Idaho considers withdrawing from WWAMI because UWash has "become political"
Should Idaho cut ties?
Recently, a bill entered the Idaho state legislature to withdraw from the WWAMI initiative. WWAMI is a acronym that stands for Wyoming, Washington, Alaska, Montana and Idaho, and is a medical partnership where the relatively smaller (pop) states send students to U Washington to train to be doctors. Historically, Idaho has sent 40 students each year to the University. Lawmakers want to revisit that because as they state “They’ve become political….. Teach how to be good doctors… but we don’t need your politics.” Is this true? Should Idaho cut ties?
Recently, a student told me about their residency interview at UWashington (which occurred in the last few months). The event began with a powerpoint slide shown and reading the land acknowledgement. This is from their website, and broadly representative of what they said.
There are dozens of pages I explored on the UWash website with programs in DEI and anti-racism, though some links appear to be removed or deleted (perhaps recently). They also have a lecture series on DEI in medicine, and I watched several videos, and encourage you to watch them as well. Some explicitly urge political action on issues of tenants rights and minimum wage.
Let us be honest what is going on at the University of Washington and many coastal medical schools. The vocal faculty, staff and students are liberal democrats, and the most liberal people have seized control of medical and resident education. Many of these people are not only themselves activists, but also want to proselytize their audience. Perhaps many in these programs appreciate their sermons, but surely some people silently and grudgingly disagree.
Students from Idaho might be more likely to be offended that their time is wasted reading a land acknowledgement that frankly will do nothing for any indigenous person and is empty virtue signalling. In my opinion, reading such statements is an abuse of the audience’s time.
Students from Idaho might think strong tenant rights policies are actually bad. That they create misplaced incentives, including housing shortages. What if Idaho students think raising the minimum wage might lead to more automation and job loss?
One of the core principles of universities is to be inclusive to all people, but it seems like University of Washington is not inclusive to conservatives, or for that matter, even centrist Democrats!
And most importantly, what the fuck does any of this have to do with heart failure and pancreatic cancer!
Recent polls show that public trust in higher education is in the toilet. The public feels betrayed by DEI, political protests on campus, and outright lying about covid-19 policy, particularly vaccines, masks, lockdowns and school closure. Universities censored professors like Scott Atlas because he opposed school closure. Even in 2024, the university declined to reverse this condemnation.
Some medical schools now hire staff to review slides before students see them. All mentions of pregnant women are removed and replaced with pregnant people or people with uteri. It is Orwellian.
Against this backdrop, it's easy to sympathize with Idaho. They have a proposal to partner instead with the University of Utah, a state which is broadly more comparable, and less obsessed with politics.
To me, it is unfortunate that medicine is becoming political. The solution is for places like the University of Washington to abandon political themes in the classroom and focus on, as suggested, teaching people to be good doctors.
It's worth remembering that medical school still fails to provide such an education. We do a bad job of teaching critical appraisal— and that is something that all the editors of Sensible Medicine have devoted their careers to improving. This should be the focus of medical school. Tenant policies and minimum wage are political issues. They are outside the scope of medical education.
If Idaho withdraws likely Montana and Alaska and Wyoming will follow. WWHAMI can then be free to shorten themselves to W and they can eliminate a few tribes from the land acknowledgement. They can then feel proud at how inclusive they have become.
A number of commenters have raised concerns that social determinants of health are important, and that poor, black and hispanic people do worse in America. I agree! And I wish to make 5 points
1. Most lectures in medical education merely restate the obvious. Poor people do worse, and minorities do worse, in so far as they are poor. At some point, this message has been conveyed. What are we going to do about it? Another 10 or 20 or 100 lectures won't help anyone.
2. There is no evidence that raising awareness has done anything to reduce disparities, just as not a single indigenous person has benefit from hundreds of people listening to land acknowledgement. This is also true for some medical disease awareness campaigns (see my JAMA paper)
3. The solutions to socioeconomic disparities largely precede medicine. These disparities begin in early life. Advocate for better elementary school education. Better nutrition for kids. Roland Frier has other good ideas (see Econ talk). But little of this has to do with medicine. (One irony is that so much of this DEI curriculum was silent about school closures during COVID-19, which did more damage to poor or minority kids than any other action in the last quarter century)
4. One of the videos I watched from UWashington discusses how doctors should advocate for (a higher) minimum wage, and stronger tenant laws. But It is entirely unclear if those policies will help poor and minority patients. Minimum wage increases have spillover effects-- some low wage jobs get replaced with robot kiosks-- and strong tenant laws often lead to fraud, as apartments are passed along in families or to friends, or kept empty. Moreover, these topics are better covered by economists rather than doctors
5. Finally, there is only so much time in medicine. Graduating students are often unable to calculate post test probabilities of basic diagnostic tests. Few can tell you what a p value means. Nearly none can dissect a NEJM paper. Not all know how to care for DKA, or COPD or HF. Medicine must prioritize these things.
There should be no tolerance for politics and baseless ideologies in medicine or medical education.