Medical School Diversity

High court sets back efforts to diversify medicine, improve care

Kevin B. O'Reilly , Senior News Editor

What’s the news: The U.S. Supreme Court has issued a decision to restrict public and private higher-education institutions from considering an applicant’s race or ethnicity in admission decisions. The court’s action effectively overturns nearly five decades of precedent allowing for limited use of affirmative action in college admissions. The Supreme Court’s six conservative justices carried the majority in two separate cases involving race-conscious admissions at Harvard University and the University of North Carolina.

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The decision “undermines decades of progress centered on the educational value of diversity and will reverse gains made in the battle against health inequities,” said AMA President Jesse M. Ehrenfeld, MD, MPH, who is a senior associate dean, tenured professor of anesthesiology and director of the Advancing a Healthier Wisconsin Endowment at the Medical College of Wisconsin.

The AMA and more than 40 other organizations joined an Association of American Medical Colleges-led amicus brief that urged the high court to “take no action that would disrupt the admissions processes the nation’s health-professional schools have carefully crafted in reliance on this court’s longstanding precedents.”

Dr. Ehrenfeld said the ruling “restricts medical schools from considering race and ethnicity among the multiple factors in admissions policies and will translate into a less diverse physician workforce.”

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Why it’s important: “While our country grows more diverse, historically marginalized communities have been left behind on nearly every health indicator. A physician workforce that reflects the diversity of the nation is key to eliminating racial inequities,” Dr. Ehrenfeld noted, pointing to convincing evidence that Black doctors could reduce the Black-white male gap in cardiovascular mortality by 19%.

“Racially diverse care teams produce measurably positive health outcomes for patients in historically marginalized populations,” he added.

The Supreme Court decision “undermines policy that was producing positive results and improving the health of our patients,” Dr. Ehrenfeld said. “This ruling is bad for health care, bad for medicine and undermines the health of our nation.”

The ruling restricting race as a consideration in admissions will reduce diversity just as focused recruitment campaigns and other strategies are beginning to succeed, as AMA Immediate Past President Jack Resneck Jr., MD, noted in an AMA Leadership Viewpoints column published last fall.

“For example,” he wrote, “the number of Black first-year medical students in the U.S. rose by 21% between 2020 and 2021, and Hispanic or Latinx students grew by more than 7%.”

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Learn more: At the 2023 AMA Annual Meeting in Chicago earlier this month, the House of Delegates adopted new policy to “recognize the consideration of race in admissions is a necessary safeguard in creating a pipeline to an environment within medical education that will propagate the advancement of health equity through diversification of the physician workforce.”

Ahead of the high court’s ruling, the AMA convened a panel of thought leaders in medical education and health equity to discuss the potential consequences of an adverse decision. An on-demand recording of the webinar, “Affirmative Action in Med Ed: Exploring the Consequences of an Adverse Supreme Court Decision,” is available free on the AMA Ed Hub™ (login required).

Find out more about the AMA’s work on equity, diversity and belonging in medical education.