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Examining Race-Based Admissions Bans On Medical Schools


In 2015, America is becoming more diverse. America's medical schools are not. Over the last several decades, some states banned schools from considering race when they admit students. So medical schools have tried other ways to recruit a diverse student body, and there's new research on how effective those efforts have been. Our colleague Steve Inskeep spoke with NPR social science correspondent Shankar Vedantam.


Hi, Shankar.


INSKEEP: So the problem for medical schools is to get a more diverse student body racially without explicitly seeking a more racially diverse student body. How are they trying to do that?

VEDANTAM: I think schools are trying a number of different things. They're trying to say test scores are not the be-all and end-all in admitting students, and they're trying to take other things into consideration. Have you tried to overcome adversity in your life? Do you have leadership skills? The other thing that schools are trying to do is they're trying to do a lot more outreach in minority communities to prepare minority students to apply for medical school in the hope that all these things will boost the diversity of the incoming students into medical school.

INSKEEP: Oh, you might go to a heavily minority college, university and offer them some kind of medical school prep course, for example?

VEDANTAM: Precisely, precisely.

INSKEEP: That sort of thing, so it's not explicitly about race. How's it working?

VEDANTAM: Well, several states have now banned schools from taking race into account. And this new analysis that I've looked at examines graduation rates at medical schools in California, Washington, Florida, Texas, Michigan and Nebraska. Now, schools in all these states have tried these techniques that we're talking about, and there are variations in how successful they are, but overall, there are strong patterns in the outcomes. I spoke with Liliana Garces at Penn State University, and along with David Mickey-Pabello, she's found that there's been a sharp drop in the number of black and Latino students graduating from medical schools in these states. Here she is.

LILIANA GARCES: If you think about before the bans, for every 100 students that matriculated in medical schools in states with bans, there were 18 students of color. But after the bans, for every 100 students matriculated, there are now about 15.

INSKEEP: We should be frank - 18 out of 100 students of color in America in the 21st century is already way, way less diverse than America is, and now we're being told that the numbers have even gone worse than that?

VEDANTAM: That's exactly right, Steve. Now, one question that Garces was asking was whether more black and Latino students are enrolling in private medical schools after the ban on race-conscious admissions in public schools. She finds that's not the case in these states. Private school admissions are not taking up the slack for the decline in enrollment of minority students in public medical schools.

INSKEEP: I suppose at least we can point out that there's only a few states who have these bans on race-based admissions, and so only a few states that really have this problem in full force.

VEDANTAM: That's partly true, Steve, but one of the things that Garces finds is that the states that do have the bans have a disproportionate share of medical schools with highly ranked research centers. So 2 in 5 of such centers are located in states which have affirmative action bans. So the effects of these bans are going to have a big effect not just on who shows up to be a doctor in 10 years' time, but who shows up to work at the NIH or the CDC or big pharmaceutical companies. It's also the case that some of the states with affirmative action bans have very large minority populations, and Garces says there's evidence from various research studies that patients of color are often better off when there are more doctors of color. Here she is again.

GARCES: Doctors of color are more likely than their white peers to work within communities of color. There was a study that was just published that documents the very strong association between racial diversity and students' self-rated reports of cultural competence, attitudes about access to health care and, for nonwhites only, plans to serve communities that are underserved.

INSKEEP: So we're getting into some real subtleties here. We're not saying black doctors should only be treating black patients, but we're saying black doctors are a little more likely to go into a black community, and there may be other subtle factors that actually affect people's health?

VEDANTAM: That's exactly right, Steve. You know, it's a controversial issue, and there are strong proponents and critics of the value of race-conscious admissions in schools, Steve. But there's a tension here between what I would call the demand side of the equation and the supply side of the equation. The states that have passed these bans have focused on the supply side. The voters in these states have said, you know, it's not fair to have race-conscious admissions because when you have race-conscious admissions, it makes it harder for some people to get into medical school.

INSKEEP: You decrease the supply of slots available for white students?

VEDANTAM: Exactly. But in terms of patients and the needs of medical and public health organizations, there's a very strong demand for a diverse workforce. And I think what the Garces study is pointing to is that these two forces of supply and demand are being thrown out of whack.

INSKEEP: Shankar, thanks very much.

VEDANTAM: Thank you, Steve.

INSKEEP: That's NPR's social science correspondent Shankar Vedantam. You can follow him on Twitter @HiddenBrain. Follow this program @MorningEdition. Transcript provided by NPR, Copyright NPR.

Shankar Vedantam is the host and creator of Hidden Brain. The Hidden Brain podcast receives more than three million downloads per week. The Hidden Brain radio show is distributed by NPR and featured on nearly 400 public radio stations around the United States.