Criminal Records as a Metric in Medical Student Admissions

Luke Higgins
Luke Higgins ’22

Written by Luke Higgins ’22

The University of Vermont Larner College of Medicine community proactively grapples with the most equitable ways to accomplish our mission “to engage with our communities to benefit Vermont and the world.” I am privileged to attend a school that fosters and elevates key discussions, such as a recent discussion around how our college can more effectively recruit persons taking action to seek a more just world – a conversation that was heavily influenced by the mass arrest of protestors using their first amendment rights to advocate for racial justice and condemn police brutality.

A group of University of Vermont Larner College of Medicine students recently authored a letter to the Association of American Medical Colleges, Accreditation Council for Graduate Medical Education, and American Association of Colleges of Osteopathic Medicine to advocate for institutional protection in admissions processes for students with an activism-related legal history. The letter stated such protection would demonstrate “commitment to antiracism and dismantling racial injustice… to punish those who speak out against racial injustice, however inadvertently, is to be complicit in racism.” We, as a profession, have the obligation to continue this conversation and examine the chronic effects of policing and structural racism on our application and selection processes.

Although one quarter of people in the U.S. have a criminal record, four in four have a criminal history. For those of us in the three-quarters without a record, it is important to remember that records do not reflect who has committed a crime. Records reflect those that are targeted through racialized institutions to be surveilled, charged, and convicted of crimes. Given entire pools of applicants to medical schools, residencies, and other programs have criminal histories, yet only a portion have criminal records, it is imperative to actively recognize the criminal justice system’s disproportionate effects on communities of color.

Stop and frisk is one of many examples of communities of color experiencing disproportionate surveillance by police. Other racialized systems of surveillance include a school to prison pipeline supported by police officers in schools, racialized discipline evident as early as preschool, and higher rates of traffic stops and unnecessary searches for people of color. Systems of surveillance continue to be influenced by housing segregation through the influence of redlining and gentrification. Presence of the police has fostered long-standing and marked structuralviolence against people of color.

Racialized surveillance is compounded by bias evident in pretrial decision-making (including setting bail and plea bargaining), juries, and media coverage. As a result, people of color face longer sentences and a disproportionate number of wrongful convictions. People of color also have a higher rate of probation failure—likely due to “social structural and historical forces” as well as “structures of opportunity.” This is also reflected in recidivism rates, which are driven by unemployment, underemployment, and educational status.

Our criminal justice system is neither just nor rehabilitative. In fact, “racialized legal status,” “based on ostensibly race-neutral legal classifications that disproportionately impact racial/ethnic minorities,” is “a fundamental mechanism of social stratification that produces racial/ethnic health disparities.”

Here is where higher education comes in. Persons who have a criminal record have barriers to higher education and the resources to pay for it. Although the Department of Education recently expanded the “second chance” Pell Grant program for incarcerated persons, federal aid is limited for persons with drug offenses, which disproportionately affects people of color based on surveillance practices outlined above. Marijuana arrests make up about half of drug arrests, and although black people and white people use marijuana at similar rates, black people are four times more likely to be arrested and have jeopardized access to federal aid.

Medical schools have the opportunity to create a pipeline, one which recruits and provides resources for people that have experienced incarceration and/or have criminal records to access premedical education and support their matriculation to medical school. Both the undergraduate and graduate programs serve to benefit too – existing programs provide evidence that persons with a criminal history bring gifts of “deconstructing stigma/teaching the university; the desire to do more and give back; intimate knowledge of how systems work on the ground, and bridging relationships” to higher education environments. Intimate knowledge of systems is especially important in medicine, as incarcerated individuals often receive inadequate care and are a federally protected research population due to a gruesome history of unethical medical experimentation.

At this point, I must take a brief pause to acknowledge that some crime is violent and/or exploits power dynamics in a way that may disqualify someone from practicing medicine. There is a place for the consideration of such actions as disqualifying, but for theft, drug crimes, and other similar actions as currently classified in the legal system, the use of criminal records can and should shift considerably. It is also notable that state licensure often screens for criminal records and may prohibit persons from practicing – a barrier that can be overcome with appropriate pressure and evidence from the medical community to licensing organizations. We, as a medical community, need not contribute further to the use of criminal records to disqualify persons from seeking to reach their full potential and serve their communities.

As we ask the Association of American Medical Colleges, Accreditation Council for Graduate Medical Education, and American Association of Colleges of Osteopathic Medicine to take imperative and urgent steps to protect protestors who have experienced arrest, we must continue the conversation, recognizing that there is a much deeper history of racism around which urgent action is also needed. We must recognize that criminal records are a racialized and inequitable metric for admissions processes. Furthermore, the medical community has an obligation to affirmatively seek to recruit, include, and support persons who have experienced incarceration in our community, which includes supporting access to education opportunities that serve as prerequisites to medical school. Such initiatives treat only symptoms of deep-seated racism and other wrongs in our country, and the conversation, as it continues, must continue to reflect on dire underlying realities.

Co-editors for this blog post include Millen Abselab ’23, Mohammed Wali ’23, Emerson Wheeler ’22, and Zeynep Tek ’22

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