Following the U.S. Supreme Court’s 2023 decision to end affirmative action in higher education, acceptance and matriculation rates for Black medical school students has declined, according to a new study published in the Journal of the American Medical Association.
To determine the impact of this ruling on U.S. medical schools, the study authors leveraged data from the Association of American Medical Colleges on applicants and matriculants to doctor of medicine degree-granting schools five years before (2019-2023) and one year after (2024) the end of affirmative action. The authors examined differences in acceptance and matriculation rates of White students, Asian students, and students from racial backgrounds underrepresented in medicine (URiM), which includes Black, Hispanic, American Indian or Alaska Native, and Native Hawaiian or Pacific Islander students.
Compared to the mean acceptance rates from 2019 to 2023, White and Asian acceptance rates increased by about 7 percentage points for each group, while Black student acceptance rates declined by almost 3 percentage points and overall URiM rates declined by 1.35 percentage points in 2024. While there were no racial differences in acceptance rates observed from 2019 to 2023, URiM medical school applicants had significantly lower acceptance rates than their White and Asian peers in 2024.
Comparing the mean of 18,304 medical school matriculants from 2019 to 2023 with the 19,018 matriculants in 2024, White student representation decreased from 55.35 percent to 53.41 percent, Asian student representation increased from 27.87 percent to 33.06 percent, and URiM student representation decreased from 24.39 percent to 20.83 percent. Notably, the post-SCOTUS decision declines in URiM representation among medical school matriculants were concentrated at institutions located in states without prior state-level affirmative action bans.
“The 2023 SCOTUS decision was grounded in the principle of meritocracy,” the authors write. “However, the concept of meritocracy in medical education exists within a broader context of persistent systemic racial and ethnic discrimination, including unequal access to educational opportunities. While the ruling was intended to increase fairness by making admissions decisions race neutral, the emergence of disparity in acceptances rate between URiM and White students may suggest that the ruling reflects the continued influence of longstanding structural barriers.”
The study was led by scholars at the Yale School of Medicine, in partnership with authors from the University of California, Davis; New York University; the American Medical Association; and the American Board of Medical Specialities.
