Dear students and faculty,
This message shares important information about the status of the Alpha Omega Alpha (AOA) Honor Medical Society at UCSF. Based on careful in-depth review, UCSF will suspend its affiliation with AOA, and students will no longer be selected for AOA. This change begins with the class of 2021.
Educators and students at UCSF have long questioned the appropriateness of AOA in the context of the UCSF medical school. To address these concerns, the UCSF Committee on Curriculum and Educational Policy (CCEP) charged a task force to make a recommendation regarding whether UCSF School of Medicine should continue participation in AOA. Led by Drs. Kathy Julian (program director of the UCSF Primary Care General Internal Medicine Residency Program) and Kanade Shinkai in dermatology, and populated by a range of faculty, residents and students, the task force considered whether participation in AOA is compatible with UCSF School of Medicine values and positively benefits the School. The group also examined what the consequences might be if UCSF were to withdraw from AOA. Based on their deliberations, the task force concluded with a recommendation that UCSF not continue to participate in AOA. As the governance committee for the School of Medicine, the CCEP endorsed this recommendation, and School of Medicine and leadership, including Dean Talmadge King, concurred with this recommendation. Throughout this process, students and faculty participated and gave voice to the reasons for this change. With this decision, we are joining other prominent medical schools such as Harvard, Stanford and others.
The reasons for this change are several-fold.
- Although the AOA has done many good things for the medical profession over the years, we do not believe that the circumstances that led to the formation of AOA over a century ago are still valid today. As detailed on their website “At that time […of the founding of AOA], the practice of medicine relied on tradition and was mostly empirical. Medical education was poorly structured and medical students were poorly prepared academically.” In 1902, founding students had reason to prioritize and incentivize measures of academic achievement. In 2020, all medical students are held to incredibly high standards and subjected to rigorous examinations that demonstrate their abilities. The AOA selection criteria and limitation on students selected to 16% of the class does not reflect our belief that all UCSF graduates are prepared to become outstanding UCSF physicians. Each year, we have to turn away highly deserving students because of the requirements and restrictions of AOA membership. That only a small percentage of students are eligible to receive this accolade can disadvantage the majority of the class by not acknowledging their excellence.
- The selection process and limitation on membership is not aligned with our educational philosophy or our commitment to equity in all aspects of education. The same issues that prompted a change to the assessment and grading system apply to the AOA process: abundant literature shows that a focus on grades and performance interferes with learning and decreases students’ wellness. Students focused on metrics of success feel compelled to do things that ‘look good’ and showcase their strengths rather than attempting new learning experiences and asking questions to further their learning. Furthermore, bias in assessment of learners is pervasive through educational systems, and is documented in the AOA selection process. Boatright et al documented bias against non-white students in selection to AOA (JAMA, 2017), and we have worked hard at UCSF to overcome population group differences in our evaluation systems that advantage some populations over others.
A decision such as this has required careful deliberation and is not without its critics. Please be assured that the disadvantages of this decision were debated at length. We continue to believe that there are many ways for our students to demonstrate their excellence and unique accomplishments. Residency program leaders and educators gave helpful input and participated in the task force deliberations. While this decision is now final, we look forward to collaboration across the medical school to residency continuum to ensure that our students’ education, and the process of selecting residents to the programs that are the best fit for their learning and the residency programs’ needs, is optimized.
Catherine R. Lucey, MD, MACP
Executive Vice Dean, UCSF School of Medicine
Vice Dean for Medical Education