In my view as elected chair of the Board of Directors of the Association of American Medical Colleges (AAMC), a position that has guided my role as Dean of Medical Education at Georgetown University School of Medicine, consideration of race as one of the many elements in the admissions process is not only appropriate but necessary. American medical schools – and health care in general – thrive on the diversity of thought, experience, and perspective made possible by this holistic approach to admissions.
What do I mean here by college? The goal of every medical school should be to select a class of physicians who demonstrate not only academic achievement but also empathy and drive to provide high quality health care. In addition to considering standardized test scores and scores, admission participants want to understand applicants’ personality, convictions, and the circumstances that helped shape their lives. A person’s race inherently influences his or her point of view – an undeniable fact that must be taken into account.
I often hear people ask, “Is the admissions process about merit or about diversity?” It is about both. They do not exclude each other.
An essential part of medical education is for a diverse group of students to learn from each other’s experiences. They share ideas and look for solutions to make the health system more equitable. At Georgetown, students eagerly volunteer at the school’s student-run health clinics, learning from and helping members of under-resourced communities take care of them.
The views and values shared by 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 proportion of those with a high school diploma of color say they intend to practice in underserved communities, where physicians are in greatest need. People feel they receive better care and communication from doctors who share their race or gender.
When clinicians meet patients where they are and build trust, they are more likely to seek preventative care and openly discuss their health concerns, both of which are important for long-term health.
I know how essential it is for clinicians to be proactive in working with neglected communities. Growing up, I saw racial inequality in health care affecting my family who lived in highly segregated communities. When his cousin was injured at home as a boy, he went to the safety net hospital in his community and waited 28 hours before getting care. I also remember family members talking about pooling money to help another cousin in case of kidney failure buy a dialysis unit because there are no dialysis facilities in his community. The shortage of physicians in these racially isolated areas has contributed to less care and less advocacy for standard treatments.
Like many students I now have the privilege of teaching, I wanted to change this broken system. I wanted to make sure that my family members – and others like them – could get care when they needed it. Being a doctor is how I can make this kind of change happen.
This virtuous cycle–a more diverse medical career, better care for the underprivileged, better health–begins with who gets accepted into medical school. However, there is still a lot of work to be done to ensure that American medical schools better reflect society.
Data from the AAMC indicates that medical school classes are becoming increasingly diverse, but progress is still incremental. Between 1978 and 2019, the number of black male medical students stopped at about 3%. As America faces a shortage of physicians, existing barriers to care will increase as resources are strained among historically marginalized communities.
If the previous Supreme Court overturns the current one, the state should prepare to face the consequences, as California did after banning consideration of race from college admissions. Medical schools in the state have seen a significant drop in enrollments for students of color. The setbacks in patient care that come from a more homogeneous student population are difficult to gauge, but they are sure to be profound.
The tragic mistake—the elimination of race as a factor in admissions—by the Supreme Court will be compounded in many ways: in the access to medical school, in the richness of that education, in the quality of care in the nation’s toughest stresses, and in the health of our families and neighbours.
Unable to consider an applicant’s race, admissions officers may view a student’s ZIP code or socioeconomic status as court-approved metrics, but these will not tell the full story of a student’s lived experience. Ethnicity is an inherent part of that. It should remain an essential part of the admissions process.
Lee Jones is a psychiatrist, Chairman 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.