Amid the shift in diversity at medical schools, a warning warns about the frightening effect of Dei.

Amid the shift in diversity at medical schools, a warning warns about the frightening effect of Dei.

The Trump administration's crackdown on DEI programs could exacerbate an unexpectedly sharp decline in medical student diversity, even in states like California, where public universities have navigated affirmative action for decades. Education and health experts warn that this could ultimately harm patient care.

Since taking office, President Donald Trump has issued a handful of executive orders to terminate all diversity, equity and inclusion, or DEI, initiatives in federally funded programs. And in his March 4 address to Congress, he described the Supreme Court's 2023 decision to ban consideration of race in college and university reporting as "brave and very powerful."

Last month, the Education Department's Office for Civil Rights, which lost about 50% of its staff in mid-March, directed schools, including post-secondary institutions, to have race-based programs or risk losing federal funding. The “Dear Colleague” letter cited the Supreme Court decision.

Paulette Granberry Russell, president and CEO of the National Association of Diversity Officers in Higher Education, said that “any expression of “diversity” is now considered a violation or unlawful or illegal. Her organization filed a lawsuit challenging Trump's anti-DEI executive orders.

While California and eight other states--Arizona, Florida, Idaho, Michigan, Nebraska, New Hampshire, Oklahoma and Washington--had already passed bans on diversity degrees in relation to race-based admissions policies before the Supreme Court's decision in the areas on a racial basis, the diversity in their margins was tortured with the margins, which were equity initiatives such as Targeted Scholarships and admissions, such as Targeted Scholarships and admissions, and admissions such as: B. scholarships and the recordings and the recordings, such as targeted scholarships, and the recordings and recordings and recordings, and the recording of scholarships and the recordings and recordings, and the recordings and recordings, such as. B. Scholarships and Scholarships and Scholarships, and the recordings and recordings and recordings, such as.

The court's decision and the subsequent backlash at the state level - 29 states have since introduced bills to curb diversity initiatives. According to the Chronicle of Higher Education, education experts said this has undermined these efforts and led to the recent rejections of diversity numbers.

Following the Supreme Court's decision, Black and Hispanic medical school enrollment fell by double-digit percentages in the 2024-25 school year compared to the previous year, according to the Association of American Medical Colleges. Black participants fell by 11.6%, while the number of new Hispanic students fell by 10.8%. The decline in American Indian or Alaska Native student enrollment was even more dramatic at 22.1%. New enrollment of Hawaiians or other Pacific Islanders fell 4.3%.

“We knew this was going to happen,” said Norma Polljunter, AAMC’s senior director of workforce diversity. “But they were double digits – much larger than what we expected.”

The fear among educators is that the number will drop even further under the new administration.

In late February, the education department launched an online portal for people to "report illegal discriminatory practices at institutions of learning" and find that students "learn free from divisive ideologies and indoctrination." The agency later issued a "Frequently Asked Questions" document about its new policies, clarifying that it was acceptable to observe events like Black History Month, but warning schools that they must "consider whether a school program discourages participation by members of all races."

“It definitely has a frightening effect,” Polljäger said. “There is a lot of fear that could cause institutions to limit their efforts.”

Numerous requests for comment from medical schools about the impact of anti-DEI actions were not returned. According to reports in the New York Times, university presidents are standing on this issue to protect their institutions.

Utibe Essien, a doctor and UCLA assistant professor, said he has heard from some students who fear they won't be considered for admission under the new guidelines. Essien, who co-authored a study on the impact of affirmative action bans on medical schools, also said students are concerned that medical schools are not as supportive as they have been in the past.

“Both fears risk limiting the options of schools that people pursue, and potentially those that consider medicine as an option in the first place,” Essien said, adding that the “lawsuits around equity policies and just the climate of anti-diversity have put institutions in this place where they feel uncomfortable.”

In early February, the Pacific Legal Foundation filed a lawsuit against Benioff Children's Hospital Oakland of California-San Francisco over an internship program that was presented to "underrepresented minority health professions students."

Attorney Andrew Quinio filed the lawsuit, which argues that his plaintiff, a white teenager, was not accepted into the program after disclosing in an interview that she identified as white.

“From a legal perspective, the issue that comes out of all of this is: How do you elect diversity without dealing with the Constitution?” Quinio said. “For those who want diversity as a goal, it cannot be a goal achieved through discrimination.”

UC Health spokeswoman Heather Harper declined to comment on the lawsuit on behalf of the hospital system.

A lawsuit filed in February accuses the University of California of favoring black and Latino students over undergraduate admissions for Asian American and white applicants. Specifically, the complaint says UC officials directed campuses to use a "holistic" admissions approach and "move away from objective criteria toward more subjective assessments of individual candidates' overall performance."

Examining this approach to admissions could threaten diversity at the UC-Davis School of Medicine, which has for years used a "race-neutral, holistic admissions model" that reportedly tripled Black, Latino and Native American enrollment.

"How do you define diversity? Does it now relate to the way we consider how someone is experienced, how they were raised? "What might they see as an unlawful proxy for equity and inclusion for diversity? That's what we're faced with."

California Attorney General Rob Bonta, a Democrat, recently joined another attorney general in issuing guidance requiring schools to continue their DEI programs despite the federal news, saying legal precedent allows the activities. California is also among several states suing the administration over its deep cuts to the education department.

If the recent decline in diversity among newly enrolled students gets worse or worse, it could have long-term consequences for patient care, academic experts said, on the huge racial disparities in health outcomes in the U.S., particularly for Black people.

A higher proportion of Black primary care physicians is associated with longer life expectancy and lower mortality rates among Blacks, according to a 2023 study published by the JAMA network.

Doctors of color are also more likely to build their careers in medically underserved communities, studies have shown, which is increasingly important as the AAMC projects a shortage of up to 40,400 primary care sites by 2036.

“The doctor shortage remains and it is severe in rural communities,” Polljäger said. "We know that diversity efforts are really about improving access for everyone. More diversity leads to greater access to care - everyone benefits."

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

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