The Trump administration's decision to rescind some guidance on affirmative action may make it more difficult for medical schools to use race as a factor when making admissions decisions.
U.S. Attorney General Jeff Sessions on July 3 announced plans to pull back a 2011 document—Guidance on the Voluntary Use of Race to Achieve Diversity in Postsecondary Education—that detailed how “postsecondary institutions can voluntarily consider race to further the compelling interest of achieving diversity.”
The guidance—issued jointly by the Justice and Education departments—was one of 24 documents Sessions deemed as “unnecessary, outdated, inconsistent with existing law.”
“When issuing regulations, federal agencies must abide by constitutional principles and follow the rules set forth by Congress and the president,” Sessions said in statement. “In previous administrations, however, agencies often tried to impose new rules on the American people without any public notice or comment period, simply by sending a letter or posting a guidance document on a website—that's wrong, and it's not good government.”
The move could have long-term implications for many schools that have pushed to promote greater racial and ethnic diversity.
The impact on medical schools is heightened by industrywide efforts to not only address diversity, but disparities in care. A growing body of evidence shows that having a more diverse workforce can play an important role in improving cultural competency, leading to better care for racial and ethnic minority groups.
“We know that minorities and women are more likely to care for underserved populations,” said Dr. Atul Grover, executive vice president at the Association of American Medical Colleges. “We continue to have large areas of people being underserved both in rural and urban areas.”
AAMC CEO Dr. Darrell Kirch expressed concern over the kind of message the administration was signaling with the rescission. He noted that the Supreme Court, in its 2016 Fisher v. University of Texas at Austin ruling, reaffirmed that schools could include race as one of a number of other factors in considering a student's application for admission.
“Diversity is an important piece of the puzzle,” said Dr. Valerie Ratts, associate dean for admissions at Washington University School of Medicine in St. Louis. “When I'm looking for medical students I am looking for the best and the brightest—there are many components that go into that equation.”
Affirmative action critics contend the Supreme Court's decision meant schools could consider race only when other race-neutral factors, such as socio-economic status, did not produce the desired result of achieving a more diversified student population. They say the Obama-era guidance was an expansion of the ruling that served as a workaround for some schools to make race a bigger factor than was intended.
“If universities were using race as a matter of last resort only when nothing else worked, they should be fine,” said Rick Hess, director of education policy studies at the American Enterprise Institute. “For those schools that were using race in a somewhat more expansive fashion, they're going to need to take another look at their policies and hopefully they will bring them in line with the Supreme Court precedent.”
Grover disagreed with the assertion that the guidance overstepped the court's precedent, adding that the rescission adds a layer of uncertainty for many schools, especially in understanding how the Justice Department will interpret and investigate admissions policies. It could also open them up to more lawsuits. He said most medical schools are unlikely to change their policies, at least in the short term.
That's the case at the University of Illinois College of Medicine, according to Jorge Girotti, an assistant professor in the department of medical education and director of the Hispanic Center of Excellence. But he worries that the rescission may deter minorities from applying.
“Individuals who feel that maybe their background, experiences and their story are not going to be important to schools of medicine may choose not to apply,” Girotti said. “Candidates who would fit very well with the mission of our school may choose to look elsewhere or look at fields other than medicine.”