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Key Takeaways
- A JAMA Network Open paper calls for medical schools to adopt 'alternative strategies' to maintain racial diversity post the Supreme Court's 2023 ruling against affirmative action, suggesting race-neutral approaches like increased scholarship support.
- Researchers noted a 11% decline in Black and Hispanic medical student matriculation following the affirmative action decision, while Asian and white student admissions increased, highlighting threats to health equity.
- Dr. Natalie Florescu, lead author, advocates for initiatives like funding minority-serving institutions and targeted programs to create equitable medical education pathways, though these approaches may face legal scrutiny for potentially being race-based preferences.
A new JAMA Network Open paper urges medical schools and policymakers to use “alternative strategies” to preserve racial diversity after the Supreme Court’s 2023 ruling against the use of affirmative action.
But such strategies could still function as race-based preferences if used to engineer specific racial outcomes, according to an expert.
The authors, led by Dr. Natalie Florescu, found racial diversity in medical school matriculation decreased after the Supreme Court confirmed that affirmative action is tantamount to illegal racial discrimination. Black and Hispanic students both matriculated around 11 percent less than years prior, while Asian and white students saw an increase.
Dr. Florescu, who is affiliated with both Temple University’s medical school and the University of Vermont Medical Center, said the decision “coincided with declines in medical school diversity, threatening progress toward health care equity and highlighting the need for alternative strategies to promote representation.”
Florescu, along with her co-authors, said medical schools should use “alternative strategies” to get around the prohibition on affirmative action.
This could include “increased scholarship support for students from underserved and economically disadvantaged backgrounds, particularly those from rural or medically underserved regions,” the authors wrote.
“These race-neutral approaches can expand access while aligning with current legal frameworks,” Florescu argued. “Additionally, investments in minority-serving institutions and targeted pipeline programs remain essential tools in building a more equitable pathway to medical education.”
She has not responded in the past month to two emails that asked whether the data indicates whites and Asians were discriminated against prior to the Supreme Court decision. The College Fix also asked about potential legal problems with her ideas.
These proposals could be illegal, according to an expert from Do No Harm, a medical reform group.
“Schools have attempted to devise workarounds to the Supreme Court’s clear restatements of long-standing anti-discrimination laws,” Ian Kingsbury told The Fix via email. His group has published multiple reports on the issue of schools working around the affirmative action prohibition.
“One result is racially disparate standards when it comes to the metrics that should matter, such as undergrad GPA and MCAT score,” Kingsbury said. “For example, through public records requests, we observed that at 13 of 23 medical schools, accepted black students had a lower MCAT score than rejected Asian or white students.”
He said this is a “pattern” that may indicate “intentional race discrimination.”
Medical schools prior to the Supreme Court ruling “were engaging in extreme racial preference in admissions” and despite some progress, “it remains a significant problem,” he told The Fix.
The academic paper also cited a well-circulated, but also highly challenged study, that claims black babies are more likely to survive when cared for by a black physician. Justice Ketanji Jackson even misquoted the paper in her dissent in the affirmative action ruling.
The study, led by Brad Greenwood, omitted some data that “undermines the narrative” his team sought, which is that black doctors are better for black babies than white ones. It has been cited nearly 800 times, Do No Harm previously found.
Other studies questioned the findings after controlling for birth weight.
Dr. Florescu, the lead author of the JAMA paper, did not respond to questions about why she cited the paper.
Kingsbury said Do No Harm has “seen almost no accountability, even now that the study has been debunked.”
“Researchers and medical organizations continue to cite the study credulously and the journal to date refuses to retract it,” he said.
“The lifecycle of this scandal really speaks to the intellectual rot and ideological capture of American medicine.”
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