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  • Medical Students Support Marriage Equality as Supreme Court Hears DOMA and Proposition 8 Cases

    As the Supreme Court of the United States heard oral arguments this week in two marriage equality cases, Hollingsworth v. Perry and Windsor v. United States, the American Medical Student Association reiterates its longstanding support of marriage equality for same sex couples.

    “The institution of marriage should be extended to any two individuals who love each other, period.” says Dr. Elizabeth Wiley, national president of AMSA-USA. “As the nation’s next generation of physicians, we must stand up for our patients. Marriage equality is a public health issue.”

    Discriminatory policies and social practices are likely to perpetuate stigmatisation of lesbian, gay, bisexual, transgender and intersex persons, resulting in negative health effects. According to a study done at Emory University, states' constitutional bans on gay marriage escalate new HIV infections at a rate comparable to four cases per 100,000 people.

    This comes as there is growing support internationally among medical students for marriage equality. Earlier this month in Baltimore, the International Federation of Medical Students’ Associations (IFMSA) General Assembly announced its support for marriage equality worldwide . This month, more than 1,000 medical students from across the globe gathered in Baltimore for the International Federation of Medical Students’ Associations (IFMSA) March Meeting.

    The Australian Medical Students’ Association (AMSA - Australia) tabled the statement, calling on governments worldwide to recognize same-sex marriage. The American Medical Student Association (AMSA-USA) and the New Zealand Medical Students’ Association (NZMSA) co-seconded the policy that was submitted to the IFMSA, which represents over 1.3 million medical students across more than 100 nations.

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  • Does affirmative action belong in medicine?

    As the gatekeepers to the medical profession, medical schools have obligations that extend beyond their individual students to society at large. Those obligations include redressing current disparities in health care, where minority patients tend to receive less and lower quality care than others.

    This statement comes from the amicus brief that AMSA has recently signed in the case of Fisher v. the University of Texas. Last week, the Supreme Court heard oral arguments in this case.

    About the case: Abigail Fischer charged that she was denied admission to the University of Texas at Austin because they gave preferential treatment to minority students. She is white. The university argues that Ms. Fischer did not meet the admission criteria and simply was not accepted to the program. 

    In any event, the issue here is affirmative action as it pertains to medicine. We won't comment directly on the case but instead discuss how physicians need to understand diverse cultures in order to make the system work. 

    Research shows that when physicians understand more about the diverse cultures of their patients, physician decision-making is better informed, patients are more likely to follow their physicians’ advice, and medical outcomes improve.

    At the same time, we see minority populations continue to disproportionately suffer from health conditions. These disparities cannot continue. AMSA signed on to this "friend of the court" because we agree with the AAMC, the main organization on this amicus brief, that medical schools are the key to eliminating the health disparities described above is to develop a workforce of people from all backgrounds to bridge the current differences between providers and patients. 

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  • Landmark Case Could Change Admissions Policies

    Ran Zhao 
    National Health Policy Associate Coordinator, AMSA
    University of Connecticut
    School of Public Health 2013/School of Medicine 2014

      On October 10, the issue of race in medical school admission policies will be introduced once again at the Supreme Court in Fisher v. University of Texas.

    In 2008, Abigail Fisher accused the University of denying her admission because she was Caucasian. The Association of American Medical Collages (AAMC) along with 28 other medically related organizations including the American Medical Association, and the American Medical Student Association, filed an amicus curiae (a brief filed by a group that is not a part of the case) in support of the University of Texas. 

    This case has re-surfaced previous landmark cases involving admissions and ethnicity. Historically, in the landmark case Regents of the University of California v. Bakke 1978, the Supreme Court stated that race should be a factor in the holistic review process of medical school admissions, even though schools cannot create a separate category for applicants based solely on race. In Grutter v. Bollinger 2003a, the Supreme Court again ruled 5-4 in favor of utilizing race as part of the holistic admissions process at the University of Michigan Law School. In the current case, Abigail Fischer and her supporters would like the court to declare the admission policy of University of Texas to be unlawful, and they seek to remove the factor of race entirely from the admissions process. 

    In this brief, the medical community argues that medical schools have obligations that extend beyond individual students to the society at large. Those obligations include redressing the current disparities in health care, where minority patients have limited access to care, and when they do receive care, it is often of lower quality. For this reason and many others, medical schools have adopted admission policies that evaluate applicants holistically, including personal interviews of applicants in order to train and produce future physicians that can serve diverse patient populations. Furthermore, numerous studies have shown that when physicians understand more about the diverse cultures and backgrounds of their patients, their decision making is better informed, patients are more likely to follow their advices, which in turn result in improved medical outcomes. Thus, there is no logical substitution for the holistic review process for medical school applicants. Test scores and academic prowess is but one component of a physician’s training. 

    If we reduce the admissions policy to measuring applicants strictly by their academic merits, we will rob our society and our patients of their health and well being. If we accept Fisher’s invitation to overrule the current holistic review process, the consequences will be catastrophic, because it means we will be defeating one of the fundamental tenets of the medical profession on a systemic level: Primum non nocere (First, do no harm). 

    Keep an eye out for the oral argument October 10th and see how ethnicity and our admissions process will evolve!

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  • Today's Supreme Court Ruling

    Elizabeth Wiley, MD, JD, MPH
    AMSA National President


    What an historic day this is. For years to come we will remember this day as the first step toward achieving quality, affordable health care for all. As you know, the Supreme Court of the United States issued its decision on the Patient Protection & Affordable Care Act (also known as the “Affordable Care Act” or “ACA”). Today’s landmark decision will shape the environment in which we will practice medicine and determine how our patients receive care.

     

    The Supreme Court held that the Affordable Care Act is constitutional, and this ruling will bring health care access to millions of Americans. At the same time, the Court ruled that states may opt out of the expansion of Medicaid. This decision is deeply concerning. If fully implemented, Medicaid expansion would provide coverage to 16 million more Americans by expanding eligibility to individuals up to 133 percent of the federal poverty level, whether they are unemployed or among the so-called working poor. Clearly, as future physicians, we must continue to champion this issue and encourage states to opt in to Medicaid expansion.

    In the wake of this historic decision, I would like to encourage you to MAKE YOUR VOICE HEARD on health care reform by submitting a letter to the editor of your local or campus paper. To make this easy, we have drafted some sample language that you may use, but please tailor this letter to express your perspective on health care reform.

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