 6,000 non-white MDs have—at one time or another—paid dues, and the NMA claims all of them.