A hard diversity quota for medical-school admissions is a terrible, counterproductive idea

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There are several good reasons why medical schools would want to graduate physicians who reflect the diversity of Canada’s population. Studies show that patients tend to feel most comfortable with physicians who look or sound like them, who can communicate in their native languages, and/or who understand their cultural norms or religious practices. We know that institutional bias still exists in our medical system, and that Black, Indigenous and other racialized Canadians experience poorer health outcomes as a result. At worst, this bias manifests in extreme cases of medical neglect, such as that of Indigenous woman Joyce Echaquan, who was taunted by Quebec hospital staff as she writhed in pain, dying of pulmonary edema.

So yes, we should strive for diversity in our medical work force. Indeed, medical schools in Canada already factor in non-academic qualities (such as a candidate’s background, ability to overcome personal challenges, community involvement and so on) when offering admission to prospective students, and some have specific pathways to admission for candidates from underrepresented groups. But there is a marked difference between striving for diversity in medicine, and mandating it by way of hard quotas.

The medical school at Toronto Metropolitan University (formerly Ryerson), which received preliminary accreditation last month, is unreservedly pursuing the latter. Of the 94 seats available for the 2025 admission cycle, the school says it expects 25 per cent will be admitted through its “general admissions stream,” and the other 75 per cent through its “Indigenous, Black, and equity-deserving admissions pathways.” Applicants are required to have completed a four-year undergraduate degree, though that degree can be in any field, “in order to attract a diverse range of applicants.” Candidates do not have to have completed the MCAT, and they require a minimum GPA of just 3.3 (the University of Toronto requires 3.6; the University of Ottawa requires 3.5), while noting that in “exceptional circumstances,” Black, Indigenous or other equity-deserving candidates with lower GPAs will still be considered for admission. These students, according to TMU, will be immersed in a curriculum “rooted in community-driven care and cultural respect and safety, with EDI, decolonization and reconciliation woven throughout.”

All of this is in service to a genuinely noble goal. But the school’s execution – it’s practically boasting of its lax admission requirements – is clumsy, short-sighted and does a disservice to its own prospective students. The unintended consequences are obvious: Canadian patients will start Googling their physician’s educational background and wonder if the resident doctor performing their next procedure was one of the TMU students who got into med school with an art-history degree, a 3.3 GPA and a compelling personal essay. Indeed, the school’s quota system will inevitably condemn all of its graduates to public skepticism about their qualifications and capabilities, even if the physicians TMU produces are in fact very capable, qualified and skilled. It’s a bias of the school’s own making that it will have to fight to counter, and probably lose anyway.

The rigour of medical school, along with subsequent residency requirements and/or various certification exams, will likely weed out students who truly can’t cut it as physicians. But that should serve as little consolation when our province is desperate for doctors, and also swimming in debt. There is an enormously high financial burden borne by the province in educating prospective doctors, and each slot occupied by a student who, for whatever reason, doesn’t end up practising represents a colossal waste of time and money. That’s why med-school admissions requirements are typically so rigorous: Schools and governments want to be relatively sure that the students they invest so much time and money in will actually work as physicians.

TMU’s experiment with its new law school, which doesn’t require a minimum LSAT score or GPA for admission, hasn’t worked out tremendously well so far. Its students signed a letter shortly after Oct. 7 that effectively blamed Israel for the Hamas attack, and some later tried to explain away their support by saying they didn’t read the letter closely before adding their names (which indicates a sloppiness and incuriosity unbefitting of prospective lawyers). Some big law firms have opted to overlook TMU students for summer positions.

But a crop of potentially bad lawyers doesn’t present the same moral, social and economic quandaries as does a crop of potentially ill-equipped doctors in a province with a critical doctor shortage, as well as an extremely limited number of medical-school slots. Doctors make life-and-death decisions every day, and they are expected to maintain their education throughout the course of their careers. That’s why we want them to be the very best learners, problem-solvers and critical thinkers our society can produce.

Maybe TMU graduates will be of that calibre; I’m sure we all hope that is the case. But the public’s skepticism will invariably undermine their credentials, which is unfair but inevitable when race-based admissions quotas are involved. In the worst-case scenario, Ontario will waste a whole lot of time and money in an area where it can’t afford to waste either.