Recognizing the benefits of diversity in classrooms and exam rooms

Research shows that achieving a physician workforce that is closer to the populations we serve will lead to better health outcomes for our nation. This is essential to improving our ability to provide high quality care to an increasingly diverse patient population.

That’s why it’s disheartening that the U.S. Supreme Court, for the third time in a decade, will hear arguments again today that could threaten more than four decades of precedent allowing for holistic, race-based admissions policies. In the latest challenge, a group known as Students for Fair Admissions is suing Harvard University and the University of North Carolina, alleging that their current selection models unfairly discriminate against white and Asian applicants in the name of a more diverse and inclusive academic body.

A decision on this matter, expected next year, will have significant implications for US higher education, including medical school admissions. A decision banning race as an admissions consideration would reduce diversity just as targeted recruiting campaigns and other strategies are beginning to succeed.

For example, the number of black first-year medical students in the US increased by 21% between 2020 and 2021, and Hispanic students grew by more than 7%. For the first time since the Association of American Medical Colleges began reporting data on race and ethnicity, a majority of applicants last year came from underrepresented communities.

However, underrepresentation persists, and we must not retreat from efforts to further stimulate the growing representation of talented and highly qualified medical students from historically marginalized racial and ethnic groups.

Recognizing the growing body of research that convincingly demonstrates that outcomes improve for patients — especially those from historically marginalized populations — who receive treatment from racially diverse health care teams, the AMA joined the Association of American Medical Colleges and 44 other leading health care organizations to push back on efforts to eliminate all consideration of race as a factor in admissions.

We jointly filed an amicus brief (PDF) in support of Harvard and the University of North Carolina, arguing that a diverse physician workforce is good for patients, good for medicine, and critical to improving the health of our increasingly diverse nation.

Our arguments are backed by science and evidence in published research. Medical students who study alongside peers from a wide range of backgrounds, cultures, and experiences gain greater cultural competence and benefit from an educational environment that values ​​inclusion and diversity.

U.S. Supreme Court decisions upholding race-conscious college admissions practices date back to 1978. In making a decision The Regents of the University of California v. Bakke that same year, in a case specifically involving medical schools, Justice Lewis Powell identified the benefits of such policies in providing “experience, perspectives, and ideas that enrich the training of the student body and better prepare its graduates to perform with understanding their vital service of humanity.”

Subsequent Supreme Court decisions upheld the constitutionality of racially motivated confessions. Most recently, in 2016, the nation’s highest court issued a 4–3 decision in Fisher v. University of Texas which confirmed the long-standing concept that educational diversity enriches the experience of all students, not just those from racial or ethnic groups that have been marginalized in the past.

As the AMA stated in an amicus brief filed in Fisher: “Removing the ability of medical schools to consider applicants’ race and ethnicity as one of many personal attributes would undermine their ability to assess the whole background of each individual, thereby defeating the goal of best serving public health.” This it remains so today.

Similarly, both experience and research show that physicians who learn and train alongside colleagues of different racial and ethnic backgrounds become better physicians. If we want to eliminate health care disparities that affect minority and marginalized communities, we must not prevent medical faculty and medical school admissions staff from considering race as part of a holistic screening of applicants that also considers test scores, grades, and other measures of previous academic achievement, personal interviews and a host of other considerations.

In holistic admissions processes, schools consider and balance this broad range of factors when building a class of students who are likely to succeed and contribute to the school, the field of medicine, and public health. Race and life experience can be considered one of many factors among highly qualified applicants to create a diverse medical school student body that is steeped in cultural humility—to help create a physician workforce equipped to meet the needs of to all patients. Considerations of race and ethnicity have a place in medical school admissions policies when they meet the requirements of narrow accommodation and strict scrutiny set forth by the courts.

The AMA is committed to a leadership role in establishing and promoting diversity among our physician ranks. Nearly one in three people in the U.S. comes from a historically marginalized racial or ethnic group, but only one in nine is a physician. This needs to change.

To accelerate this process, the AMA has spent nearly a decade convening leading medical institutions through our efforts to accelerate change in medical education. Our Reimagining Residency initiative, launched in 2019, strengthens our efforts not only to create a diverse pipeline, but also to ensure that all future physicians are prepared to meet the enormous challenges of 21st century medicine, including the advancement of equity in healthcare.

We take critical steps in our journey to provide optimal care for everyone, no matter who they are, where they live or what they look like. To achieve greater diversity in our physician workforce, we must preserve and use every tool at our disposal, so we vigorously oppose any effort to abandon the benefits of diversity in our classrooms, exam rooms, or wherever and be elsewhere.