When Medicine Becomes an Ideological Sorting Machine

Several years ago, I sat down with a group of residency program directors in the offices of the Idaho Department of Health and Welfare. The department’s director at the time, Richard Armstrong, was not present, but two representatives from his agency joined us to explain the funding and deployment of assets for the new Idaho Health Data Exchange. They gave generously of their time, and I left the meeting with a clearer view of how the system was supposed to work—though I confess I probably know less about what has happened with that agency today than I did then. The roughly one hundred million dollars that has gone unaccounted for only deepens that uncertainty.

As we wrapped up and exchanged the usual pleasantries, I made an offhand remark to one of the residency directors. I told him that if I were applying to his program today, I probably would not be competitive. He was puzzled then, and I suspect he would be no less puzzled now.

By conventional measures, my credentials are not the problem. I am double boarded in both internal medicine and general surgery, a combination of training that is increasingly rare. I see young physicians today emerging from residency with an added certificate in public health, which has its place, but is not a clinical discipline no matter how vigorously people like Dr. Anthony Fauci—who likely last cared for an actual patient during his clinical clerkship or internship—speak as if it were equivalent.

My point was not about grades, test scores, or clinical skill. It was about what the profession now selects for.

Over the past two generations, medical education has been quietly transformed into an ideological sorting machine. A profession once grounded in both secular and Christian virtues—”service before self,” charity care as the measure of success, humility before the suffering human being—has adopted the language and categories of progressivism: power, oppression, and privilege. The hopes and dreams of young people who feel called to heal are translated into someone else’s political vocabulary.

I hear this directly from residents and medical students. They tell me, again and again, that they must keep their heads down. They must conceal their Christian faith, or their conservative political and economic views, if they hope to match into competitive programs or advance in academic medicine. Be “down for the struggle,” be visibly woke, and you can earn an “A” from the attending or the program director. Speak honestly about conscience, or dissent from a mandated orthodoxy, and doors close.

In one case, a student who refused to participate in a late‑term abortion was quietly blackballed from a top residency program. The message was unmistakable: clinical excellence matters, but ideological compliance matters more.

When politics becomes the ornament of the academic physician, humility and service are displaced by a secular humanism that, in practice, often centers the physician, the institution, or the grant‑making agency. The “why” of medicine—serving a particular patient, made in the image of God or at least deserving of irreducible dignity—is blurred. In its place we are told that we serve “mankind,” or “the university,” or “the pharmaceutical partner,” or “the federal agency” that supplies the grant money our patients will never see and seldom understand.

The result is not just moral confusion; it is a slow erosion of our humanity and of our credibility with the public. This erosion did not begin with Covid‑19, but the pandemic dramatically exposed it. Under Dr. Fauci’s leadership, we saw not only scientific guidance but political theater, not only public health recommendations but shifting, conveniently timed narratives. Many of my colleagues watched our profession’s claim to universal trust diminish almost in real time. Patients noticed, and they have not forgotten.

Today, across the country, medical education and research are increasingly organized around the expectation that physicians will affirm the reigning ideology on matters far afield from the bedside. Admissions, hiring, promotion, and publication are all touched by this expectation. The profession is still filled with good people doing good work, but the system in which they move pressures them to conform, not to think.

A profession that systematically sorts for ideological conformity will, in time, lose its soul. Medicine cannot remain a true healing art if it demands that its practitioners leave their consciences—and often their faith—at the door.

If we want to restore trust in medicine, we must begin by reclaiming its first principles: service before self, the primacy of the individual patient, and the freedom of physicians to practice according to both sound science and well‑formed conscience. Anything less, no matter how noble the rhetoric, will continue the drift from vocation to ideology—and from healing to mere management.