UCSF School of Medicine suspends affiliation with Alpha Omega Alpha (AOA) Honor Society

Based on careful in-depth review, UCSF School of Medicine announced May 15 that it will suspend its affiliation with AOA, the national medical honor society, beginning with the class of 2021. This decision came after the UCSF Committee on Curriculum and Educational Policy (CCEP) charged a task force in 2019 to review and make a recommendation about UCSF’s participation. Throughout the task force review, students and faculty participated and gave voice to the reasons for this change. The CCEP endorsed the task force recommendation which was then approved by school leaders, including Dean Talmadge King. With this decision, UCSF joins other medical schools including Harvard, Stanford and others who do not participate in AOA. 

In an announcement to School of Medicine faculty and students, Vice Dean for Education Catherine Lucey stated that the reasons for this change were several-fold:

• Although the AOA has done many good things for the medical profession over the years, we do not believe that the circumstances that led to the formation of AOA over a century ago are still valid today. As detailed on their website “At that time […of the founding of AOA], the practice of medicine relied on tradition and was mostly empirical. Medical education was poorly structured and medical students were poorly prepared academically.” In 1902, founding students had reason to prioritize and incentivize measures of academic achievement. 
  
  In 2020, all medical students are held to incredibly high standards and subjected to rigorous examinations that demonstrate their abilities. The AOA selection criteria and limitation on students selected to 16% of the class does not reflect our belief that all UCSF graduates are prepared to become outstanding UCSF physicians. Each year, we have to turn away highly deserving students because of the requirements and restrictions of AOA membership. That only a small percentage of students are eligible to receive this accolade can disadvantage the majority of the class by not acknowledging their excellence.
   
• The selection process and limitation on membership is not aligned with our educational philosophy or our commitment to equity in all aspects of education. The same issues that prompted a change to the assessment and grading system apply to the AOA process: abundant literature shows that a focus on grades and performance interferes with learning and decreases students’ wellness. Students focused on metrics of success feel compelled to do things that ‘look good’ and showcase their strengths rather than attempting new learning experiences and asking questions to further their learning. Furthermore, bias in assessment of learners is pervasive through educational systems, and is documented in the AOA selection process. Boatright et al documented bias against non-white students in selection to AOA (JAMA Intern Med., 2017), and we have worked hard at UCSF to overcome population group differences in our evaluation systems that advantage some populations over others.
  
  A decision such as this has required careful deliberation and has incorporated input from students, educators, residency program leaders and faculty from across the School of Medicine. Please be assured that the disadvantages of this decision were debated at length. We continue to believe that there are many ways for our students to demonstrate their excellence and unique accomplishments. While this decision is now final, we look forward to collaboration across the medical school to residency continuum to ensure that our students’ education, and the process of selecting residents to the programs that are the best fit for their learning and the residency programs’ needs, is optimized.