The year was 1976. I was graduating from a small branch of my state university with a bachelor’s in chemistry when I first applied to medical school. I was living at home and paying my own tuition. There were no physicians in my family, but I became interested in medicine after I was impressed with a surgeon who had operated on my shoulder. I had a better-than-the-medical-school-acceptance-rate average on my grades and MCAT scores, stellar recommendations and tons of extracurriculars, so I was confident. Still, I heeded the advice of a professor who advised me to apply to a graduate program where I could get a master’s in chemical engineering.

I applied to 19 medical schools including two state schools. I got interviews at 10. By the time I got past my third interview, I knew I was in trouble. By the end, I was thoroughly disgusted. Here are a few examples of what I was told:

1) “60 percent of our class comes from children of professors and alumni.”

2) “If your family made a contribution to our alumni fund, we will look upon your application favorably.”

3) “If you were black, we could accept you.”

4) “If you were a black female we could accept you.”

5) “We have found that students from schools like yours have higher grades than more competitive schools.” When I pointed out that my MCAT schools were well above the acceptance average of that particular school, all I got was a blank stare.

Needless to say, I wound up going for my master’s.

Just after college, I started dating a girl who was one year behind me earning a bachelor’s in nursing. She had a friend who came from a very prominent and connected family. In the spring of 1977, she started dating a man who had been trying to get into medical school for three years. It was late April when she decided she would like to go to medical school. She not only was admitted to the 1977 class, but she also got her boyfriend admitted as well.

My disgust was complete.

During that summer, I met with a few of my old fraternity friends for drinks. When asked how I was doing I said grad school was challenging, but I was doing well. However, when asked if I was going to apply to medical school again, I said absolutely not. A few drinks later, one of my friends said that I should apply to just the two state schools, where I had my best chance. After thinking about it for a few days, I decided, that I had nothing to lose.

The spring of 1978 was a busy time. I was finishing up grad school, putting the final touches on my master’s thesis, starting wedding plans and interviewing jobs. Compared to my medical school interviews, the job interviews were elaborate, roll-out-the-red-carpet affairs. I also had my two medical school interviews. The first went as expected. In full suit and tie and 15 minutes early, I was once again reminded of how “competitive” entrance to medical school was. My only thought when I left was, what a waste of time.

Two weeks later, I had my second school interview. It was scheduled for 12 noon, but as it turns out, I had a meeting with my thesis advisor at 12:30. Around 10 a.m., my thesis advisor called to say he would have to re-schedule. When I checked my calendar to pick a new meeting time I noticed the medical school interview which I had, in fact, completely forgotten about. Since the school was only a 45-minute drive away, so I decided what the heck.

I arrived 10 minutes late, shaven but with no tie or jacket. There were three interviewers, two men, one woman. After reviewing my records, they seemed particularly interested in my master’s thesis and why and how I managed to get a master’s in chemical engineering. I was more than happy to tell the entire story, including my disgust with the whole process. From their reaction, I could sense there was subtle agreement. However, after saying that I had an impressive record, they again tried to emphasize how “competitive” was medical school. In fact, this particular school had on its letterhead: “An Affirmative Action, Equal Opportunity Medical School,” an oxymoron if there ever was one.

I held my hand up and said “Look, as I said, I have heard this many times before. The medical school admissions system is rigged, and you know it. I am done. I have a bright future ahead of me, so I don’t have to put up with this. Thank you for your time.”

I stood up, shook their hands and walked out. The shock on their faces was evident.

Over the next several weeks, I finalized my plans and had moved back in with my parents temporarily. During this time every month, I would get a single page letter from this medical school saying I was on the “waiting list.” That’s nice, I would say, then I would proceed to tear up the letter. One day in early August I walked through the door to find my mother going through the mail. She handed me another single page envelope from the school. I simply tore it up and put it in the trash. My mother asked why I did that and I said, “It’s just another waiting list or rejection letter,” and I went upstairs. Soon after I heard a scream from the kitchen. I ran downstairs to find my mother holding the two halves of the letter which said I got in. I was so shocked that to this day I can’t remember what happened next.

The rest they say is history.

So here we are 40 years later. I have retired, and a lot has changed. What has not is that the same questions are asked regarding what qualifies someone for admission to medical school and the same arguments are used. One thing I am certain of is that if I had to go through it today and seeing how medicine has changed and the costs involved, I would have taken that letter from my mother’s hands and thrown it back in the trash.

Thomas D. Guastavino is an orthopedic surgeon.

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