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Black and Latino enrollment in American medical schools has fallen sharply after the 2023 US Supreme Court decision effectively ending affirmative action in higher education, a new report finds.
In the first class selected post-affirmative action, the numbers of Black and Latino individuals entering medical school in the 2024-2025 academic year dropped by 11.6% and 10.8%, respectively, compared with the previous year, according to annual data compiled by the Association of American Medical Colleges (AAMC).
“These are pretty devasting numbers,” Dan Ly, MD, PhD, University of California at Los Angeles (UCLA), told Medscape Medical News. “When you compare to last year, it’s as if we lost over 250 Black medical students and over 300 Hispanic medical students.”
“We’re losing a generation of doctors from these underrepresented groups,” said Ly, who studies diversity in medicine.
The number of incoming American Indian or Alaska Native students declined even more sharply, by 22.1%. Native Hawaiian or other Pacific Islander student enrollment declined by 4.3%.
About half of the 23,156 1st-year enrollees described themselves as White individuals (50.7%; 11,738), followed by Asian (31.6%, 7323), Latino (11.2%, 2595), and Black (8.8%, 2036) individuals. Participants could describe themselves as being in more than one group.
In contrast, the US Census reports that the percentages of these groups among the general American population are 58.4% (non-Latino White), 6.4%, 19.5%, and 13.7%, respectively, and another 3.1% are multi-race.
In its ruling, the Supreme Court banned affirmative action programs in both public and private colleges/universities. “Many universities have for too long…concluded, wrongly, that the touchstone of an individual’s identity is not challenges bested, skills built, or lessons learned but the color of their skin,” wrote Chief Justice John Roberts for the majority. “Our constitutional history does not tolerate that choice.”
The new report suggests — but doesn’t prove — that the court ruling contributed to the sharp decline in acceptances. Meanwhile, states such as Florida, North Carolina, and Texas have recently cracked down on diversity, equity and inclusion (DEI) programs in higher education.
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In an interview, Norma Poll-Hunter, PhD, AAMC’s senior director of DEI, said the declines in certain enrollment numbers are expected.
“We knew, based on history, that this would happen,” she said. “What’s concerning is that it’s at double digits.”
Applicants from historically underrepresented groups can face challenges such as weak public school education, lack of knowledge about opportunities, and unaffordable tuition, Poll-Hunter said.
Diversity in medical school classrooms helps students “feel better prepared to work with patients who are different than themselves, she added. “Based on higher education research, we know that diverse classrooms lead to more civic engagement and better understanding of people from different perspectives, values, and viewpoints.”
The AAMC report finds that more Black and Latino applicants applied in 2024-2025, with applications up among these groups by 2.8% and 2.2%, respectively.
“The most straightforward explanation is that students from groups underrepresented in medicine have yet to be discouraged to apply,” UCLA’s Ly said. “But due to the inability to consider race and ethnicity as one of many factors in admissions decisions, rates of acceptance into medical school have precipitously dropped for (underrepresented) students.”
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Ronnie A. Sebro, MD, PhD, of the Mayo Clinic, offered another perspective.
“The Supreme Court wants to ensure a fair environment for all citizens. Favoring one group over another has the potential to lead to tremendous inequalities,” said Sebro, who studies diversity in medicine. “In fact, this behavior has led to the current inequalities in medical training as noted.”
The new report also finds that women still make up most applicants (56.8%) and 1st-year enrollees (55.1%). Few 1st-year enrollees are military veterans (166), and nearly all new students are under age 30 years (97.2%).
Ly had no disclosures. Sebro is an advisor and co-founder of the startup company RadiologyVRIfy.
Randy Dotinga is an independent writer and board member of the Association of Health Care Journalists.
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Blythe Wiers