Diversity in medical schools declining after SCOTUS ruling

Racial diversity among medical school admissions declined following a 2023 Supreme Court ruling that affirmative actions were unconstitutional, finds newly published research in JAMA.

In looking at doctorate program applicants from 2019 to 2024, researchers from Yale School of Medicine, University of California School of Medicine and the American Medical Association found racial and minority groups who were underrepresented in medicine (URiM) were further underrepresented in the 2024 admissions cycle.

Groups that are underrepresented compared with their white and Asian peers include students who are Black, Hispanic, Native American, Native Alaskan, Native Hawaiian or Pacific Islanders.

Specifically, there was a 14.59% relative decrease in URiM matriculants to MD programs over that time. There were no racial or ethnic differences in acceptance rates prior to the Supreme Court ruling. 

WHAT'S THE IMPACT

The disparity in URiM representation compared with white and Asian representation was concentrated mainly in states that did not have affirmative action bans prior to the Supreme Court's decision, the study showed.

The 2023 decision was grounded in the principle of meritocracy, authors said, but the concept of meritocracy in medical education exists within a broader context of persistent systemic racial and ethnic discrimination, including unequal access to educational opportunities. The ruling was intended to make admission decisions race neutral, but instead, the ruling highlights longstanding structural barriers, authors said.

The implications of a less inclusive physician workforce could worsen the projected nationwide shortage of more than 130,000 physicians by 2030, the study found, with medically underserved areas being the most disproportionately affected. URiM physicians are more likely to provide medical care to uninsured and Medicaid patients and individuals living in medically underserved communities, data showed.

Authors said a decline in physician workforce inclusivity could hamper scientific progress and hinder the learning environment of all learners. Students in racially diverse learning environments felt better equipped to care for patients from racial and ethnic backgrounds different from their own, compared with white medical students in less diverse environments, data showed.

THE LARGER TREND

Because of the observational nature of the study, authors cautioned that other factors may have influenced URiM acceptance rates and representation among matriculants, including year-to-year changes in the number of applicants, the characteristics of MD programs to which students apply, and the surge in applicants due to the COVID-19 pandemic.

Also, while there were increases in Asian representation following the SCOTUS ruling, Asian professionals still are underrepresented in leadership roles within medicine and academia, authors found.