Did Politics Trump MCAT in an Admissions Decision at the University of Florida?

Several stories in the Gainesville (Florida) Sun and the Florida Alligator suggest issues with the leadership of the University of Florida College of Medicine. As first reported in the Sun,

In a move that breaks with the norms established by medical school accreditors, the dean of the University of Florida's College of Medicine has opted to admit a student from a politically connected family, even though the student didn't have the backing of the Medical Selection Committee.

Kone wouldn't name the student, but sources close to the situation identified him as Benjamin Mendelsohn, the son of Dr. Alan Mendelsohn, a Hollywood ophthalmologist and a Republican fundraiser who was a grassroots organizer for Gov. Charlie Crist during his 2006 campaign.

Before Kone took over as dean in May 2007, Gov. Crist sent a letter to UF in February 2007 on Mendelsohn's behalf. The letter, addressed to UF's admissions officer and copied to UF President Bernie Machen, urged UF to admit Mendelsohn to the Junior Honors Medical Program, an accelerated seven-year program that combines bachelor's and medical degrees.

'I have known Benjamin and his family for several years and know that Benjamin's affiliation with the University of Florida will mutually enhance the reputation of both Benjamin and the Medical Program,' Crist's letter states.

In 2006, the Mendelsohn family gave at least $33,257 to political candidates, 94 percent of which went directly to Republicans, according to the Florida Department of State's Division of Elections. Of that money, $1,682 went to Crist, including a $500 donation from Benjamin Mendelsohn himself.

Alan Mendelsohn is a known fundraiser in the medical community. In 2005, he held a fundraiser in his own home where more than 150 physicians raised more than $100,000 for Crist, according to a news release from the Florida Medical Political Action Committee.

The Dean denied that politics influenced his decision.

'I can't even comment that there were any political connections that this person had, but I certainly wasn't influenced by any outside forces,' Kone said Thursday.

'There was no political influence related to this thing,' Kone added in a second interview Thursday night. 'There never will be. There never has been. This was an exceptional student, and I wish to God I could even tell you about (the student's) credentials.'
The Dean also asserted that he had the power to admit the student against the wishes of the committee. It appears, however, that his action may have violated rules set by medical school accreditors.

The move breaks with procedures described by the Liaison Committee on Medical Education, which provides accreditation to UF and medical schools throughout the U.S. and Canada.

'The final responsibility for selecting students to be admitted for medical study must reside with a duly constituted faculty committee,' according to the accrediting body's standards.

Furthermore, the accreditation standards say 'the selection of individual students must not be influenced by any political or financial factors.'

Barbara Barzansky, co-secretary of the Liaison Committee on Medical Education at the American Medical Association in Chicago, said the central role of faculty in admissions is well-established in the medical community.

'I think the standard speaks for itself. It expects that there be a faculty decision around admission,' she said.

'Deans may be under pressure from groups, alums, sometimes the Legislature, depending on the type of school and the location,' she added.

A follow-up in the Gainesville Sun suggested more irregularities in the admissions process. First, it appears the student had never taken the MCAT, a test usually required as a prerequisite to medical school admission.

When the committee considered the 2008 application of Benjamin Mendelsohn, the son of a prominent Republican fundraiser and contributor, Mendelsohn had not taken the Medical College Admissions Test, or MCAT, according to three members of the selection committee and two other sources close to the situation. The MCAT is a standard admissions requirement for regular admission to the program, selection committee members said.

A peculiar memo to medical school administrators, and copied to University President Bernie Machen, suggested that the Dean's actions may have had even murkier origins.

In the e-mail, time-stamped Friday at 10:52 p.m., Kone said Machen's staff did not 'sho(o)t straight' when he met with them, adding that they were not sufficiently courteous to him when they discussed the admissions issue.

'I don't know if it was cowardice, a lack of compassion, or what, but it is symptomatic of why this university is stuck in mediocrity and has been since I left here 13 years ago,' wrote Kone, a former UF student and faculty member.

Kone said that he followed university precedent, 'delivered a great student. Took many bullets for the team. Protected the mother ship.'

Asked whether Kone's reference to protecting the 'mother ship' implied that he was pressured to accept the student, Machen responded Wednesday, 'Please don't make inferences that would be pure conjecture . . . I assure you neither I nor any member of my staff had any involvement in the medical student admission decision.'

Finally, it appears that faculty are disturbed, but fearful of speaking up.

Several faculty members who contacted The Sun said they feared what might happen to their careers if they were publicly critical of the dean's actions. As evidenced by his Friday e-mail, Kone has openly criticized those with whom he disagrees - even Machen's own staff.

Obviously, there are some fuzzy aspects to this story. We may not have heard anything like a final version yet.

What is most disturbing about it, however, are the implications that medical school leadership may have been acting at odds with the institution's mission. In particular, it appears that at least one admission decision may have been affected by politics rather than students' credentials, and faculty are afraid to criticize it. The integrity of the admissions process is fundamental to the integrity of the medical school. Suppression of dissent clashes with the academic ideal of free enquiry. Finally, power within this school seems to have centralized to an unusual extent. Transforming the corporate culture of academic medical institutions into central domination by an "imperial CEO," as is now common in business, is fraught with danger for institutions that are supposed to be about excellent patient care, and discovering the disseminating the truth.