What are the consequences of medical school admissions going ‘race-blind’?

By Naveed Saleh, MD, MS | Fact-checked by Barbara Bekiesz
Published December 9, 2022

Key Takeaways

  • “Race-blind” admissions could be the new standard for medical schools, as the Supreme Court is hearing arguments in two cases that take aim at a 2003 case that allowed institutions of higher learning to consider race as a contributory factor during admission.

  • Racial and ethnic diversity among physicians boosts access to healthcare, enhances care quality for underserved populations, and helps to fulfill the needs of an increasingly diverse population.

  • Organizations, including the AMA and AAMC, have petitioned the Supreme Court to not overturn holistic decision-making (which takes into account a candidate’s unique experiences as well as test scores and grades) in medical school admissions.

The possibility that the US Supreme Court will mandate a “race-blind” admissions strategy in medical schools and other institutions of learning has stirred up controversy within the medical industry.

Medical school admissions practices based on holistic assessments have been key to providing more opportunities to diverse applicants. Research shows that promoting racial and ethnic diversity among physicians helps to boost access to healthcare for populations of color and improves the quality of that care; it also helps address an expected physician shortage.

The cases before the Supreme Court could threaten such opportunities for diverse candidates. But efforts by medical industry organizations may help retain race-blind admission practices.

Two cases could spell trouble for diversity

In the fall of 2022, the Supreme Court heard oral arguments on Students for Fair Admissions Inc. v President and Fellows of Harvard College and Students for Fair Admissions Inc. v University of North Carolina et al.

These hearings focused on whether the Court should overrule Grutter v Bollinger, a 2003 case that permitted higher-education institutions to consider race a factor in admissions.

According to a report published by the AMA, if the Court overrules Grutter v. Bollinger, medical schools may no longer be able to use race and ethnicity as factors while reviewing applicants.[]

Diversity status quo indicates a long way to go

Results from a cross-sectional study published in JAMA Network Open point to a possibly bleak future for minority representation in medicine.[]

Using data for 2010 and 2015, the investigators found a deficit of 113,758 Hispanic and 81,358 Black physicians when compared with the proportions of these racial groups in the US population. In other words, between 2010 and 2015, per 100,000 Hispanic and Black people, there were 196 and 191 fewer physicians, respectively.

Put in perspective, it would take 92 years of sustained doubling of the number of matriculating Hispanic medical students from 2015 levels to address the deficit of Hispanic physicians, and for Black medical students, it would take 66 years of doubling.

Other research has demonstrated that given the length of time it takes to train a physician, it would be 10 years before any initiatives to boost minority numbers could make a positive difference, according to the JAMA Network Open article.

Dire implications

Racial and ethnic diversity among physicians and other healthcare professionals improves access to healthcare, enhances care quality for underserved populations, and helps to meet the medical needs of an increasingly diverse population. Thus, it is important to sustain initiatives that support diversity in physician training.

“If the goal is to achieve a diverse and representative physician workforce within our lifetimes, a sustained and multifaceted approach must be implemented that will address both the size of the underrepresented medical school applicant pool as well as the number of underrepresented medical students and postgraduate trainees,” the authors of the JAMA Network Open article wrote.

“Given AAMC’s projected physician shortage of roughly 37,800 to 124,000 physicians by 2034, the creation and expansion of medical schools that prioritize the education of Black, Hispanic, and other underrepresented students would not only decrease the overall physician shortage, but also shorten the time required to attain a representative physician workforce and help mitigate the societal harm inflicted by decades of structural racism,” they continued.

Instead of moving toward such a solution, however, the Supreme Court proceedings may push diversity to the backburner.

Related: Healthcare equity: What can doctors do?

An industry-wide effort

The potential for harm is so great that the AMA and 40 other healthcare organizations joined the AAMC in publishing an amicus brief petitioning the Supreme Court to refrain from action that would disrupt the race-compassionate admissions process at medical schools, according to another AMA article.[]

In the brief, the organizations stressed that a wealth of research promotes the thesis that when physicians better understand the diversity and individuality of their patients, outcomes improve.

Eliminating holistic review (which takes candidates’ racial and ethnic considerations, and unique experiences, into account as well as academic achievements) during the admissions process could translate into literal lives lost.

“There is no way to know how non-diverse the healthcare community would become in future years and decades if holistic review were forbidden in medical education, but it is clear that the lives and health of the American public would be gravely diminished,” the amicus brief authors wrote.

What this means for you

If medical schools lose the right to consider race and ethnicity during admissions because doing so is deemed unconstitutional by the US Supreme Court, the schools would no longer be able to individually assess candidates in a holistic fashion. Such review is necessary to form a heterogeneous student body and future physician workforce. Consequently, medical schools would need to develop other ways to promote diversity in the profession.

Read Next: Did COVID-19 thwart medical school diversity pathway programs?
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