Affirmative Action Repeal and Racial and Ethnic Diversity in US Medical School Admissions

Was the US Supreme Court decision ending affirmative action associated with changes in the racial and ethnic composition of medical school matriculants?In this cross-sectional analysis of Association of American Medical Colleges and American Association of Colleges of Osteopathic Medicine data including a mean of 55 037 applicants to Doctor of Medicine (MD) programs and 214 163 applicants to Doctor of Osteopathic Medicine (DO) programs from 2020 to 2024, significant declines in MD matriculation were observed between 2023 and 2024 among Black (−11.6%) and Hispanic/Latinx (−10.8%) students, while matriculation of Asian and White students increased. DO programs showed persistent underrepresentation of all underrepresented in medicine groups.These findings suggest that elimination of race-conscious admissions coincided with declines in medical school diversity, threatening progress toward health care equity and highlighting the need for alternative strategies to promote representation.

Corresponding Author: Natalie Florescu, MD, MPH, Department of General Surgery at the University of Vermont Medical Center, 111 Colchester Ave, Burlington, VT 05401 (natalie.florescu@uvmhealth.org).

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