In a click-bait headline, the Globe and Mail pronounces, A hard diversity quota for medical-school admissions is a terrible, counterproductive idea (link to paywalled article).

All other things being equal, access to essential social services such as higher education should reflect the demographics of the wider society, within a reasonable margin of error. This is what we would expect if all demographic groups had more or less equitable access to essential services at a younger age.

If there is a substantial difference between access to, say, medical school, and the wider demographic balance, then this needs to be explained. Because if there is such a difference, this is prima facie evidence of systemic discrimination at an earlier age, being reflected in unequal access to opportunities at a later age. In other words, if a demographic group is unable to succeed based on merit, then there is a reason for this; it’s not simply that they are unqualified.

Obviously, simply applying quotas to admissions is a blunt instrument that doesn’t address underlying causes. There are some things that can be done, though, even given we have limited resources to offer medical school:

• – admissions to things like medical school are limited by resources; we should consider expanding the resources available to find medical school in general, and to make it accessible to more people in general

• – admissions exams should be focused on whether you’re good enough to succeed at medical school, not whether you’re better than other people. If you’re good enough, there’s no reason why another person should be admitted; even if they’re better than you at admissions, that makes no difference, and so admissions of qualified people could be weighted demographically

• – admissions should also look at direct factors inhibiting people from applying to medical school, such of cost of the program, or distance from the nearest school, and if these demonstrate significant demographic differences, then measures addressing these should be considered

• – finally, an evaluation of access to services at a younger age should be considered. If certain demographics do not have relative equal access to high school services, or health and welfare, or even things like food and housing (especially at an early age), these could be contributing to inequity of access at a later age, and should be addressed

I’m being careful not to use loaded terms like ‘race’ when I discuss this. That’s because it doesn’t just concern race (or, more accurately, skin colour or cultural background). It also concerns gender (and this may also be an impact of cultural group). It concerns socioeconomic status, which is a well known predictor of academic success. It concerns whether people live in rural or urban regions.

I’m also being careful not to frame this argument in terms of identity politics. Quite the opposite; it’s based on the idea that there shouldn’t be an appreciable difference in access to essential services based on one’s identity. It’s not an argument stating that there should be ‘more’ for some or even ‘less’ for others. What we don’t want is for some group to be able to ‘game the system’ at the expense of another group. That is, after all, what merit is about.

Some people may argue that there is no a priori good reason why we should be concerned about demographic balance at all. After all, medical professions are not like public opinion surveys. There’s no good need for them to be representative of the population as a whole. But I disagree. The medical profession isn’t just a bunch of individual doctors providing care. It’s also a loosely organized association of professionals who study, learn from their experiences, and advance knowledge in their field. For this reason, diversity is essential; an association of professionals that is unbalanced runs the risk of developing collective ‘blind spots’.

Some might say that we want the very best people to become doctors, and so this consideration outweighs any other consideration. But again I disagree. It would make a lot more sense to distribute the very best across society. We should be equally concerned about the professionalism and high quality of police officers, engineers, teachers, even politicians.

There are many things we can do, at all levels, to address equity of access to essential social services. Those that reduce the issues and proposed solutions to caricatures are not being helpful.