Medical School Diversity Declines Following Affirmative Action Repeal

The racial and ethnic diversity of students entering US medical schools fell sharply in the first year after the Supreme Court struck down affirmative action, according to a new study published in JAMA Network Open.¹ Researchers warned that the trend could reverse years of progress toward a more representative physician workforce and, ultimately, worsen health disparities.

“Restrictions to diversity, including the recent ban of diversity, equity, and inclusion programs for institutions receiving government funding, could create additional setbacks and decreased outcomes in both diversity of health care professionals and the quality of patient care,” researchers said.

To come to their findings, they analyzed data from both the Association of American Medical Colleges (AAMC) and the American Association of Colleges of Osteopathic Medicine (AACOM), covering more than 55,000 applicants to Doctor of Medicine (MD) programs and 214,000 applicants to Doctor of Osteopathic Medicine (DO) programs from 2020 through 2024. After the Supreme Court’s 2023 decision in Students for Fair Admissions v President and Fellows of Harvard College that race-conscious admissions policies were unconstitutional, there was a clear decline in enrollment of Black, Hispanic, and Latino students.^1,2

Between 2023 and 2024, the number of incoming MD students who identified as Black fell significantly by 11.6%, while those identifying as Hispanic or Latino dropped by 10.8%. Numerically, this translated to a decrease from 2304 Black students in 2023 to 2036 students in 2024, and a drop from 2910 Hispanic or Latino students to 2595. Enrollment of American Indian or Alaska Native students also decreased by 22.1%, but this was not statistically significant.

Conversely, the proportion of Asian students matriculating into MD programs increased by 8.4% during the same period. Matriculation of White students also rose significantly, with these students consistently making up at least half the group.

“These declines threaten progress toward health care equity,” the authors stressed. “Medical schools must explore alternative admissions strategies, such as holistic review processes that account for structural barriers. Without such efforts, reduced diversity in medical education may worsen existing health disparities.”

Broader Gaps in DO Programs

The study found even wider disparities among DO programs. Across every underrepresented racial group, applicants were less likely to be admitted compared with their White and Asian peers. For example, Black students made up 6.1% of DO applicants but only 3.9% of students who entered, while Hispanic applicants represented 9.9% of applications but only 9.0% of entering students. The study also noted that no students who identified as American Indian or Native Hawaiian entered DO programs during the study period.

White students accounted for more than half of all new DO students, and Asian students were the only non-White group with enrollment rates similar to their application rates.

Why Physician Diversity Matters

A growing body of research shows that when doctors share racial, ethnic, or gender identities with their patients, outcomes improve. According to the authors, patients often communicate more openly, are more likely to follow treatment plans, and report greater satisfaction with their care.

“Beyond promoting equity, increasing representation among physicians is beneficial, as patients who share ethnic or gender identities with their doctors experience improved communication, better health care outcomes (including lower newborn mortality and inpatient death rates), and higher patient satisfaction,” the authors explained. “Additionally, racial concordance between physicians and patients has been linked to greater use of preventive care, reduced emergency department visits, and lower overall health care costs, even when accounting for socioeconomic status.”

Still, medical education has never reflected the nation’s demographics. In 2023, 19.4% of new MD students were identified as underrepresented in medicine—as defined by the AAMC—compared with 11.2% of new DO students. Roughly 35% of the US population identifies as part of 1 or more of these same racial or ethnic groups, according to the US Census Bureau.

The authors noted that their analysis relied on publicly available data that may not capture the full range of racial and ethnic identities, particularly among students who identify with more than 1 race. Because many applicants apply to both MD and DO programs, some overlap in counts may also exist. The study did not include other health professions, such as nurse practitioner or physician assistant programs, which play an increasingly important role in US health care delivery. Even with these limitations, the authors said these findings provide one of the clearest early looks at how the end of affirmative action is reshaping the medical education pipeline.

To mitigate further declines, the authors called for “race-neutral” approaches to foster diversity while complying with legal constraints. These include increasing scholarships and pipeline programs for students from underserved and rural regions, expanding holistic review processes, and investing in institutions serving minority populations.

“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,” the authors said.

References

1. Florescu N, Lin A, Temucin S, Rae L. Affirmative action repeal and racial and ethnic diversity in US medical school admissions. JAMA Netw Open. 2025;8(10):e2535020. doi:10.1001/jamanetworkopen.2025.35020
2. Summary of the supreme court’s decisions. Lawyers’ Committee for Civil Rights Under Law. August 2023. Accessed October 14, 2025. https://www.lawyerscommittee.org/wp-content/uploads/2023/08/LC_Harvard-UNC-Cases_D.pdf