THERE'S A REASON EXPANSION TEAMS TEND TO UNDERACHIEVE.

Matt "Dean Dad" Reed makes an observation, "Rigor and scarcity are not the same thing," that could be a Friday short take, although the article elaborates on a variety of Cold Spring Shops themes.  He's commenting on a situation that recently arose at New York University, where a distinguished but elderly biochemist got fired, apparently because disaffected students didn't like his grading methods.  To the conservative-populist-traditionalist observer, that student complaint is yet another manifestation of the dumbing down of higher education.  ("Every American should be worried because this kind of standard-lowering is becoming commonplace in medical school.")

There might be more in play, though.  First, college teaching is a lot like farming.  Thus, "rigorous" is not always well defined, nor is washing out a lot of people necessary.

To my mind, at least, a rigorous class is one that compels significant student engagement. A class that pushes them to do more than just memorize or go through the motions in order to be successful can count as rigorous. That’s true no matter the grade distribution. If a class goes so well that everyone is intensely engaged, everyone does great work and everyone gets an A, I’d happily consider it rigorous. (In many graduate programs, an A is the default grade for a seminar, but I don’t remember anyone complaining about how easy they were.) On the other side, a class with a harsh grade distribution can still be shallow.

The kind of rigor I’m endorsing relies on a blend of the material, the instructor, the format, the setting and the students. I’ve had classes that I thought met the standard and classes that missed on one or more levels.

Yes, I suppose, even the most hard-boiled of Special Forces trainers would be pleased if all who turned up for muster earned the badge. So, too, might it be with physicians and surgeons.  That might be what New York Post contributor Stanley Goldfarb has in mind.

We must never forget that the high standards required of future doctors reflect the complexity and high stakes of the work. They exist to protect future patients, period. That’s why physicians and patients alike should fight the imposition of diversity, equity and inclusion policies — which are inherently divisive and often discriminatory — in all aspects of medical care. The health and well-being of patients depends on pushing back and keeping standards high.

The pre-med curriculum, thus, might have more in common with the Special Forces regimen than with the trivium and quadrivium.  Back to Dean Dad:

Engagement works wonders, educationally. Students who roll up their sleeves and really dig into the material will develop their skills at a higher level, will learn more and may well develop inclinations they didn’t know they had. Those classes can be life-changing. Classes that are difficult but not engaging, by contrast, can feel almost punitive. And yes, a class with shallow or simplistic material can do only so much.

That imperative, though, to ensure that the physician, or the paratrooper, is up to the job without endangering the mission, might not be the sole imperative behind weeding out the pre-meds with organic chemistry or some other course.

My frustration with the discourse around the NYU chemistry class is that it largely ignores that the production of scarcity is the purpose of the course. A high fail rate is a feature, not a bug. “Weed-out” classes—never liked the term, but there it is—exist because a system requires narrowing down the number of students who want to pursue something.

Premed requirements are an obvious case. In order to keep doctors’ salaries high, the medical profession restricts the number of seats in medical schools. That forces admissions committees at medical schools to find grounds on which to exclude the majority of applicants. Academic records are a facially nondiscriminatory basis on which to exclude. If everyone were suddenly to get A’s in organic chemistry, another scarcity mechanism would have to develop to take its place. The system isn’t built to allow everyone who wants to be a doctor to be a doctor.

Here I’ll make the obvious asterisk. Yes, we want doctors who are smart and capable. But I just don’t believe that the current system uses up the entire possible talent pool.

There, dear reader, is why I didn't simply slap a number and a link on that "rigor and scarcity" line.  Matt is not making the same point Insider contributor Eric Levitz is.  ("Every year, 'orgo' thins the ranks of the nation's premeds, with those unable to master the famously difficult course forfeiting their dreams of practicing medicine.")  At the risk of going astray, organic is also notorious for cut-throat pre-meds sabotaging the lab work of classmates so as to obtain a more favorable grading curve.  But I digress.

The point both Dean Dad and Eric Levitz make is about the political economy of medicine.  In Insider, the article continues, "One answer is that we need some arbitrary mechanism for filtering aspiring doctors into other professions because we manufactured a scarcity of medical school and residency slots."

What you mean "we," Kemosabe?  What we have is a cartel.

[P]erhaps the best thing for the government to do is go away.  In City Journal, Tom Coburn and Paul Howard summarize their case thusly. "State and federal mandates hamstring competition in the name of protecting consumers and providing charity care, but they don’t do either job particularly well."  The details are complex in places, but the political economy is straightforward.  Why should a medical cartel be different from any other cartel?  The purpose of a cartel is to generate monopoly rents for insiders and then dissipate them in ways that get spun as in the public interest but in a full analysis generate deadweight losses.  Where there's a fear of rationing by price meaning the poor people die, it's an easy sell.

Instead, organic chemistry helps limit the supply of physicians and surgeons, raising salaries, and then monopsonistic manipulations such as the Medicare reimbursement rate and the new price caps on some prescription drugs attempt to reduce the pain, but reducing the return on investments that have been boosted by other public measures is ... silly, to use a technical term.

Dean Dad's concluding paragraphs, though, are what inspired the seemingly off-topic title of this post.

If we want to do away with arbitrary mechanisms for scarcity, we need to look much more widely than just at higher education. To the extent that desirable jobs are scarce, competition for them will ensue; as they get scarcer, the competition will intensify. But if good jobs are plentiful, then suddenly we don’t need weed-out mechanisms anymore. If anything, we need to throw the doors open even wider. Over the last year or two, we’ve seen what happens to arbitrary barriers when there’s a labor shortage; all of a sudden, employers who wouldn’t consider anyone without a four-year degree discover that talent comes in many forms. It always did, but it wasn’t always welcome. Now it is.

I don’t know if Maitland Jones was wronged. But I do know that large-scale failure is built into our current systems for allocating scarce goods. Arguing over the distribution of scarce goods while taking their scarcity as given is something, but at a more basic level, it misses the point. With many ways to succeed, we could encourage all talent to flourish. And education could focus on empowering students rather than excluding them.

At Cold Spring Shops, we call "many ways to succeed" a case for trade-tested betterments.  But if the cartel goes away, and the pool of aspiring medical doctors expands, some of that "talent that comes in many forms" might be less prepared, aptitude at organic chemistry or not.  But the hardest transition is Saturday to Sunday, and the supply curve of quarterbacks, or surgeons or physicians, is not infinitely elastic.