End of affirmative action badly hit medical student diversity

The number of ethnic minority students in US public medical schools declined by more than a third within five years in states that banned affirmative action programmes, an analysis has found.

The study, published in the peer-reviewed journal Annals of Internal Medicine, was based on data from 1985 to 2019 at 53 medical schools at public universities in 32 US states.

The sample included 21 schools in eight states that banned affirmative action in admissions between 1997 and 2013. Students from under-represented minority groups accounted for 14.8 per cent of total public medical school enrolment at the time of their state ban. That average was found to have shrunk by 37 per cent five years later.

Some connection was expected, although the numbers came out as overwhelming, said one co-author of the study, Dan Ly, an assistant professor of medicine at the University of California at Los Angeles.

“A decrease in under-represented students by more than a third was pretty shocking,” Dr Ly said. “This is a large decrease despite probable efforts to diversify the student body at these public medical schools in other ways.”

The finding comes at a perilous moment for affirmative action in US higher education. The US Supreme Court announced in January that it will consider two cases – in lawsuits against Harvard University and the University of North Carolina – that could overturn repeated past precedents allowing colleges and universities to consider race as a factor in their admissions practices.

The nation’s top court is due to hear those cases in the session that begins in October, marking its first review of the topic since the Trump-era addition of three Republican-appointed members gave it a 6-3 conservative majority.

The study in the Annals of Internal Medicine also comes just as a leaked document shows that the Supreme Court is likely in that October session to end its 1973 ruling that protects the right of women to end a pregnancy.

The expected shift on abortion is being widely seen this week as a sign of the conservative-dominated court’s willingness to put partisanship ahead of settled law on politically charged topics. The fate of affirmative action in higher education is even more precarious given polling showing that – unlike with abortion – the majority of Americans appears to side with the conservative perspective.

Along with Dr Ly, other authors on the Annals-published study were affiliated with Harvard, the University of Pittsburgh and Columbia University. They noted that past studies have found that a lack of diversity in US medical care has substantial negative effects on people from minority communities, including a lack of empathy from doctors and an absence of trust among patients.

“It underscores how necessary affirmative action is if we want a diverse physician workforce – and the good such a workforce can do for the health of our communities,” Dr Ly said.

The eight states that forbade affirmative action in admissions between 1997 to 2013 were Arizona, California, Florida, Michigan, Nebraska, Oklahoma, Texas and Washington. Texas reversed its ban in 2003.

paul.basken@timeshighereducation.com