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Special Communication |

The Consequences of Premature Abandonment of Affirmative Action in Medical School Admissions

Jordan J. Cohen, MD
JAMA. 2003;289(9):1143-1149. doi:10.1001/jama.289.9.1143.
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The US Supreme Court recently accepted on appeal 2 cases from the University of Michigan regarding the constitutionality of race-conscious decision making in higher education admissions. The consequences of the Court's decision will directly affect the future of medicine in the United States. Medical schools have a societal obligation to select and educate the physician workforce of the future. To outlaw the use of affirmative action in the admissions process would cripple the profession's ability to achieve racial and ethnic diversity. Preserving this diversity in medical school admissions programs is important for 4 major reasons (1) adequate representation among students and faculty of the diversity in US society is indispensable for quality medical education; (2) increasing the diversity of the physician workforce will improve access to health care for underserved populations; (3) increasing the diversity of the research workforce can accelerate advances in medical and public health research; and (4) diversity among managers of health care organizations makes good business sense. This article explores these reasons in detail, reviews the history and effectiveness of affirmative action in medical school admissions programs, and explains why alternatives to affirmative action are unworkable.

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Figure 1. Underrepresented Minorities (URMs) in the US Population and Among Medical School Matriculants, 1960 to 2001
Graphic Jump Location
Data sources are as follows: (1) data from 1960 through 1980 derived from the Statistical Abstract of the United States; URM population for 2000 derived from US Bureau of the Census, The Hispanic Population, (available at http://www.census.gov/prod/2001pubs/c2kbr01-3.pdf) and Overview of Race and Hispanic Origin (available at http://www.census.gov/prod/2001pubs/c2kbr01-1.pdf); (2) URM population data for 1990 from US Bureau of the Census, We the American . . . Hispanics (available at http://www.census.gov/apsd/wepeople/we-2r.pdf, September 1993), and "Population by Race and Hispanic or Latino Origin, for the United States: 1990 and 2000" (Table 4) (available at http://www.census.gov/population/cen2000/phc-t1/tab04.pdf, April 2001); (3) data for 1960 through 1980 from US Bureau of the Census, Population Division, "Race and Hispanic Origin of the Population by Nativity: 1850 to 1990" (Table 8) (available at http://www.census.gov/population/www/documentation/twps0029/tab08.html, March 9, 1999); (4) data for URMs among medical school matriculants derived from the Association of American Medical Colleges (AAMC) Minority Physician Database as of January 2003. Data from 1969 to 1973 are based on first-year enrollments from Table B3 of the AAMC Data Book: Statistical Information Related to Medical Schools and Teaching Hospitals, January 8, 2002. Data for URM matriculants from 1974 through 2001 are from the AAMC Data Warehouse as of January 8, 2003. Reprinted with permission from Cohen et al.5
Figure 2. Medical College Admission Test (MCAT) Scores and Grade Point Averages for All Students Who Applied to the 125 Medical Schools in 2001 and for All Students Who Were Accepted That Year
Graphic Jump Location
A, Applicants other than underrepresented minorities (non-URM) (n = 29 683); B, URM applicants (n = 3979); C, students other than URMs offered acceptances (n = 14 763); and D, URM students offered acceptances (n = 1830). Each column represents the number of students whose MCAT scores and grade point averages fell into the corresponding percentile ranges for students composing the entire applicant pool.
Figure 3. Influence of Parental Income on Average Medical College Admission Test (MCAT) Scores for Underrepresented Minority (URM) and All Other (Non-URM) Applicants for Admission in 2001
Graphic Jump Location
Error bars are not shown; because of the large sample sizes, the SEs of the mean are too small to register on the figure.

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