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The standardised admission ratio for measuring widening participation in medical schools: analysis of UK medical school admissions by ethnicity, socioeconomic status, and sex

BMJ 2004; 328 doi: (Published 24 June 2004) Cite this as: BMJ 2004;328:1545

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Re: The motivations of other scientists are problematic to interpret...

I apologise to Chris McManus for any 'vehemence' he found in my post
about his views on meritocracy in Britain. I am genuinely sorry that the
points I made do seem to have come out more ad hominem than ever I
intended and I will just have to accept that damages my case slightly. I
regret failing to polish and tone down the parts of it that probably stem
from a general impatience with 'scientists' expressing comments about
complex social issues in specifically reductionist and numerical terms,
which they have a bad habit of doing, and which can be simplistic, non-
insightful and crass—in many cases. However, I am pleased he enjoyed the
article by Roscoe.

Aside from that, however, and getting back to the main point, I note
that he does not respond to my rebuttals of his points, specifically that
although Britain is more meritocratic than it was 50 years ago, it is
still not a meritocracy and that career progression in the professions
cannot be adequately defined solely in terms of qualifications,
'intelligence,' [whatever that is] or numerical data. I attempted to
expose the existence of a sizeable cluster of complex and unquantifiable
social factors that more adequately describe and explain the social
patterns we have been discussing. I think I gave a justifiably
comprehensive account of the shortcomings of the positivist approach,
which remains the core of the problem.

In brief, Chris McManus was wrong to claim that Britain is a
meritocracy and that any impressive juggling of figures—in isolation from
social class descriptors—can somehow generate useful insights about career
progressions in the professions—they can't and don't. What they do
generate, of course, are the type of simplistic illusions 'scientists'
seem to enjoy. It might have been better had Chris McManus admitted his
failings more candidly.

The British rock band Oasis inadvertently [?] described the
epistemological problem quite well in a song lyric thus:

"And all the roads we have to walk are winding

And all the lights that lead us there are blinding." [1]

This adequately summarises the problem too many scientists create by
kidding themselves that they have knowledge they do not in fact
possess—but which requires far deeper analysis—and which flows from their
feeble and intrinsically doomed impulse to explain and quantify things
that are much better left as descriptive statements. In truth,
reductionist and positivist 'lights' seem especially blinding.

Positivism is "the view that all true knowledge is scientific," [2;
669] and that all things are "ultimately measurable." [3] Because of its
"close association with reductionism," [2; 669] it is worth saying that
positivism and reductionism involve the view that "entities of one
kind...are reducible to entities of another," [2; 737] such as societies
to numbers, or mental events to chemical events. It also involves the
contention that "processes are reducible to physiological, physical or
chemical events," [2; 737] and even that "social processes are reducible
to relationships between and actions of individuals," [2; 737] or that
"biological organisms are reducible to physical systems." [2; 737]

Ultimately, all this means that science eagerly accepts the primary
assumption that all life experience can be satisfactorily reduced to
solely physical and chemical events, that is to matter and molecules in
various states of size, activity and interaction. This is the positivism I
railed against in my previous post. It is a position that is absurd to the
obvious extent by which it is out of touch with real-world life experience
at the social and artistic level, which brings us back to precisely all
those things I said before and what Berlin says, which need not be

The stark gulf between the humanities and science appears as wide and
as unbridgeable as it ever was. The issue is certainly about positivism
and reductionism—that science eagerly assumes to be a valid step towards
real understanding, but which the humanities have long since rejected as
an unwarranted assumption that might be applicable in limited cases, such
as in in vitro chemical and physical systems, but which is unworkable for
larger and in vivo systems or societies. Crucially, in this act of crude
reductionism the key complexity of such systems is lost.

The contention is that you cannot satisfactorily reduce social
phenomena to chemical events and numerical studies and to do so merely
create simplistic nonsense of the McManus type. This means that you cannot
truly make much sense out of such social systems without recourse to the
views of people like Kant, Hegel, Marx and Husserl, as a minimum, because
the alleged 'sense' that you do get from untenable
reductionsim/postitivism is non-insightful ‘garbage’ of limited
"predictive power." [4] I'm sorry if Chris McManus regards that as
another unwelcome dose of 'vehemence,' but it is an infinitely more honest
account of how things are than masquerading pure kidology as
'dispassionate science.' I don't actually believe that any of the greatest
scientists were as remotely dispassionate as their devotees like to
pretend, but that is another topic.

I hope this sufficiently illuminates the requested 'motivation'
behind the comments I made previously, which the sentiment implicit to
Chris McManus' post seemed to hold in question. My motivation is
transparent enough—to seek a wider view, in the context of which many
things become better understood. My principle objection therefore—to
positivism and reductionism—is that such approaches always adopt an
excessively narrow view of phenomena, and this necessarily precludes the
wider view of life I prefer—a bad case of throwing out several babies with
the proverbial bathwater.


[1] Oasis, You're my Wonderwall, released 10 March 1995

[2] Alan Bullock and Stephen Trombley, [Eds] The Fontana Dictionary
of Modern Thought, London: Harper-Collins, 1999

[3] O E Guttentag, Trends toward Homeopathy Present and Past, Bull
Hist Med, 8.8, 1940, 1172-1193; [quote from p.1177]

[4] Ferguson et al, Pilot study of the roles of personality,
references, and personal statements in relation to performance over the
five years of a medical degree, BMJ 2003;326:429-432 (22 February)

Competing interests:
None declared

Competing interests: No competing interests

18 August 2004
Peter Morrell
Hon Research Associate, History of Medicine
Staffordshire University, UK