Medical Student Demographic Changes Following Legal Ruling

Members of racial and ethnic communities considered underrepresented in medicine are less likely to be admitted and enrolled in U.S. medical schools since the 2023 Supreme Court decision that banned considering race in university admissions, a new paper from Yale School of Medicine (YSM) and New York University (NYU) researchers has found.

This could have long-term effects on U.S. physician workforce diversity and on the country’s health, according to the researchers. The paper was published August 26 in JAMA Network Open.

“Before this research, there was an unanswered question of whether the ruling would change anything in medical school admissions,” says Sarwat Chaudhry, MD, YSM professor of medicine (general medicine) and the paper’s senior author. “Our data demonstrate that in fact, it has.”

The researchers studied data from the Association of American Medical Colleges about MD program applicants and MD students enrolled from 2019 to 2023, the years before the ruling, and from 2024, the year after. The researchers used applicants’ and students’ self-reported race and ethnicity to classify them as White, Asian, or members of groups that are, based on U.S. population, considered underrepresented in medicine: Black, American Indian, Alaskan Native, Native Hawaiian or Pacific Islander, or Hispanic.

“We wanted to do a deep dive into how this policy has shaped or can potentially shape the future physician workforce,” says Mytien Nguyen, a YSM MD-PhD student mentored by Chaudhry and lead author Dowin Boatright, MD, of NYU.

The researchers found that acceptance rates for White, Asian, and underrepresented applicants were similar in the years before the ruling. But in 2024, applicants from underrepresented groups had a 9% lower acceptance rate than White applicants and a 7% lower rate than Asian applicants. Among enrolled medical school students, the percentage from underrepresented groups dropped from 24.4% before the ruling to 20.8% after. When comparing medical schools in states that had established similar bans before the Supreme Court ruling with those in states that did not, the researchers found the decrease was concentrated in the states that did not.

The admissions differences could have serious consequences for the country’s health, the researchers note. Many studies have shown that patients feel more comfortable and receive better care from physicians who share their backgrounds and perspectives, Nguyen says. Fewer providers from diverse communities could make existing health disparities worse, she adds.

Studies also show physicians from underrepresented groups are more likely to work in underserved areas that badly need health care providers and that diverse research teams produce better work, Chaudhry says. And White and Asian students who train in diverse groups are better prepared to treat patients from many backgrounds, she adds.

“Those of us who care about improving care for patients in underserved settings and in underresourced settings and about strengthening the rigor of U.S. biomedical research should be concerned,” says Chaudhry.