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Step 1 of Medical Licensing Exam Made Pass-Fail
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When affirmative action was introduced over a half century ago, many assumed that once the under-represented demographics were given a little help getting past the initial gatekeeper, they’d do well at all subsequent levels. Unfortunately, that proved naive. So ever since there have been unending struggles over how far up the ladder to extend affirmative action.

For example, if you have affirmative action in medical school admissions, should you also have affirmative action in doctor licensing?

One obvious but little-discussed problem for the beneficiaries of affirmative action at professional schools is that both law and medicine school lead to professional licensing exams, which can be disastrous if the student can’t pass. In contrast, business school students don’t have to take exams to get a job (outside of a few specialties), so an MBA can be a safer bet for an underrepresented minority. Or at least that’s what logic implies: I’ve never seen this question investigated by academics.

Not surprisingly, black medical students, many of whom are beneficiaries of affirmative action, tend to do worse on the three stage medical licensing exam. Lower scores on the Step 1 of the three part medical licensing exam, a 7 hour exam given to med students in the summer after their second year, make it harder to get desired residencies.

Assuming a standard deviation of 22, compared to white medical students, from 2005 to 2014 black med students score about 0.74 standard deviations worse, Hispanics about 0.51, and Asians about 0.04.

The authorities this week declared that Step 1 will no longer be graded with a 3 digit score. Instead it will be pass-fail.

If the current mean is about 228 and the standard deviation is 21 and the passing score is 194, you only need to score about 1.6 standard deviations below the mean to pass. So unless you are in the bottom 10% of med students in the country, you don’t have too much to worry about now.

This will disadvantage the smarter med students at lower prestige med schools and advantage the dimmer med students at elite med schools, which is, I guess in 2020, considered to be a Good Thing.

This week’s change is pretty similar to what we see with firemen’s hiring and promotion tests, where it is often decided in the name of civil rights and fighting disparate impact discrimination to stop hiring based on rank order of test scores, but instead only require a passing grade on the test, which is set so low that almost all whites pass, and then use more randomized procedures to choose among all those who pass.

Logically, it would seem like a better idea to simply have race quotas and choose in rank order within each race. That would get higher average knowledge firemen than the pass-fail system. But that kind of system is often demeaned as a quota and is seen by beneficiaries as embarrassingly blatant. In contrast, pass-fail systems at least obfuscate the reality of racial preferences, even if a few extra people must burn to death each year.

 
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  1. SFG says:

    They’re lowering the standards for medical licensing exams now? They are really doubling down hard on this diversity stuff.

    There needs to be a truce between the alt-right and the Amy Wax meritocracy types, or something. People are going to get killed.

  2. Polynikes says:

    I hate to be this way, but the diversity/affirmative action crowd basically forces your hand. I really wouldn’t a non-white doctor at this point.

  3. Pass/Fail is so binary. I can’t even.

    • Replies: @Frogger
    , @Aardvark
  4. Flip says:

    I imagine we are not going to be able to pick our doctors under Bernie-care for all either and so can’t avoid the affirmative action ones.

  5. Jack D says:
    @SFG

    My wife works with dyslexic kids – she gets them extra time on tests and so on – schools are legally required to give this under the ADA. Some of these kids have number and letter reversals – if you tell them 250 (mg) they might right down 520. She has been doing this for a long time. Some of these kids are in med school now and still getting ” special accommodations” for their disability.

  6. @SFG

    “People are going to get killed.”

    People are already getting killed by affirmative action all the time. It’s not a new thing, but it will of course get much, much worse.

    We are not going to be able to share a single country with these people for much longer.

    • Replies: @Jack D
  7. @Flip

    Oh, it’s going to be far worse than that. We will have medical care “busing,” where White patients are deliberately assigned to AA doctors, and black patients get the smart White, Asian and Jewish doctors. If you have a heart attack on the Upper East Side, the ambulance will drive you all the way to Coney Island Hospital. (Mysteriously, of course, this will not happen to heart attack victims on the Upper West Side.)

    • Agree: ben tillman
    • Replies: @SFG
  8. newrouter says:

    mediocrity is our strength!

  9. @Jack D

    Some of these kids are in med school now and still getting ” special accommodations” for their disability.

    In a just system those “spec accoms” would diagnose, anesthetize and operate on the blackhearts that relaxed the rules. How long would that last before the woke repented?

    • Replies: @anonymous
  10. trelane says:

    Third World medicine for Americans.

  11. J.Ross says:

    He shot and killed five people in a mass shooting but today black mass shooter Cheron Shelton is free. Wonder how diverse the jury was.
    http://www.wtae.com/amp/article/wilkinsburg-mass-shooting-verdict-cheron-shelton/30861609
    (Heh – he takes people to the underworld and his name is Cheron.)

  12. Jack D says:
    @The Germ Theory of Disease

    You’re wrong about this. White people are getting killed left and right in S. Africa and most are not leaving. In Nazi Germany, Hitler kept turning the screws tighter and tighter trying to get the German Jews to leave and most didn’t until the pressure was absolutely unbearable. Inertia is a thing. You talk a good game here on the Internet but what are you going to DO about it?

    • Agree: Desiderius
  13. I’ve reviewed a lot of USMLE step 1 scores in selecting residents although I’ve been out of academic medicine for over a decade and haven’t picked residents in 20 years. Some thoughts:

    Selective programs are going to start asking for USMLE step II scores, MCAT or even SAT scores. I heard through the grapevine of a few of the top programs in selective fields asking for SAT scores at least 15 years ago. Stuff like that will become more widespread.

    USMLE step II is probably a better measure of clinical readiness than step I but it is usually taken after residency applications are over so it wasn’t traditionally used. I always found that it correlated _much_ better with clinical skill than Step 1 (we got everybody’s step 2 scores after they had been matched to make sure they had passed.) Regardless, this may now scramble the whole process; are people going to start taking step 2 earlier and submitting?

    Evaluations on clinical rotations will become much more important; the big winners in this change are people with good teeth and good manners (and, frankly, women). People who are good at schmoozing and good in a pseudo-secretarial/clerkish role. Good followers. Clinical rotations are much less structured and less standardized than normal classroom environments so this data is going to be extremely noisy. I was always seeing narrative evaluations where it says such-and-such is the best ever and on the next page they are the worst ever on their next rotation.

    USMLE step I had always had somewhat limited predictive value for a variety of reasons that take too long to go into here, but I think most people understood that and took them with a grain of salt. A barely passing score always got my attention because it indicated they might struggle clinically and we might have issues getting this person to pass the specialty boards. Once they reached a certain threshold we were deciding based mostly on other factors. But–the more information, the better.

  14. At least with firemen, as fires become rarer and less dangerous in modern cities with modern building codes, this nonsense should cause less harm than in the medical field. Until another 9/11.

  15. J.Ross says:

    Little known fact, tourism to New York City is pass-fail.
    https://www.dailymail.co.uk/news/article-8006237/French-tourist-left-critical-condition-crazed-stranger-slashes-neck-Harlem.html
    Don’t worry, the neck slasher will be fine, and even if he is found they can’t hold him.

    • Thanks: Mr McKenna
  16. J.Ross says:
    @Jack D

    I think you misunderstand his last line, and possibly the people he meant. Anyway, however bad it gets here, absolutely nobody is going to help us, it would be like South Africans trying to move to Europe and getting permanently barred instead.

    • Agree: Mr McKenna
    • Replies: @Anonymous
  17. Art Deco says:
    @Jack D

    Over 70% of the Jewish population of Germany emigrated during the period running from 1933 to 1939. Wm. Rubenstein has taken the view that the rest would have left within a few years had war not broken out. The trouble for them was that many went to neighboring countries and ended up back under German rule when Germany conquered much of the continent in 1940 and 1941.

    • Agree: Ed, Redneck farmer
    • Replies: @Desiderius
  18. Anonymous[270] • Disclaimer says:

    OT: Avenatti verdict… obvious steroid abuser?

    The roid culture plays a role in America’s increasing insanity.

    Hardly discussed: Our professional class is cocktailing steroids with antidepressants and whatever else. Everybody’s looking for an edge.

    • Agree: Carol
    • Replies: @Anonymous
    , @Lugash
    , @guest
  19. @Polynikes

    Last time I had to choose a Primary Care physician, I had to search screen after screen of Pajeets and Chens until I hit paydirt………a “Dr. Howard”……perfect……that’s the guy for me! Probably a Litvak, like a group of brothers you may be familiar with who shared the same last name. (Though theirs was originally “Horwitz”.)

    To be honest it’s not JUST a “white” thing……the most important thing is that I be able to communicate with the MFers. I WANT A GUY (OR GIRL) WHOSE FIRST LANGUAGE IS ENGLISH.
    That’s all I ask. With a Chen or Pajeet you can never be sure……and usually it’s not.

    And why are there SOOO MANY foreign doctors? We (well, the AMA) keep domestic medical schools few in number and small in size, far, far less than overall demand requires, and are then forced to import them from prestigious Bangladesh U. to make up the shortfall. What sense does that make?

    Am I the only one who notices that just about every policy we have as a nation – from this, to immigration, to what-have-you………is INSANE?

    (….”…..Calling Dr. Howard, Dr. Fine, Dr. Howard!…..” LOL…over 85 years later and it’s still funny.)

    • Replies: @Anonymous
  20. @SFG

    People are going to get killed.

    People are already killed, by the tens and hundreds of thousands. And so long as there are at least a few incompetent white professionals (which there surely are), the machinations Steve describes will ensure that whites shoulder the blame for what ‘everyone’ does. That’s how we roll in Wreckage America 2020!

  21. This just gets them another year older and a deeper in debt. Makes them less likely to get a good job at the end, not more.

    Mismatch plus. Some beneficiary.

  22. Kronos says:

    This is probably one of my favorite interviews by Stefan Molyneux. Keep in mind Linda Gottfredson came to Charles Murray’s recuse during the 1994 publication of “The Bell Curve.” She rallied the troops with experts writing in defense of Murray’s work and that Behavioral Psychology was essentially bonkers.

    https://en.wikipedia.org/wiki/Linda_Gottfredson

    She also helped defeat additional Civil Rights legislation from the 1990s that would racially norm test takers for public service exams. (It’s mentioned in the interview.) So that a black who scored an IQ of 85 (average for blacks) would actually score an 100 IQ normalized toward black participants. That “higher” score would be seen as equal to White/Asian IQ scores.

    • Replies: @Kronos
    , @anon
    , @J
  23. Anyone remember Dr. Patrick Chavis?

    He’s the black doctor admitted to UC Davis medical school under affirmative action in 1973 and displaced a white medical student, Alan Bakke, who was the respondent in the Supreme Court case of Regents of the University of California v. Bakke, 438 U.S. 265 (1978).

    Affirmative action does indeed kill people, even according to the New York Times:

    https://www.nytimes.com/2002/08/15/us/patrick-chavis-50-affirmative-action-figure.html

    • Thanks: Harry Baldwin, Thomas
  24. @Polynikes

    I really wouldn’t a non-white doctor at this point.

    Hey kids! Here’s where you at home can play along! What’s the missing word?

    1. trust
    2. hire
    3. screw
    4. slap
    5. deport

    ——————————————-

    PS: Look at it this way. If you have an incompetent POC physician, who read the NYT this morning and is certain that all white people are Nazis, s/he probably won’t be able to take justifiable revenge upon you. Too much skill required! Well, we can hope.

  25. dvorak says:
    @SimpleSong

    I heard through the grapevine of a few of the top programs in selective fields asking for SAT scores at least 15 years ago. Stuff like that will become more widespread.

    Lol, right back to IQ. SAT is likely closer to a pure IQ test than Step I is.

    I wonder if the Miller Analogies Test is even more so, kryptonite for NAMs.

    The med school process in the USA is stupid. They should just take high schoolers who scored highest on Math/Chem/Phys/Bio Olympiad and offer them half of the spots in the top 40 med schools, skipping undergraduate school. Then use affirmative action for the other half of the class to get the woman and NAM numbers where they want them.

  26. Anon[324] • Disclaimer says:

    Logically, it would seem like a better idea to simply have race quotas and choose in rank order within each race.

    Yep.

    But it doesn’t achieve the goal of eliminating standardized test scores by race in order to obfuscate relative performance. If you get rid of the SAT/ACT requirement for college adminssions, how can you say, for sure, that blacks are less qualified, rather than being the victims of discrimination?

    What the medical board doesn’t know is that it’s relatively trivial to reconstruct an approximation of the two bell curves just from pass/fail data and the racial profile of the two categories. This was a specialty of La Griffe du Lion. I wonder if they will release the race breakdown at all?

    • Replies: @dvorak
  27. anonymous[277] • Disclaimer says:

    Anyone not listening to Nick Fuentes now is badly missing out. Since leaving youtube for Dlive, the show’s energy has been unreal. I’ve never seen anything like it. This young man is for real.

    • Replies: @Lot
  28. anonymous[117] • Disclaimer says:
    @Charles Erwin Wilson 3

    The East Coast Woke generally have the bucks to hire best-quality NY/Boston docs to operate on them.
    Tavarious M’Quan Jones, M.D., don’t enter into it.

    They won’t care.

    Bad Docs are for little people.

  29. Clichéd, but obligatory.

  30. Anonymous[277] • Disclaimer says:

    A few observations:

    1) I don’t think they’re lowering the standard per se, simply converting the score from quantitative (194-270+ for a passing score) to qualitative: pass/fail, as most professional licensing exams (e.g., the bar) already are.

    2) The medical-licensing testing scheme comprises 3 parts: in total, it’s 3 long multiple-choice exams and 1 exam testing “real” clinical skills (by having examinees talk to standardized patients, formulate differential diagnoses and then be graded on their interactions and summary notes). The exams are taken over several years: parts I and II (“Step I” and “Step II”) are typically taken while in medical school, and “Step III” is typically taken some time during residency. This pass/fail change only applies to the first part of the sequence, or “Step I.” Step II will still have numerical scores, and I suspect students applying for residencies will now be judged entirely on these Step II scores. As it stands now, both Steps I and II are usually considered; if anything, this seems to put even more weight on a single test (Step II).

    3) The decision to judge students by their step scores is 100% at the discretion of residency programs. As long as the students have passed they’ll have no issues getting licensed, and unlike colleges and SAT scores the average Step score for a residency program is not public knowledge and plays no part in any kind of ranking. The directors of residency programs use Step scores as a screening tool because they see it as a reasonable proxy for–if not practical or people skills–than perhaps intelligence and/or work ethic. At the very least, success on the standardized Step exams predicts success on the standardized board-certification exams, which is a metric program directors care very much about.

    Tl;dr this is a largely symbolic decision that won’t have much of an effect, although I agree with Steve that high-performing students at smaller schools will suffer

  31. Dr. X says:
    @Polynikes

    I really wouldn’t a non-white doctor at this point.

    When they institute socialized medicine, they’ll force you to accept a non-white doctor.

    • Replies: @JMcG
  32. Interrupting a video today was an ad for this fine institution:

    St. George’s University School of Medicine

    Can’t beat the campus.

    • Replies: @black sea
  33. Rob says:

    They’ve changed the test to get into med school, the MCAT. I assume to help girls and non-whites. They’ve added a section on sociology, psych and biological bases of behaviors. So this is clearly meant to benefit blacks and girls. It won’t work, because smart people can study stupid subjects. I am also sure the question “Cletus is addicted to fentanyl. His parents were both heroin addicts. Why is Cletus an addict? the answer “c. Cletus inherited a genetic tendency to be an addict from both parents” will not be the correct answer.

    The’ reason added a few more questions on each section, but they’ve increased the time even more. This is mixed, more questions means randomness matters less. This should help more intelligent testees. The more time per question helps dimmer test takers. This helps less intelligent test takers. The actual questions are probably oriented towards ranking the dumb.

    The new test is scored from 472 to 528, with an intended mean of 500. This is done “emphasize the center,” rather than finely differentiate the top third. Apparently the average testee makes a good doctor. They can differentiate the bottom half well, this means they’re planning on admitting lots of lower ability students. Why not 1 to 57? I can only thing this is meant to bamboozle testees, other college students, and people involved in med school but not in admissions.

    Soon to be doctor halfwit can say “I got a score of 478. It’s out of 528.” That sounds like ms dumbass did well. Only people knowledgeable about the test will know.

    Already med schools focus on things besides intelligence. I don’t think we’re getting better doctors.

    • Replies: @Joe Schmoe
  34. Anon7 says:

    OT: Rashida Tlaib is clever, and I think she’s hit on the strategy that beats Trump, at least in certain districts. She was arrested today for taking part in a labor protest at Detroit’s Metro airport.

    Turn Donald Trump’s wealth and status against him by pandering directly to ordinary blue collar workers. She’s shown up at union walkouts and strikes before. Trump is unmistakably management, not labor. I think it’s a smart play.

    • Replies: @Mr McKenna
    , @Reg Cæsar
    , @JMcG
  35. Rob says:

    Why not have some diversity? Let the test-takers decide if they want to be scored or just judged pass/fail. Then hospitals taking residents can choose which sort of candidates they prefer. They can fill the (racist and fewer each year) merit-based slots with scored students, and fill the aa slots with “passes.” Absolutely nothing would be lost.

  36. Anonymous[367] • Disclaimer says:
    @Anonymous

    And Ritalin/Adderall

  37. @Anon7

    How does Michael Bloomberg fit into your scenario?

    • Replies: @Anon7
  38. Re disadvantaging students at lower tier med schools, I was reminded of complaints from students at Ross University that they couldn’t get hired for residency programs because of the taint of that institution.

    Meanwhile doctors from med schools of unknown quality in Mumbai and Manila swoop in, get resident posts and fill up the doctors’ rolls in every insurance company database.

    How does this happen?

    And of course the Atlantic claims we’re being too tough on these future Medicaid fraudsters.

    https://www.theatlantic.com/health/archive/2014/11/doctors-with-borders-how-the-us-shuts-out-foreign-physicians/382723/

  39. Kronos says:
    @Kronos

    I forgot to add this on the top.

    Logically, it would seem like a better idea to simply have race quotas and choose in rank order within each race. That would get higher average knowledge firemen than the pass-fail system. But that kind of system is often demeaned as a quota and is seen by beneficiaries as embarrassingly blatant. In contrast, pass-fail systems at least obfuscate the reality of racial preferences, even if a few extra people must burn to death each year.

  40. El Dato says:
    @Flip

    “Medical busing” – you heard it here first!

  41. El Dato says:
    @Ian Smith

    In fairness this seemed to be a maximally problematic delivery. These things happen.

    Laxman had started work at 8.30am the previous day and went home at 6pm for five hours before returning to the hospital at 11pm.

    Good work NHS.

    The difference between, saym medical personnel working hours and airplane personnel working hours are probably a problem.

    • Replies: @GeologyAnon
    , @Ian Smith
  42. Obligatory:

    I was grandfathered into having a black, female PCP for a few years.

    What a joke.

  43. anon[178] • Disclaimer says:
    @Kronos

    If you have to have quotas, race norming is actually less objectionable than dumbing down the tests so much that an adequate number of NAMs get passing grades. At least you identify the smartest ones of each race. But even this half-sensible compromise isn’t allowed.

    Bill in Glendale

  44. @J.Ross

    Cheron? I think we can guess his parents’ favorite Star Trek episode

  45. @Anon7

    You think these people are worth $15/hr?

    Remember, the original minimum wage was intended to keep people like this out of the workforce. Indeed, for some time they applied only to women.

    Hey, there’s an idea. Affirmative action minimum wage.

    • Replies: @Anon7
  46. @dvorak

    Yeah, the more I’m thinking about it the more I think this may not be the worst thing in the world.

    The passing marks for the USMLE haven’t changed so nobody is going to get licensed who couldn’t get licensed before. There’s just no numerical score for residencies to use to try to select what residents they want; so the lives of residency directors are made a bit more difficult. But to some extent they may also be saving residency directors from themselves. The way that step 1 was being used was not really what it was designed for–people thought of step 1 as being a measure of g, but it very much is _not_ that, it is by design a pure knowledge test.

    Thus one’s score is very much a function of how many months the student spent preparing, whether their undergrad major covered some of the material or whether this was all new to them in med school, whether their preclinical curriculum was geared towards board prep, the quality of the test prep they used, etc. And of course it does correlate with g as well. I realize this sort of thing is true of every standardized test…but some more than others. The USMLE is on the extreme end of the spectrum.

    I can think of a few residents who were stellar who had pretty average step 1 scores, and the profile was 1.) engineering/physical science major as undergrad, very little biology until med school, 2.) Elite med school that disdained ‘teaching to the test’, 3.) took step 1 very early and dove right into clinics rather than spending a few more months with intensive prep. Some people start clinical rotations as early as April while others start in September and take the whole summer for step 1 prep.

    The flip side to this is I can’t count how many times I’ve heard people say, “I know specialty X has super high step 1 scores, but everybody I meet in specialty X is extremely underwhelming…” Specialties get into this strange cycle whereby a specialty will become desirable, they get a surplus of applicants, they start to wheedle down the applicants based on USMLE step 1, the averages go higher, then anyone who wants to go into that specialty realizes they need higher USMLEs to get into that specialty, so they now spend much more time on test prep than average, so then the scores go up even more…the whole thing is self-reinforcing.

    The kicker is that the knowledge tested on Step 1 is not knowledge that you need to know to practice effectively. At least not compared with the later steps or the specialty boards. And the specialties that have very high USMLE scores don’t tend to be the ones where you would even want to deploy your best brains. (Ideally you would want to sprinkle your best brains around everywhere in different specialties, to be honest.)

    Anyway, if residency directors want to select for g, then they should use an appropriate test, rather than use a knowledge test. Of knowledge that is only very marginally relevant to their specialty…

    • Replies: @candid_observer
  47. anon[667] • Disclaimer says:
    @J.Ross

    Police continued to hunt throughout Friday for a black male in his 20s wearing all black and white Air Jordan sneakers.

    Well, at least that narrows down the list of suspects. Especially in Harlem.

  48. Twinkie says:

    Fear not. Most hospitals and larger practices still require BE/BC – board-eligible/board-certified – status as a condition of employment. This is where the real weeding out is done for the AA types. Board certification tests are not legally required, but is insisted upon by most healthcare systems. It is usually a two-part test (written and oral) and, with the exception of the old folks who are grandfathered, requires periodic re-certification (around 10 years or so).

    White and Asian passing rates are similar (I think Asian passing rates might be slightly lower in the oral section, as I recall from the data when I looked at it a few years ago).

    As can be expected, NAM passing rates are abysmal. A large (50+ physicians) local specialty practice I know had to let go of ALL the black doctors it brought on, because ALL of them failed the boards. They had been working temporarily on the BE status, but there is an expiration for that, and they all had to take the tests eventually. All failed and all had to be terminated from employment, as they could not be credentialed at the local hospitals, with which the practice had contracts and privileges.

  49. JimB says:

    I’m reminded of an old joke.

    Q: What do you call someone who graduates last in his med school class.

    A: Doctor.

  50. Twinkie says:
    @Polynikes

    I really wouldn’t a non-white doctor at this point.

    Verb?

    That’s a not an adequate filtering mechanism to use when your health is at stake. You need more specific and granular data.

    I know plenty of white doctors who are FMGs (foreign medical graduates), e.g. couldn’t get into medical school in the U.S., so went to Grenada – remember that little war to rescue American medical students? Some turn out okay, but many are going to be bottom of the barrel.

    Likewise, even though I am not a big fan of Indian immigrants in general, there are some Indian docs I have met who are phenomenal. And of course there are many highly competent physicians of East Asian ancestry (esp. if they went to med school state-side).

    The key is to get good referrals/word-of-mouth information. The medical world, especially in various specialities, is not a big world. Reputations travel fast. If you are familiar (friend or family) with a nurse or a physician, he or she can find out rather quickly whether someone is quacky or competent. Instead of relying on a very unreliable “white/nonwhite” filter – as with any service or product, do a bit of research. It will potentially save you a lot of grief later.

    Also, don’t be swayed by “bed-side manners.” There is no correlations between that and clinical/surgical competence. Pick someone who is good at his craft, not someone who makes you feel comfortable with his words.

  51. Anon7 says:
    @Reg Cæsar

    I’m not talking about wages or economics, I’m talking about politics. What will appeal to blue collar people who might otherwise vote for Donald Trump? A lot of union workers voted for Trump in 2016.

    In the last presidential election, lots of the big unions, like AFSCME and the American Federation of Teachers, announced their support for HRC in 2015, a year before the election. This year, they’re all hanging back.

    Most of the people here believe that by reducing unemployment to low levels, Trump has endeared himself to workers. So if you’re a Dem, how do you fight that? By psychological appeals to blue collar workers; in this case, showing up on a tiny picket line to support the little guy against management.

  52. One quarter of the US residents are foreign graduates. Three of the four paragraphs of the press release “explain” that the change is not aimed at them.

    In fact, the scores on the standardized exam were the best way to compare how foreign med students compare with US-schooled counterparts. Unlike many other postgraduate students, residents are indentured workers, whose skills and endurance are key for their “mentors” comfort. So your ability to talk about ball sports and full bodied wines won’t take you too far. Often a subcon would be preferred to the unending crops of Ivy graduates who “test poorly”. (Unsurprisingly, since Ivies hardly test anyone.) That sucked for Americans, and had to be changed. Fewer than 5% of Americans failed to enter residency, but an increasing number had to go into Family and Peds, which are better paid in England or Australia.

    But tbh, the first nativist revolution happened in my days, when the de facto abolition of Subject GREs was meant to stop the invasion of Chinese grad students. But pass/fail or scored, Americans are just lazy. Their focus is on how to avoid competition, rather than on competing. American grad schools are now majority Chinese. Dropouts are nearly always natural born.

  53. @J.Ross

    The prosecutor said “It is very difficult for the police and my office to investigate and prosecute crimes when the number of witnesses is limited.”

    The hood knows that snitches end up in ditches, so he walked.

    • Replies: @Mr McKenna
  54. Twinkie says:

    By the way, the primary author of the study that Mr. Sailer cited is Dr. Selina Poon. 😉
    https://shrinershospitalsforchildren.org/pasadena/meet-our-team/selina-poon-md-mph-ms-144

    • Replies: @Joe Schmoe
  55. Anonymous[322] • Disclaimer says:
    @william munny

    The decline of smoking is much more significant.

  56. SafeNow says:

    “People are going to get killed.”

    People are ALREADY getting killed. A 2016 Johns Hopkins study concluded that 250,000 die annually as a result of medical negligence. The 3rd-leading cause of death. That’s equivalent to — which Idiocracy shall I use? — like if several Max planes were crashing themselves each and every day. And of course that’s just mortality — there is also morbidity.

    • Replies: @Dan Kurt
  57. Anon7 says:
    @Twinkie

    Big medical centers have been using H1B visa doctors (from India and China, primarily) to increase profits and cut costs. This is especially true in subspecialties that pay a lot. There are Asian McMansion enclaves within easy commuting distance of big hospitals all over America. They like the work, they like the money and they like the lifestyle.

    Some big medical centers let you search their subspecialty practitioners by language, notably Arabic, Mandarin, Hindi, and Gujarati.

    Now, the children of the early beneficiaries of this program are entering the US university system, and are denying the children of legacy America places in medical school that might have gone to them.

    You’re not going to have much choice about your doctor, just by sheer force of numbers. They are well out ahead of the “browning” of America curve usually quoted.

    • Agree: Mr McKenna
    • Replies: @J.Ross
  58. In North America nowadays, there is a huge push to have at least 50% of med school entrants be women and 10% black. The remaining 40% largely consist of the sons of Tiger Mothers and upper-class Indians. White males are being pushed out. Remember the recent fracas at Harvard when the portraits of white male medical legends were being removed from the walls. The white male students in the Boston area are so vanishingly small and politically impotent that they did nothing about it.

    Here in Toronto, outside of a few Jewish superstars, white male doctors under the age of 50 don’t really exist anymore. Go to a hospital nowadays and all you’ll see are vulgar white female doctors with tattoos, Panjits, Chens, and the odd Jew. Gay flags adorn the walls. I feel as if I’ll either die at one of these places due to neglect or else get a Chinese flu infection

  59. Kim says:

    The big takeaway here is to look after your health.
    Go low carb. high veg. no seed oils (coconut oil is great. palm oil is fine if you can ignore the social devastation in borneo) skip breakfast so your insulin levels reset every day. do something active, like walking, every day. do some whole body resistance exercises, weights, rings, latex bands, all good to maintain strength and muscle mass. eat probiotics like sauerkraut or kim chi to maintain healthy gut biome. get adequate sleep. get adequate sunlight.

    • Agree: Triumph104
  60. Anon7 says:
    @dvorak

    Most medical schools have ended the practice of offering direct admission to medical school from high school, or some sort of combined degree that shortens the usual four years of college followed by four years of medical school, owing to the unusually high suicide rate.

    This is one of the main reasons for making the first two years of med school pass/fail, the pressure is unbelievable. It’s not about IQ, it’s about EQ.

  61. When I was nearing 50 my dear wife started bugging me to schedule a colonoscopy. After a period of gentle nagging I got a referral for a GI doc to set up the procedure. When I got home from the appointment my wife asked if I had scheduled the scope. I told her, “No. The doc looked like he came from the Taliban. I told them when they could find an American to shove a camera up my ass they could give me a call.”

    Of course I was just yanking her chain. I had it done and all was good. If I had known what choice drugs they use I would’ve been scheduling one every week. Fentanyl to get you drowsy and Versed to send you to la-la land. Better living through chemistry.

    • Replies: @Jim Don Bob
  62. black sea says:
    @Reg Cæsar

    I used to know a guy who attended medical school in the Caribbean and became an anesthesiologist. Has gone on to a very lucrative career in Connecticut. I was somewhat surprised, but I guess he knows his stuff.

    • Replies: @Anon
    , @nebulafox
  63. J.Ross says:

    This deserves to go through even if my comment does not:

  64. Anonymous[427] • Disclaimer says:
    @J.Ross

    The bad part is that absolutely no one will help us and, deep down, we know it.

    The good part, though, is that absolutely no one will help us, and deep down we know it, and- we’re white. A few of us will do the needful thing. When we get going, no one does death like we do.

    Deep down that scares the living hell out of certain people. It ought to.

  65. Anon[260] • Disclaimer says:
    @black sea

    What was his race?

    • Replies: @black sea
  66. Ed says:
    @Polynikes

    The last white American doctor I had was an ophthalmologist. Most doctors I encounter are non-white, they’re not black either though.

  67. By the way, the primary author of the study that Mr. Sailer cited is Dr. Selina Poon.

    Of the Poon-Tang Clan?

    Selina Poon, MD = Diplomas? None!

    • Replies: @Danindc
  68. Anonymous[427] • Disclaimer says:
    @Fred C Dobbs

    And why are there SOOO MANY foreign doctors? We (well, the AMA) keep domestic medical schools few in number and small in size, far, far less than overall demand requires, and are then forced to import them from prestigious Bangladesh U. to make up the shortfall. What sense does that make?

    Perfect sense if your goal is to keep the salaries of elite American trained doctors high. The proles get Pajeet. The elites carefully elect the best doctors and pay the freight. Win/win for them.

    As long as states license doctors, the AMA will be able to control the state legislatures because no state leg will piss them off. They are afraid of getting primaried out, and they have at least a subconscious fear that if they piss the AMA off badly, when they go in for surgery, an oh so subtle mistake could occur.

    The truth is that we should have a lot more doctors relative to the population in years past because there are now so many specialties and medicine can do so much more than, say, in 1960.

    My mother was born in 1930, had her tonsils out in 1936 or 1937, her ears lanced a little after that, her appendix out in 1944, a broken arm set in around 1951 or so, a cyst on her thigh cut out in about 1953 and her pre-marriage exam in 1955. The same doctor did all that. Today that is an absolute minimum of four doctors, except in a rural hospital in western Kansas or the Dakotas or somewhere.

    In 1955, if your kidneys failed you died, and horribly. If you had blockages of coronary arteries thy had no way to find out and if they did, they gave you nitro pills for the angina and eventually you dropped dead. Cancer they could cut out and did, but it almost always came back, and killed you. Brain tumors they’d have a go at , but you usually wound up dead or severely impaired. No pacemakers, no hip. knee or shoulder implants, no transplants. Anesthetics made you puke like a dog when you woke up, assuming you did, and you were miserable for a week. OR explosions from ether and cyclopropane were a thing. They had X-rays (roentgenography) and even the now obsolete fluoroscopes, and radiation, but it was brute force stuff, no CT scans, no MRI’s. It probably caused almost as many cancers as it located.

    Some things were better-you could still get paregoric for benign stomach issues and effective opiate anti-diarrheal meds, as you still can in most of the rest of the planet. And there is a theory that the routine tonsilectomies of the old days (to prevent rheumatic fever) reduced sleep apnea and made a lot of people better singers, though it made them more susceptible to colds and caused the deaths of a couple of dozen kids a year. And the likelihood of living fifteen or twenty or more years with reduced IQ and emotional problems after surviving a sudden cardiac arrest or really serious infarction with brain oxygen deprivation, or “pump head” from excessive time or debris on perfusion in open heart surgery was nil-you just died, and sometimes that was a blessing.

    But on the whole, we are better off now, a lot better off. Being subject to 1955 or 1965 medicine would suck, even at the prices of the day.

    • Agree: Jim Don Bob
    • Replies: @Yngvar
  69. @J.Ross

    Remember J., only those suffering from Whiteness can be mass shooters.

  70. JMcG says:
    @Dr. X

    When they socialize medicine, whites and Asians won’t want to be doctors.

  71. JMcG says:
    @Anon7

    The skilled trades will vote overwhelmingly for Trump. Can’t speak to service workers. Teachers and municipal students will vote demo like always.

    • Replies: @Anonymous
  72. Frogger says:
    @Mr McKenna

    Shush, you’re giving away next year’s agenda.

  73. @Twinkie

    Good advice, except women make too many decisions about medicine. “I don’t like him, he doesn’t seem to pay attention to what you’re saying (that’s not relevant to your condition)” is pretty common female blathering.

  74. @Jack D

    Look at the bright side: black South Africans wouldn’t be able to operate trains as well as Germans.

    • Replies: @Just passing through
  75. Affirmative action has never worked because of bad economics.

    Outside the United States in Malaysia the ethnic Chinese still do better than the local Malay despite decades of tribal props.

    The same applies to South Africa where it has also helped create a rent-seeking society (free lunch) plus contributed to rising income and wealth inequality (the worst in the world according to the World Bank).

    Ironically despite heavy discrimination in the job market and state contracts, the remaining competent persons of European descent who comprise about 8% of the general population are the ones preventing South Africa from total collapse.

    The Costs of Malay Supremacy
    https://www.nytimes.com/2015/08/28/opinion/the-costs-of-malay-supremacy.html

    Rent-seeking is gobbling up our economy
    https://mg.co.za/article/2015-09-10-rent-seeking-is-gobbling-up-our-economy/

    • Replies: @Lockean Proviso
  76. You think they have it hard in the States?

    https://www.theguardian.com/education/2020/feb/14/bame-trainee-doctors-in-climate-of-fear-over-racism

    “Many black, Asian and minority ethnic trainee doctors are experiencing a “climate of fear” at medical schools amid a failure to address widespread racism, according to the British Medical Association.

    Dr Chaand Nagpaul, BMA council chairman, said the schools’ inadequate response to racism had left many BAME medical students afraid to speak out.

    His criticism came after an investigation by the BMA and the British Medical Journal (BMJ) found medical schools were ill-prepared to deal with racism against students, with only 11 formal complaints recorded since 2010.

    Of the 32 medical schools who responded to freedom of information requests by the BMJ, only half said they specifically record complaints about racism.

    Nagpaul said there was a worrying disparity between the significant scale of racist incidents BAME students raised with the association and the tiny number of formal complaints.”

    I was a bit surprised by this, because the middle class white kids who still (just) are a majority of med students have been socialised since first grade about racism, and doctors as a whole are clever people who’ve invested years of training in their careers and don’t want to be fired. Where was this racism coming from?

    “Gurdas Singh, co-chair of the BMA’s medical students committee, said the most common racist incidents raised by their BAME members included patients refusing to be treated by them, and female black medical students being perceived to be nurses. “

    I know a white med student who’s sometimes taken for an HCA (“Healthcare Assistant”, lowest form of medical life*). Nurse? Luxury!

    “Toni Robinson, a black medical student at Keele University and member of the BMA medical students committee, said she had experienced many racist incidents but had never reported them.

    She added that BAME students often did not feel confident that white staff would understand their complaints, or would dismiss them. “I was on a ward round and a patient said I looked like a golliwog,” she said. “The consultant and other students, who were all white, did not respond. It was brushed under the carpet – completely ignored.””

    That’s the standard British “let’s just pretend that didn’t happen” response to something that everyone knows is unfortunate – as if, say, the patient had let off a loud fart. Ms Robinson should have been pleased with her colleagues, not aggrieved. What did she expect them to do? First of all, the students are there at the patient’s pleasure – the patient is always asked if they mind them being there and can ask for them not to be. Secondly, what student is going to “go off” on a patient in front of a consultant? You are there to observe – the consultant may ask you to talk with the patients at his or her pleasure. Thirdly, we’re told nothing about the patient – they may have been drugged up, demented or seriously ill and not caring what they said. It’s your job to treat them.

    Now the consultant is at liberty to say something to the patient (and potentially get involved in a lot of meetings and paperwork) – but I’m sure the stunned silence will have sent its own message. In his place I might have talked to the student afterwards and explained why I let it slide – but maybe that could have got the consultant into trouble.

    I guess the BMA plan is that “racist patients” don’t get treated (but health tourists do). Ain’t diversity wonderful?

    ###############################################################

    * the story of the disasters that have befallen UK medical training in the last 50 years is a long one.

    Management summary

    Once you had
    Doctors
    Registered General Nurses (RGN) – needed better school grades – A level
    State Enrolled Nurses (SEN) – not such high grades – O level or GCSE

    Nurses trained in hospitals, with real patients, and got paid to train, no loans, no debt. A good system in that people who weren’t cut out for it found out very quickly.

    Then the Royal College of Nursing, supposedly the ‘union’ for nurses, got involved. SEN training slowly disappeared, and “Project 2000” happened under a so-called Conservative government.

    All nursing training now happens at university, funded by student loans (and including a LOT of non-medical PC bollocks). So you get people who aren’t cut out for it amassing huge amounts of debt before they hit the wards full time and realise it. But that’s all they’ve trained for, so they stay on.

    Now you have (much simplified – there’s one grade of nurse that can operate on patients sans surgeon)
    Doctors
    “Nurse Practitioners” – nurses who can prescribe in (usually) limited areas, formerly a prerogative of doctors only.
    Nurses
    “Nursing Associates” – (“The job is seen as a bridge between healthcare assistant and registered nurse (RN)“) – the SEN makes a comeback!
    Healthcare Assistants

    But… the same jobs that were done by RGNs and SENs are being done by four different grades of staff, two uni-trained and two not.

    “Some critics see Nursing Associates as a threat to nursing’s graduate-entry status, implemented five years ago, and a reinvention of the state-enrolled nurse (SEN), training for which was phased out from the 1980s.”

    For the RCN idiots, I’m sorry to say, its not about medicine, its about status. Of course the huge expansion of universities and lowering of standards means that the non-graduate nurses of the past were just as clever as graduate nurses today.

    https://www.theguardian.com/healthcare-network/2018/mar/06/nursing-associates-cheap-substitute-nurses

    • Replies: @PiltdownMan
    , @Carol
    , @Lurker
  77. California does something similar with nursing school admissions. The admissions process to get into the state’s highly impacted programs used to be competitive but because not enough black and brown students were getting admitted, they simply set a minimal requirement (e.g. 2.5 gpa, Hesi score in the 80th %) and then randomly selected candidates.

    • Replies: @dvorak
  78. anon[198] • Disclaimer says:

    https://en.wikipedia.org/wiki/Xenophobia_and_racism_related_to_the_2019%E2%80%9320_Wuhan_coronavirus_outbreak

    Restaurants in China Town in Boston, Massachusetts lost customers due to fears of coronavirus.[86] The same has been observed in New York City.[87]

    Chinese restaurants and establishments in Sydney and Melbourne have seen a dramatic drop in business, with trade declining by over 70%.[14]

    Not wanting Chinese food is racist. So I guess all the people who hate on English food for being bland are racist.

  79. There are hundreds of Indians studying at Philippine med schools. Why? The curriculum is identical to an American school.

  80. So won’t the obvious result be that most people who take the test will now study less, since they only have to do well enough to pass rather than doing super well in order to impress the residency admissions boards?

  81. @International Jew

    Pretty sure the Black Hutus killed Tutsis at a higher rate than the Nazis allegedly killed Jews at. Those Blacks are pretty efficient when it comes to genocide.

    • Replies: @Reg Cæsar
    , @Corvinus
  82. @J.Ross

    Rooty Tooty Fresh and euuuhh mon Dieu that’s arterial blood…

    Enviously authentic encounter with a local! If the French guy lives, he’ll have a great dinner party travel tale to tell.

  83. Danindc says:
    @Reg Cæsar

    Lol. That was hilarious. I take back my criticism from months ago. My apologies.

  84. Bill says:
    @SFG

    Wait, let me guess. The idea is that we should work together on “things we agree on.” IOW, complete capitulation to the muh meritocracy types.

  85. dr kill says:

    If only there was a country somewhere who treated all it’s citizens as individuals.

  86. Realist says:
    @Flip

    I imagine we are not going to be able to pick our doctors under Bernie-care for all either and so can’t avoid the affirmative action ones.

    You won’t be able to pick your nose under Bernie-care.

  87. @YetAnotherAnon

    Gurdas Singh, co-chair of the BMA’s medical students committee, said the most common racist incidents raised by their BAME members included patients refusing to be treated by them …

    Perhaps his patients misunderstood when they were told that they were going to be treated by a Sikh doctor.

  88. Art Deco says:

    The real mystery is why it’s now modal among the professional-managerial class to want to institute these social work programs. Some of it is induced by statutory law, but a great deal of this goes well beyond what statutes require. The only thing I can think of is that it’s some sort of self-aggrandizing exercise wherein the contemporary holders of these gatekeeper positions trash their ancestors.

    • Agree: Johann Ricke
    • Replies: @Desiderius
  89. nebulafox says:
    @black sea

    Scott Alexander attended school in Ireland, and he does OK.

    Back before WWII, physics was dominated by the German speaking world to the extent that Bose had to ask Einstein to translate his work from English to German, so there were some American guys like J. Robert Oppenheimer who did go to Germany to do their PhD. Nobody went to America. But, of course, one of the big shifts that took place because of the war was that academic science became dominated by Anglo-American culture instead, and the subsequent flow of young prospective researchers who chose to cross the pond reversed.

  90. Hibernian says:
    @william munny

    Many people are killed in fires in old buildings in the inner city.

  91. oneworld says:
    @SFG

    As a practicing surgeon with 30 years of experience teaching residents and medical students, I can tell you that scores on part 1 of the medical licensing exams have little correlation with clinical competence. Part 1 may correlate with IQ, but not skill as a doctor. Many of the worst clinicians I’ve encountered in my career came from Harvard Medical School (also a few of the best) which no doubt has very high scoring medical students. Some of these truly dangerous doctors were obviously very bright, but also self absorbed, vain and uninterested in caring for sick people. Those who believe that IQ should be the top criterion for selecting doctors, and probably other professionals, are foolish. Intelligence is one feature of a good doctor, but energy, drive, moral integrity and interest in disease are at least as important.

    BTW, I scored in the 98th percentile on part 1 of the USMLE. In my career the only meaningful thing it did, beyond impressing other residents and medical students, was help me land a competitive residency spot. Whether I have been a good or bad doctor in my career has little to do with that test. I pity the society that selects it elite based on standardized tests alone.

    • Agree: Triumph104, Antonius
  92. Carol says:
    @YetAnotherAnon

    The insistence on BSN now in the States seems to be somewhat of a joke too. RNs can meet the new requirement with easy but expensive online courses full of useless PC crap. Hospitals don’t care if you got it at Penn or University of Phoenix.

    BS indeed.

  93. need a medical bracelet that says ” NO BLACK DOCTORS”

  94. Aardvark says:
    @Mr McKenna

    So can we have:
    Two Spirited I passed and I failed
    Non-Binary I didn’t pass or fail

  95. “Logically, it would seem like a better idea to simply have race quotas and choose in rank order within each race. That would get higher average knowledge firemen than the pass-fail system”

    this happens in brazil. it’s like milk chocolate with not much cocoa powder in it

  96. @Twinkie

    “Fear not. Most hospitals and larger practices still require BE/BC – board-eligible/board-certified – status as a condition of employment. This is where the real weeding out is done for the AA types. Board certification tests are not legally required, but is insisted upon by most healthcare systems.”

    Oh my sweet summer child, how long do you think that will last before it’s found to be discriminatory?

    • Agree: JMcG
    • Replies: @Reg Cæsar
    , @Twinkie
  97. @SimpleSong

    This matches my experience on the other side of the process as well. Step 1 is fairly useful info but not that important for a future medical career. I doubt most doctors (including the good ones) still remember the random step 1 stuff that isn’t relevant to their speciality, which is most of it. It was also initially designed to be pass/fail for this reason. Generations of gunners turned it in to something it wasn’t meant to be.

    Clinical rotations are a terrible way to evaluate anyone for the reasons you mentioned. Got an a-hole attending? Bad luck. Your attending is so distracted they won’t notice mediocre or worse performance – good luck!

    I recall standing at the foot of an operating table “watching a surgery” where I could only see the surgeons’ arms because so many residents and fellows were closer to the action. In a sane system I should have just left, but instead you’re graded on the enthusiasm you display during such tedious irrelevant BS that has no bearing on how good a physician you might be.

    Step 2 is probably a better criteria but then not everyone takes it in time. Also, without board scores how will the selective but not too difficult specialties justify their salary? The reason they make so much of course is they limit the supply of doctors. But they justify it by being more selective/higher scoring. Now what?

  98. @Twinkie

    A large (50+ physicians) local specialty practice I know had to let go of ALL the black doctors it brought on, because ALL of them failed the boards.

    Did this roster include any foreign origin blacks, that you know of?

    • Replies: @JMcG
    , @Twinkie
  99. Polynikes says:
    @Twinkie

    That’s all well and good *after* you’ve narrowed the pool of people to an acceptable group (which is what I was talking about). Of course, as with anything affirmative action related, East Asians are a bit of an exception. I would certainly let a renowned surgeon of Japanese descent operate on me.

    FWIW, the worst two medical professionals I’ve had in my life were Indian. OTOH, one of the smartest guys I know is Indian (and hilariously a quite frank race realist). So there’s a lot variance with that population who emigrates to the US.

    • Replies: @Twinkie
  100. @Art Deco

    Which does more to confirm Jack’s point than refute it. It most cases where it matters you’re not getting to choose your doctor today and the quality is already all over the map. I’ve had two organ transplants in the last fifteen years (and several follow-up surgeries due that uneven quality), so I’ve seen it up close.

    The time to leave this Germany was a generation ago. Now we’re in triage.

    • Replies: @Jack D
  101. @Polynikes

    And maybe think twice before accepting treatment by a woman doctor, even a white one: tending as they do to work fewer hours than the men, they can have much less experience.

    Moreover women also tend to quit the practice of medicine sooner than men, making them in this respect poor candidates for a place in medical school, these places being as limited as they are.

  102. @Twinkie

    Another prog policy with the effect of beheading black communities by draining their brains and leaving them on the trash heap.

    • Agree: Dissident
  103. Jack D says:
    @Desiderius

    Yes, exactly. There was a lot of denial at the beginning – this Nazi thing is just a passing fad. Hitler will be out at the next election. Very few people budged at first. I have a business here, a home, friends, family, etc. Germany is my homeland – I fought for it in the war. My family has been here for centuries. I don’t speak any other languages. What would I do in another country where my degree is useless? And so on. As I said before, every year the Nazis would turn the heat up some more in an attempt to make life more unbearable for the Jews – new decrees, new restrictions, more arrests. They made no secret of the fact that (before the war started and it became impossible) that they wanted every last Jew to leave and eventually most did but by Sept. 1939 30% of them were still there despite being, by that point, 4th class citizens who had been stripped of almost every conceivable right. (In their defense many countries had closed their doors so that they had no place to go to.)

    • Replies: @anon
  104. My brother graduated from a state university medical school 20 odd years ago. He said the saying going around the school was “An A or a D, either way you are still a doctor!”

  105. gregor says:

    I actually like the idea of pass/fail for medical licensing since above all you want to ensure a solid minimum level of competence. But the first-time pass rate for Step 1 is 94%. That is too high to be anything more than a perfunctory hurdle.

    Really they should open up the admissions some and then have a first year pass/fail qualifying exam with say a 60% pass rate. If you pass that you go on to do clinical work. They seem very hesitant to flunk anyone I assume because of the high cost of medical education, but it should be possible to design the programs to have lower first year cost. As it stands, they are letting the admissions office do all the filtering.

    • Disagree: Triumph104
  106. @Art Deco

    For a long time it was to allow AWFLs and their enablers (i.e. fathers) to keep up with the men with whom they were theoretically equal (but mysteriously and stubbornly not in practice) by snaking the social work programs intended for blacks.

    I get the sense they’ve now lost control of things but are loathe to admit it.

  107. Lugash says:
    @Anonymous

    I think Avenatti was a combo of natural high testosterone and sociopathic behavior.

    But yes, ‘roids and other drugs by our leaders and professional class are causing trouble.

  108. res says:
    @dvorak

    I wonder if the Miller Analogies Test is even more so, kryptonite for NAMs.

    Does anyone have race data for the MAT? I am having trouble finding any.

    • Replies: @Desiderius
  109. dvorak says:
    @Anon

    But it doesn’t achieve the goal of eliminating standardized test scores by race in order to obfuscate relative performance.

    Everyone admits the race differences; the AA industry just ascribes it to racism.

    Dropping SAT requirements may just allow some schools to move up the rankings, because they can pass the message to NAMs that they shouldn’t take the test. Meanwhile, high scorers will continue to take the test. Result: sky-high SAT average to report to US News.

    UChicago might start to report higher SAT numbers than Harvard does.

  110. In my locality, a Nigerian has a lock on infectious disease, but lately a Mexican has opened a practice. Both seem to be somewhat competent, but neither compared to the Vietnamese doctor I saw in the hospital who was awesome. What you need to watch out for are all the black LPNs who think they are RNs with the empowerment to disregard rules regarding hygiene, patient rights, licensing laws, etc. You know, typical black stuff.

    Had one recently who could not wear gloves because of her artificial fingernails (torquise IIRC).
    Her hair was also bizarre. I did not ask to touch it.

    What is interesting is that a Hispanic CNA from Pennsylvania complained to me about the lower standards here versus there. Hmmm…..

  111. dvorak says:
    @Malcolm X-Lax

    California does something similar with nursing school admissions. The admissions process to get into the state’s highly impacted programs used to be competitive but because not enough black and brown students were getting admitted, they simply set a minimal requirement (e.g. 2.5 gpa, Hesi score in the 80th %) and then randomly selected candidates.

    You sure? Can’t they use the “socioeconomic factor” scam to usher in NAMs, while still finding the cream, of the many Chinese/Viet/White girls that apply?

  112. OT:

    People think Bloomberg is smart? Guy is considering signing his own death warrant:

    Bloomberg Considers Hillary For Running Mate

    https://www.zerohedge.com/political/bloomberg-considers-hillary-running-mate

    LMFAO

    • Replies: @SFG
    , @Corn
    , @sayless
  113. anon[366] • Disclaimer says:
    @Jack D

    I’ve followed Steve for 25 years now (how many remember when he used to get MSM columns accepted for Canada’s National Post?), so obviously, since the beginning here at Unz. And I have to say, the decline in vigorous racialism here in the last several months has been incredible. Half the comments for any article above the middle-brow level seem like pure hasbara.

    Human life is not magically immune from Darwinism. It had, has and forever will have a nasty side. In a mass world, that’s mass nastiness. Jews have a parasitic evolutionary strategy on Whites that periodically produces legitimate backlash. Germans, indeed Whites all over the West, are dying right now at the hands of feral peoples, because the Jew-backed side won WW2.

    Opening my emails, I get ads about entitlement for ‘2nd generation Holocaust reparations’, featuring photos of sad Jewesses (no idea why they’re targeting this goy). These people went too far a long time ago.

    I have no idea what this site’s owner really wants. His heart does seem to be in the right place but even if that’s true, the ‘gradually, then all at once’ decline here just shows what happens with Jewish ownership, even when that’s by one of the very few well-meaning Jews: relative monopolization, then decay.

  114. firemen’s hiring and promotion tests

    The problem is that, as public employees, firemen are scandalously overpaid. A lot of white people who aren’t qualified to do anything else will study day-and-night in order to do well on the fireman exam. However, there is no evidence that having a higher score makes one a better fireman per se, unless one believes that having a higher IQ makes one better at everything.

    • Replies: @Muggles
    , @Rob
  115. TWS says:

    Used to joke with my doc that he should get out his turtle shell rattle and feather fan. Now that’s a valid choice I guess.

  116. black sea says:
    @Anon

    White guy; his mom was an immigrant from Germany.

  117. TWS says:
    @SFG

    People have been getting killed for years. What happens when an all female ambulance crew refuses to lift a heavy patient, because I’ve seen just that.

  118. SFG says:
    @dvorak

    Eh, you need people skills. I agree having a few superbrainy doctors to make the discoveries is probably necessary.

    • Replies: @dvorak
  119. SFG says:
    @The Wild Geese Howard

    I’ve never quite subscribed to the full set of Clinton conspiracies, but this strikes me as politically stupid. The right hates her for being Hillary, the left hates her for not being leftist enough, and the center hates her for reminding them of the 2016 election.

  120. J says:
    @Kronos

    That’s the way it is done.

  121. @Lockean Proviso

    And you’ll notice that there are very very few angry marches in the streets about the perps walking.

  122. Corn says:
    @The Wild Geese Howard

    He better hire someone to taste his food if he does.

  123. Bruno says:

    I read that there were no correlation among step1 results and interns excellence even if it was a criteria for selecting specialty and places. I wonder how much the test is G loaded. As it’s knowledge intensive, must have quite a lot of’ crystallized intelligence in it (just regurgitation).

    McKinsey, the management consultancy, had an extremely g loaded selection process. But there were no correlation between scores and further success, probability in making Principal or Director.

    Maybe it’s a threshold thing. Then level wouldn’t be hurt by a fail/pass maybe considering that MD students are above the 3th percentile on scholastic test compared to general population at least. A 15th percentile in MCat is a 6th percentile in SAT wich is a 3th percentile in general population. So you don’t need to take out more than 10% of this group ….

  124. El Dato says:
    @J.Ross

    Black History Month: Coming on Stronk!

  125. SFG says:
    @The Germ Theory of Disease

    Nah, the public system will have AA doctors and upper middle class and higher people of all shades will be able to afford Dr. Jane Goldfarb-Chen (whose parents met at Harvard, natch).

    There are plenty of Jews on the Upper West and East Sides at this point; that particular stereotype is about 40 years out of date.

    • Agree: Dissident
  126. @SimpleSong

    Yeah, I think that many of the commenters here don’t understand just how the Steps are designed.

    At base, they are licensing exams, and they are meant to test basic competence on a variety of subjects relevant to medicine. To do this, they focus on questions related to what a physician might need to know to perform their duties. But the thing about medicine is that the vast majority of what they need to know to do so is in fact not that difficult. In the case of purely clinical decisions, virtually all they are doing is applying a relatively simple algorithm (or at least that is all that can be tested in a written test in any case). But the number of such things a physician needs to know is, on the other hand, quite vast. It’s a case of knowledge that is a mile wide but an inch deep — again, insofar as basic competence goes.

    But these tests have been co-opted to perform standard relative rankings of students. What they test, though, is mostly ability and willingness to memorize. The ability does indeed correlate somewhat with g, but it is a very imperfect correlation. There is a very good reason that memory per se is not a big component of any g oriented test; the correlation with g is relatively low.

    One of the unfortunate consequences of increasing emphasis on the Steps is that the mean, and the lower bound for passing, have increased very significantly over the years. Originally, in the 90s I believe, the targeted passing score for all Steps was 180. That passing score has risen to 194 for Step 1, 209 for Step 2 CK, and 198 for Step 3, where 20 is roughly the standard deviation. There’s been a runaway selection for the abilities crucial to passing Step tests.

    What this means is that the ability and willingness to memorize have become only more important, and the gap between that ability and willingness from g only greater. Students with high g and unremarkable talents at memorization are more penalized. Knowledge of increasingly arcane, and unlikely to be seen or important, scenarios becomes more rewarded.

    Restoring the original purpose of these tests seems like a very good step in the right direction.

    Nobody thinks that scores on, say, a bar exam should be used as a metric for ability as a lawyer. Passing the bar exam demonstrates basic competence in the law, and that’s the end of it.

    Why should potential physicians be judged by such a seemingly irrelevant metric?

    • Replies: @Reg Cæsar
  127. The step 2 exam scores for black medical resident wannabes are already godawful. They get in with scores that the programs would laugh at for whites and Asians

  128. MrLiberty says:

    Consumer Reports goes out of their way to prevent any hint of impropriety in their ratings. UL/TUV/ETL, all compete with each other for business in the FULLY PRIVATE realm of electrical safety testing (even going so far as to do their own destructive and safety tests, manufacturing site inspections/audits, etc. The non-GMO certification project also prides itself on transparency and honesty.

    Meanwhile, a conspiracy of the AMA, state, and federal government “authorities” has created a virtual monopoly position for the western medical establishment, all backed by the guns and violence of government at every level. NO competition is allowed, and NO private, independent certification is required to practice medicine. In fact private folks are pushed out by the monopoly government-protected powerplay. And then there is this.

    The ONLY SOLUTION to all of it, is to demand an END to ALL government professional licensure requirements, all government-legislated restrictions on professional practices, and the strong market push for independent certification bodies that will actually stand behind the certifications they provide. The monopoly position we have ALLOWED the AMA and the useless government conspiracy to command, MUST END.

    • Replies: @Hibernian
  129. I’ve dealt with black female doctors at the ER before. They seem to be just faking it and ordering unnecessary tests that would provide little or no information to the situation. On two separate occasions another doctor (white and Indian) stepped in to contradict the black doctor and either cancel or order different tests that seemed more in line with what I expected.

    • Replies: @baythoven
  130. Muggles says:
    @ScarletNumber

    >>The problem is that, as public employees, firemen are scandalously overpaid. A lot of white people who aren’t qualified to do anything else will study day-and-night in order to do well on the fireman exam. However, there is no evidence that having a higher score makes one a better fireman per se, unless one believes that having a higher IQ makes one better at everything.<<

    This reminds me of a lawsuit filed by a failed police dept. applicant in Connecticut, I think. He was rejected because his test scores were too high. He sued but lost. They argued that someone with his high IQ would be "bored" by routine police work.

    • Replies: @RadicalCenter
  131. J.Ross says:
    @Twinkie

    The bitterest irony is that if we could have (not official racism but) official objectivity, we could give the blacks a materially better deal. It’s the same problem as every single kid needing to go to a four year college. This is a bad system that poorly serves everybody, burning up the credit of better systems in the past.

    • Agree: Twinkie
  132. Anonymous[329] • Disclaimer says:

    I had a question for my surgeon friend one day:

    Me: Throughout your medical school training, you worked amongst the same crowd of students, right?

    Him: Yes.

    Me: So how many of the students did you get to know fairly well during those years? By which you feel you know their work habits, how they think, etc.

    Him: I’d say about 120.

    Me: Suppose you had to go under the knife yourself for a fairly complicated operation. Of those 120, how many would you pick with total confidence for the operation, if the stakes were your ass?

    Him: I’d say about 4.

    Me: Out of 120, there must have been more than 4 high flyers in the group. People who work hard and test well? Why only 4?

    Him: Because you can’t teach judgement.

  133. JimB says:
    @Twinkie

    That’s a not an adequate filtering mechanism to use when your health is at stake. You need more specific and granular data.

    First consultation is important. Learn all you can about your condition, including standard of care, prognoses, followup care, and any experimental treatments on the horizon. If the doctor/surgeon seems confident and knowledgeable, he is probably as good as anyone else at the medical center. But get a second opinion to compare stories. If both doctors are advising the same thing, and seem to know the same things, then flip a coin. Otherwise, get a third opinion. If opinions are all over the place, try another medical center where your problem is a listed specialty. Although we’re conditioned to be impressed by M.D. at the end of a name (see my earlier comment), our health is ultimately in our own hands. Of course, once President Sanders remakes the health care system, and private medical insurance is abolished, you’ll just need to get really drunk before you’re surgery and hope the Nigerian or Punjabi with a face mask really is a heart surgeon.

  134. @El Dato

    Docs haven’t had their NATOPS moment like Navair did, many decades ago when they introduced crew rest rules.

    I guess because pilots go on to run Navair, and so if their is a 25% mortality rate among aviators they would both be well aware of it and highly motivated to fix it. When doctors mess up they kill people, when pilots mess up they kill people and themselves. So you can see why that has more oompf for driving change in a profession.

  135. @Just passing through

    Pretty sure the Black Hutus killed Tutsis at a higher rate than the Nazis allegedly killed Jews at. Those Blacks are pretty efficient when it comes to genocide.

    In Burundi, the Tutsis killed the Hutus.

    THE BURUNDI KILLINGS OF 1972

  136. J.Ross says:
    @Anon7

    So reject a bad system. Same destination, more dignity.

  137. @candid_observer

    Students with high g and unremarkable talents at memorization are more penalized

    Is that so bad? A great deal of medical malpractice is not from lack of intelligence, but from lack of attention. That’s what The Checklist Manifesto is all about.

    Who wants an absent-minded physician?

    • Replies: @candid_observer
  138. Rob says:
    @ScarletNumber

    However, there is no evidence that having a higher score makes one a better fireman per se, unless one believes that having a higher IQ makes one better at everything.

    To a first approximation, IQ does make one better at everything. I would bet performance IQ matters more for firefighting than verbal IQ, but I’m sure verbal matters some. Some of firefighting is rote, sure, but there’s a lot that’s novel to each fire. It certainly helps if firefighters can estimate how much hose they need, or form a mental map of the building, or accurately estimate how long they can stay in on the air remaining, or whether the floor’s about to collapse. I’m definitely not saying that IQ is the only thing that matters, being brave and up to it physically are two obvious requirements, but smart matters.

    • Replies: @ScarletNumber
  139. dvorak says:
    @SFG

    Eh, you need people skills.

    Super-brains can learn people skills – certainly enough of them to pass through the uncanny valley with a short interaction with a patient.

    – Smile with your eyes, mention local sports/weather, give bad/good news using certain tested phrasings.

  140. @Kim

    Alcohol! You forgot alcohol!

    Ein mal ohne wein ist wie das leben ohne lachen.

  141. @Enemy of Earth

    When I had my last colonoscopy, the doc asked me if I wanted to be awake for the procedure. I said not unless you need my help with something. Then it was 10, 9, … and next thing I knew I woke up in the recovery room.

  142. anon[552] • Disclaimer says:

    OFF TOPIC: iStevey: Since Jeanne Calment died, in 1997, at a hundred and twenty-two, her claim to the longevity record has come under attack.

    https://www.newyorker.com/magazine/2020/02/17/was-jeanne-calment-the-oldest-person-who-ever-lived-or-a-fraud

    • Replies: @Stephen Dodge
  143. Anon7 says:
    @Mr McKenna

    I do think that there are a lot of people who want to be told that they will be taken care of. Not that they can get a job if they want, not that the country will be in better shape due to less taxation, regulation and immigration – they just want to be told that they will be taken care of. Bloomberg’s ads are amazingly good at doing just that.

    I don’t know whether Bloomie can actually be elected, but it might not be his goal. He spent hundreds of millions of dollars in 2018, got the Democrats more seats in Congress and Pelosi as Speaker, and thereby got Donald Trump impeached, even if he was acquitted.

    Just a hobby for a guy worth $62,000,000,000.

    We’ll know more after Super Tuesday: it is rumored that he has made a vast ad buy. Maybe he just wants to do a leveraged buyout of the Democratic party (as Mark Stein says), similar in outcome if not in method to the way Donald Trump has effectively taken over the Republican party.

  144. Dan Smith says:

    In 1977 when I took part 1 of the medical boards, we knew that students who scored higher had a better chance of nailing a prestigious residency 2 years later. I remember about 10% missed the cut. They could try again but if they still failed they were done. Going to pass/fail will make it a little harder to identify the top students, but it’s not hard to pick them out. I look at this move as a sop to affirmative action people that won’t change much in the long run.

  145. @Reg Cæsar

    It’s not at all obvious that not being absent minded correlates better with good memorization skills than with g. In general, job performance doesn’t, so far as I know, ever correlate better with good memorization skills than with g — that’s why all the focus on g. And I think that grades in med school would be a better index of relevant conscientiousness than the Steps, if that’s what you’re trying to measure.

    There really do seem to be people whose ability to memorize things far outstrips their other intellectural talents.It’s not just a question of effort.

    No doubt that simply ditching all the Step scores as indices of merit would not be a good solution. Better would be the use of something more like the MCAT. The MCAT, though it does demand knowledge of certain basic things in biology, chemistry, and physics, makes a very real effort to emphasize analytical and logical abilities. MCATs are therefore, and deliberately, quite g loaded for those who have knowledge of the basics.

  146. @anon

    Anyone who knows anything about French record keeping knows that she was not 122 when she died.

  147. OT:

    ZOMG! Putin controls everything in the US!!!

    Playing on Kansas City Radio: Russian Propaganda

    https://www.nytimes.com/2020/02/13/us/russian-propaganda-radio.html

    Because this is so much worse than say, homegirl Nessa Diab having a drive time slot on NYC Hot 97 to spew anti-Americanism.

    Seriously though, if Putin is so good at controlling everything in the US, maybe we should elect him President….

  148. Most tests of competency are just pass or fail. Do you know what score your airline pilot got on his or her license test? Do you know what score your child’s school bus driver scored on their bus driver test?

    Doctoring involves many levels of skill from general practice to specialty to teaching and research, and there are many ways to measure suitability for more advanced positions in the field.

    At the most basic level a degree of competence is needed, but these days docs have secret medical databases they can surreptitiously consult on their cell phones like Epocrates which is a drug prescribing reference guide, the Medical Encyclopedia of the University of Maryland, and the Skyscape Medical Library, plus Google images is pretty useful for identifying skin rashes and suchlike, however docs don’t usually let patients see them cribbing on the job.

    However doctors do need to be at the higher level of intellectual functioning relative to the general population so that they are smart enough to understand the basics of reading ECGs, and because every decision that they make during the course of a working day–and there can be many–is potentially a matter of life and death for the patient, and because they have to deal with a lot of sick and frightened people who may be very stupid and have very stupid and volatile families who need to be managed with respect, confidence, and competence.

    • Replies: @Lugash
  149. baythoven says:
    @Arthur Biggs

    A few years ago, I took my mother to an urgent care facility, as instructed by her regular physician. After a very long wait, enter black diva doctor. She orders blood test. Result: electrolytes are off. Her conclusion: The result is suspect because our lab is not always reliable. Go home for now with this prescription for potassium pills, we we’ll have the sample checked elsewhere. Four hours later I had Mom ambulanced to ER. She had septic shock. Five days in the hospital and she recovered. But she might have died.

    Lesson learned: Have no qualms about appearing racist when stuck with a black doctor.

    Also by the way, it’s in urgent care and emergency facilities that black and foreign doctors are overrepresented, for obvious reasons.

  150. Anonymous[257] • Disclaimer says:
    @JMcG

    The construction industry is the skilled trades.

    The entire construction industry, from giants like Peter Kiewet, Turner etc down to the non union assistants who deliver material to the work sites vote solidly democrat. That’s because both the companies and unions have done the math for more than 100 years.

    The construction industry has always, always flourished under democrat presidents. The trades vote for the party that delivers work for the construction industry.

    • Disagree: Desiderius
    • Replies: @JMcG
  151. Hibernian says:
    @MrLiberty

    all backed by the guns and violence of government at every level.

    Pure or near pure libertarianism is dangerous. Everyone has to hire his own private army.

    • Replies: @Reg Cæsar
    , @HammerJack
  152. JMcG says:
    @Anonymous

    I’m in a skilled trade. I am intimately familiar with the workings of my local union, less so with the district or international. The leadership at the local level doesn’t even try to talk up democrats on the national level because they get laughed at. The few blacks probably vote democrat, I’ll give you that.

  153. • Replies: @ben tillman
  154. @Hibernian

    Pure or near pure libertarianism is dangerous. Everyone has to hire his own private army.

    Isn’t the Emerald Isle held up as a thousand-year anarchist’s utopia? Are you saying Murray Rothbard was wrong about your people?

    • Replies: @Hibernian
  155. @Rob

    Yeah, I think this is a whole lot of wishful thinking on your part.

    • Troll: HammerJack, Ben tillman
  156. @res

    Has anyone here ever tried the super I.Q. tests with the crazy analogies? I broke the computerized MAT when I went back to get my teacher cert and I can still only make sense of maybe one in three on the super I.Q. ones.

  157. @Rob

    Cletus

    A lot of people don’t actually know where the name comes from.

    “The name “Cletus” in Ancient Greek means “one who has been called”, and “Anacletus” means “one who has been called back”. Also “Anencletus” (Greek: Ανέγκλητος) means “unimpeachable”.

    The Roman Martyrology mentions the Pope in question only under the name of “Cletus”.The Annuario Pontificio gives both forms as alternatives. Eusebius, Irenaeus, Augustine of Hippo and Optatus all suggest that both names refer to the same individual.

    Pope Anacletus (died c. 92), also known as Cletus, was the third Bishop of Rome, following Peter and Linus. Anacletus served as pope between c. 79 and his death, c. 92. Cletus was a Roman, who during his tenure as pope, is known to have ordained a number of priests and is traditionally credited with setting up about twenty-five parishes in Rome. Although the precise dates of his pontificate are uncertain, he “…died a martyr, perhaps about 91”. Cletus is mentioned in the Roman Canon of the mass; his feast day is April 26.

    https://en.wikipedia.org/wiki/Pope_Anacletus

  158. @Johnny Smoggins

    Oh my sweet summer child, how long do you think that will last before it’s found to be discriminatory?

    a

    Why hasn’t been found so long before now, Mr Cynic? Who has been protecting it?

    • Replies: @anonymous
  159. @Twinkie

    Dr. Sellin’ a Poon

    you can’t make this up!

  160. Lugash says:
    @Jonathan Mason

    At the most basic level a degree of competence is needed, but these days docs have secret medical databases they can surreptitiously consult on their cell phones like Epocrates which is a drug prescribing reference guide, the Medical Encyclopedia of the University of Maryland, and the Skyscape Medical Library, plus Google images is pretty useful for identifying skin rashes and suchlike, however docs don’t usually let patients see them cribbing on the job.

    I had a foreign born doctor check WebMD in the office and immediately prescribe an anti-depressant for a medical issue that had a lot of other things that should have been checked first. The nurse who checked me out noticed the skepticism in my voice and rolled her eyes at his diagnosis. The scrip when into the trash.

  161. @william munny

    Firemen are primarily paramedics.

    • Replies: @Jim Don Bob
  162. @dvorak

    Lol, right back to IQ. SAT is likely closer to a pure IQ test than Step I is.

    Not IQ. Intelligence.

    • Thanks: sayless
  163. @Desiderius

    That was awful. I feel like throwing up.

    • Replies: @Desiderius
  164. @Kim

    Also:
    Supplemental magnesium for heart health- the soil is depleted and Mg offsets excess calcium and calcification, also Mg intake dramatically lowers heart disease risk

    Aspirin to lower inflammation/ risks of dementia; avoid other NSAIDs or acetaminophen unless necessary due to increased kidney stress

    Good fats like avocados and nuts

    Don’t drink undiluted booze to avoid oral or stomach cancer

    Balance work to keep steady on your feet in old age and avoid falls- standing on one foot at a time to put on pants and shoes on a daily basis helps

    High-intensity Intervals for time-efficient cardiovascular fitness training- physical fitness is indispensable, also ability to escape can make the difference in Zombie apocalypse or similar scenario

    • Replies: @anonymous
    , @Joe Stalin
  165. @Amerimutt Golems

    despite heavy discrimination in the job market and state contracts, the remaining competent persons of European descent who comprise about 8% of the general population are the ones preventing South Africa from total collapse.

    Would that there could be a general white strike. Let Atlas shrug. The connection between the outcome and its cause due to self de-Europanization would probably not be made by the bulk of the population, though. It takes a certain IQ to ascertain cause and effect and to reject specious explanations.

  166. Hibernian says:
    @Reg Cæsar

    If you’re talking about the timeframe I think you’re talking about, it wasn’t pleasant for St. Patrick.

  167. When it comes to medical doctors (especially surgeons) it goes from jews, to white doctors with 10-15 years of experience, to indians with a similar track record as whites have (maybe even a bit more as some egregioius malpractice has happened at the hands of indian doctors), and upper class hispanics with a track record.

    No way in hell I’d let a black doctor cut on me if I could in any way avoid it. Outside of the US, and maybe Canada, this is something everyone else in the world knows, but they aren’t as plagued by PC attitudes as we are.

    Being smart counts for a lot, especially if your life is on the line. And for the most part, there’s just no way of knowing if your black doctor is a high-performing Ben Carson, or Kwame from the hood. And the AMA keeps it that way.

    Me, I’ve just reached the age where I don’t give a damn about ‘authentically black hairstyles.’ No f-ing way, and as long as I’m likely to live at least another few hours, I’m going to a different hospital.

  168. @anon

    Not sure what the site’s ownership has to do with it, really. The effects you (accurately) note are almost universal. An “irate, tireless minority” and such, especially one with tremendous reserves of time and money.

    If anything, unz.com is notable as being one of the few places where we can even point out the phenomenon. That certainly doesn’t happen in the traditional media, or on their online analogues, and RU is most definitely the man to thank for that.

  169. @Hibernian

    A sweeping generalization, though largely valid in my opinion. But did you read and understand the man’s first paragraph?

  170. Yngvar says:
    @Anonymous

    Some things were better — you could still get effective opiate anti-diarrheal meds

    Imodium is opium. It works.

  171. @Muggles

    Other government employees may be overpaid, but firefighters are vital, they risk their lives on a regular basis (in dense cities at least), and they should be well compensated.

    The big exception, as with police, is the overtime scam.

    • Replies: @JMcG
  172. @ben tillman

    That’s the healthy reaction to the decay he describes around him. That which is uprooted naturally rots.

  173. anonymous[336] • Disclaimer says:
    @Lockean Proviso

    “physical fitness is indispensable, also ability to escape can make the difference in Zombie apocalypse or similar scenario”

    Good advice, I had not thought of that. Any Zombie apocalypse up here in cold Central New York state would be exacerbated by the climate (they would stay fresh a lot longer).

  174. Lurker says:
    @YetAnotherAnon

    Where was this racism coming from?

    Other Bad Whites who are not you, your friends or family. But they exist, oh yes.

  175. @Lockean Proviso

    “Aspirin to lower inflammation/ risks of dementia”

    I had a Doctor put me on the “baby aspirin” 81mg as well as Fish Oil over a decade back.

    The medico I am now seeing states the literature as well as the cardio docs at the hospital now DO NOT recommend this ANYMORE.

    Also, there apparently is not real evidence of Fish Oil doing anything of any significance for our health, so lay off the stuff because you are wasting your money. Eat real fish for fish benefits.

  176. JMcG says:
    @RadicalCenter

    I don’t know about firefighters specifically, but overtime is often used instead of hiring additional employees with all the associated costs and benefits. Think about it as increasing the tooth to tail ratio.
    Two guys working 3k hours/year are each making a pile of money, but they have two thirds of the vacation days and benefit expenses that three guys working 2k hours/year.

  177. Corvinus says:
    @Just passing through

    “Those Blacks are pretty efficient when it comes to genocide.”

    Whites have been far more effective and efficient. It’s in our DNA.

    • Replies: @anon
  178. @ben tillman

    Firemen are primarily paramedics.

    Right. Here in the Peoples’ Republic, there are actually very few, you know, fires. Most of the calls in the winter are frozen pipes. Then there are faulty alarms going off and 911 medical calls. We don’t have abandoned buildings with drums of toxic waste ready to fire up.

    Being a firefighter is 24 hours on 4 times in a 10 day period (I think) which allows many of them to have second jobs. And many departments use the rule of 80 for retirement, so you can get out at 50 years old with a full pension if you’ve been in 30 years.

  179. anonymous[336] • Disclaimer says:
    @Reg Cæsar

    “Why hasn’t been found so long before now, Mr Cynic? Who has been protecting it?”

    Sanity, which is short supply these days in discrimination law (by that I mean judge-made law, generally state legislators are reluctant to do anything that will terrify their subjects).

    Progressives will get around to it when the time is right, believe me.
    That’s Progress.

  180. Dan Kurt says:
    @SafeNow

    RE: ” several Max planes were crashing themselves”SafeNow

    The “Max planes” didn’t crash themselves. Both planes went down with pilot error causation. The aircrews panicked unlike American aircrews presented with the same situation.

    • Agree: JMcG
  181. anon[380] • Disclaimer says:
    @Corvinus

    Tiny Crow says:
    Whites have been far more effective and efficient.

    You’ll have to provide some evidence for this, perhaps starting with the “ghost” Africans who no longer exist for some reason. Your archeology should be done properly.

    It’s in our DNA.

    Where? Point to the specific alleles.

  182. Twinkie says:
    @Johnny Smoggins

    Oh my sweet summer child, how long do you think that will last before it’s found to be discriminatory?

    Requiring BE/BC status for employment isn’t going anywhere soon. If hospitals were to do that and those un-certified docs have bad outcomes, personal injury lawyers will be all over that discovery. I never thought I’d say a kind word about them, but the threat of expensive judgments and poor PR is the last backstop to the carnage of Affirmative Action doctors.

    • Agree: Jim Don Bob
  183. Twinkie says:
    @Johann Ricke

    Did this roster include any foreign origin blacks, that you know of?

    None.

    By the way, my orthopedic surgeon is a “foreign-origin” black, and he is very competent. To clarify, he was born overseas, immigrated as a small child, and went to top-notch medical school and residency/fellowship programs.

    • Thanks: Johann Ricke
  184. Twinkie says:
    @Polynikes

    That’s all well and good *after* you’ve narrowed the pool of people to an acceptable group (which is what I was talking about).

    Your narrowing process will also leave out competent providers who happen to be in your undesirable ethno-racial categories.

    Are there many black doctors who are incompetent? Yes, absolutely. But there are also black doctors who are competent. Like I wrote, narrowing by race has false positives (positives being incompetent docs). Forget about race and get a nurse or another doc to find out. Reputation is much more salient than race.

    I happen to sit on the board of a large, multi-state healthcare system, and I know for a fact that good surgeons get “requests” all the time from “friends and family” of nurses, doctors, and administrators, as is the norm with any skilled trades.

  185. Ian Smith says:
    @El Dato

    If I remember correctly, she refused to do a c section against staff advice. It’s telling that she skulked off to India.

  186. sayless says:
    @The Wild Geese Howard

    Bloomberg knows. He must know. He could not not know. This is a feint.

  187. Jack D says:
    @Kim

    no seed oils (coconut oil is great. palm oil is fine

    I’m not so sure I agree w. this. Lots of contradictory advice about oils but no one seems to have anything bad to say about olive oil, which certainly has a very long history of consumption by (Southern) Europeans. The other good thing about (extra virgin) olive oil is that it is just squeezed out of the ground up olives and that’s it. If you are talking about your usual tasteless vegetable oil (soy,canola,corn, etc.) the process for making them is horrifying. You can only extract maybe half of the fat by squeezing in an expeller press so they get the rest out by washing the mash with hexane. Hexane is more familiarly known as gasoline. Then you heat up the oil to drive off the gasoline (hexane boils at 154F). And that’s just the first step – then it’s “deodorized”, “winterized”, blah, blah blah. It’s more like a process for making refined petrochemicals than something you would want to eat.

    • Replies: @res
  188. guest says:
    @Anonymous

    Avenatti was so obviously nutty, though, that it’s difficult for him to be a reason to care. If dudes wanna “get ahead” like that, it’ll be easy to spot them.

    This ain’t like Bladerunner, where mutinous humanoids blend in.

  189. Dissident says:
    @anon

    And I have to say, the decline in vigorous racialism here in the last several months has been incredible. Half the comments for any article above the middle-brow level seem like pure hasbara.

    Do you mean for The Unz Review in general, or just iSteve in particular?

    Jews have a parasitic evolutionary strategy on Whites that periodically produces legitimate backlash. Germans, indeed Whites all over the West, are dying right now at the hands of feral peoples, because the Jew-backed side won WW2.

    An awful lot of tendentious and dubious presumptions are packed into those two sentences. Point-by-point:

    – Your citing of Kevin MacDonald’s theory as if it were settled fact no different than The sun rises in the East and sets in the West is amusing.
    Judaism as a Group Evolutionary Strategy: A Critical Analysis of Kevin MacDonald’s Theory
    Is Kevin MacDonald’s Theory of Judaism “Plausible”? A Response to Dutton (2018)

    – Just because submissive, self-flagellating, and even suicidal policies and attitudes have prevailed in the West after WWII does not mean that they had to inevitably follow as a result of the outcome of that conflict.

    [MORE]

    – No less compelling a case could be made that it was the excesses of Nazism that the pendulum swing in-question was a direct, reflexive reaction to.

    – One can acknowledge that Nazism was an understandable reaction to legitimate grievances and threats (and even maintain that some degree of resentment toward and wariness of Jews was not without any basis) without going as far as justifying what ultimately was nothing short of an all-out maniacal genocide as a “legitimate backlash”.

    – Nazis demonized, attacked and slaughtered plenty of non-Jewish Whites as well.

    I have no idea what this site’s owner really wants. His heart does seem to be in the right place

    One thing Ron Unz certainly seems to want is continued mass immigration.

    In 1994, he launched a surprise Republican primary challenge to incumbent Gov. Pete Wilson of California, running on a conservative, pro-immigrant platform against the prevailing political sentiment, and received 34% of the vote. Later that year, he campaigned as a leading opponent of Prop. 187, the anti-immigration initiative, and was a top featured speaker at a 70,000 person pro-immigrant march in Los Angeles, the largest political rally in California history to that date.

    I often wonder how much awareness of this there is among those who laud Ron Unz as one of “the righteous ones” who, they assure us, an exception will be made to spare.

  190. res says:
    @Jack D

    The primary issue with olive oil is the somewhat low smoke point. This article gives some useful details.
    https://www.prevention.com/food-nutrition/a20470582/cooking-with-olive-oil/

    Each type of olive oil has a slightly different smoke point:
    Extra virgin: 375 to 405°F
    Virgin: 390°F
    Pure: 410°F
    Light: 470°F

    As you say, probably the least arguable choice among oils.

    • Replies: @Jack D
  191. @anon

    Obviously you’ve never had your heart touched by the International Fellowship of Christians and Jews.

  192. Jack D says:
    @res

    I rarely if ever deep fry. No good reason to heat oil above 375 anyway.

    Pure and light are made they way they make soy oil, with lots of processing to remove all taste and color from low grade oils. Avoid.

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