TThe U.S. Supreme Court heard oral arguments Monday in two cases that could eliminate race as a factor in college admissions processes. The precedent set in 2003, when the court ruled that race, along with other factors, may be given limited consideration in higher education admissions when necessary to achieve student body diversity is now in jeopardy. If the court overturns its previous decision, the consequences will be felt widely in all sectors of society – including the health care system.
From my perspective as chair-elect of the board of directors of the Association of American Medical Colleges (AAMC), a position informed by my role as dean of medical education at Georgetown University School of Medicine, considering race as one of many elements in the process of acceptance is not only appropriate but also important. US medical schools—and health care in general—thrive because of the diversity of thought, experience, and perspective made possible by this holistic approach to admissions.
What do I mean here by holistic? The goal of any medical school should be to select a class of physicians who demonstrate not only academic excellence, but also compassion and a drive to provide quality health care. In addition to looking at standardized test scores and grades, admissions people want to understand applicants’ character, beliefs, and circumstances that have helped shape their lives. A person’s race inherently affects their perspective, a fact that cannot be denied and must be taken into account.
I often hear people ask, “Is the admissions process about merit or about diversity?” It’s about both; they are not mutually exclusive.
An essential part of medical education is for a diverse set of students to learn from each other’s experiences. They share ideas and search for solutions to make the healthcare system more equitable. At Georgetown, students eagerly volunteer at the school’s student-run health clinics, learning from and helping care for members of under-resourced communities.
The perspectives and values shared among students during medical school are put into practice after graduation. A more diverse workforce leads to better patient experiences—especially among marginalized groups. A higher percentage of college graduates of color say they intend to practice in underserved communities where there is a greater need for physicians. People believe they receive better care and communication from doctors who share their race or gender.
When doctors meet patients where they are and build trust, they are more likely to seek preventive care and openly discuss their health concerns, both of which are important for long-term health.
I know how important it is for physicians to be proactive in working with underserved communities. Growing up, I saw how racial disparities in health care affected my own family living in very racially segregated communities. When his cousin was injured at home as a boy, he went to his community hospital and waited 28 hours before receiving care. I also remember family members talking about pooling money to help another cousin with kidney failure buy a dialysis unit because there were no dialysis facilities in his community. The shortage of physicians in these racially segregated areas contributed to both reduced care and reduced advocacy for standard treatments.
Like many of the students I now have the privilege of teaching, I wanted to change this broken system. I wanted to make sure my family members – and others like them – could get care when they needed it. Becoming a doctor was the way I could make that kind of change.
This virtuous cycle—a more diverse medical profession, better care for the underserved, improved health—starts with who gets accepted to medical school. Still, much work remains to ensure that America’s medical schools better reflect society.
AAMC data shows that medical school classes are becoming more diverse, but progress remains gradual. Between 1978 and 2019, the number of black medical students has stalled at about 3%. As America faces a physician shortage, existing barriers to care will become even greater as resources become increasingly strained among historically marginalized communities.
If the Supreme Court overturns current precedent, the country should prepare to suffer the consequences, as California did after it banned the consideration of race in university admissions. The state’s medical schools have seen significant declines in the enrollment of students of color. Harder to measure are the failures in patient care that come from the more homogenous student population, but they are sure to be profound.
A tragic mistake — the Supreme Court’s elimination of race as a factor in admissions — would compound in many ways: who gets the chance to attend medical school, the richness of that education, the quality of care in the nation’s most disadvantaged communities and in the health of our families and neighbors.
Unable to consider an applicant’s race, admissions officers may look to a student’s zip code or socioeconomic status as court-approved indicators, but they will never tell the full story of a student’s lived experience. Race is an integral part of this. This should remain a core part of the admissions process.
Lee Jones is a psychiatrist, chair-elect of the Board of Directors of the Association of American Medical Colleges and dean of medical education at Georgetown University School of Medicine in Washington, DC