APA Speaks Out Against Supreme Court Ruling on Affirmative Action in Higher Education
Abstract
APA said the ruling will undermine efforts to increase the diversity of the physician workforce, which in turn may impact access to care.
APA denounced the U.S. Supreme Court’s ruling in Students for Fair Admissions v. President and Fellows of Harvard College and Students for Fair Admissions v. University of North Carolina, saying in a statement that the ruling will “undermine the ability of colleges, universities, and medical schools to build a workforce of health care professionals that can effectively treat the increasingly diverse body of patients they serve.”
In the case, the Supreme Court ruled 6-3 that the admissions programs at Harvard and the University of North Carolina (UNC) that relied in part on racial considerations violate the Constitution’s guarantee of equal protection under the 14th Amendment.
APA disagreed with the ruling, pointing out that the decision will impede progress to achieve health equity. “A holistic race-conscious admissions process is an effective tool in assembling a diverse mental health workforce, which is critical to providing quality mental health care for all and addressing the mental health inequities that marginalized and minoritized individuals experience. Research supports that race concordance between physicians and patients and cultural sensitivity are associated with improved communication and better overall mental health outcomes.”
In July last year, APA Trustees voted to sign on to an amicus brief filed by the Association of American Medical Colleges (AAMC) in support of the UNC and Harvard admissions programs.
The brief stated, “[T]he legacy of American racial injustice has endured longer across the health care and medical-education systems than many might have predicted. As a result … if a program seeks a racially diverse student body with more than token representation, most schools will necessarily continue to rely on the consideration of an applicant’s racial or ethnic background in some cases. And any prohibition on the consideration of race in student admissions will therefore result in a student body with significantly fewer minority students.”
The AAMC brief did not address the particular practices of any particular university, but instead provided information to the Court regarding the importance of affirmative action in ensuring that medical schools have diverse undergraduate applicants to fill their classes. The brief pointed out that diversity in medical schools promotes a wide range of cultural benefits that help physicians better understand the populations they serve.
APA Area 4 Trustee and forensic psychiatrist Cheryl Wills, M.D., told Psychiatric News that she agrees the Supreme Court’s ruling is likely to result in diminishing the diversity among students entering medical school and the “cultural humility” of young physicians entering residency. She is the past chair of the APA Presidential Task Force to Address Structural Racism Throughout Psychiatry, established in 2020 by then APA President Jeffrey Geller, M.D., M.P.H.
Wills cited a study published in JAMA Open Network in April that found a greater representation of Black primary care physicians (PCP) in the workforce is associated with improved survival-related outcomes for Black people. That study found that every 10% increase in county-level Black PCP representation was associated with 31-day higher age-standardized life expectancy among Black people. Higher Black PCP representation levels were also associated with lower all-cause mortality rates among Black people, as well as reduced mortality rate disparities between Black and White people.
Art Walaszek, M.D., chair of the APA Council on Medical Education and Lifelong Learning, told Psychiatric News that as the population of the United States becomes more diverse, it is increasingly important to train medical students and psychiatry residents and fellows to effectively provide mental health care to the diverse populations they will see.
“Recruiting racially and ethnically diverse medical students, residents, and fellows who represent the populations we serve is critical to achieving this goal,” Walaszek said. “APA's Council on Medical Education and Life-Long Learning has, as one of its strategic goals, the goal of ensuring that educational activities are inclusive and relevant to addressing disparities in mental health care.
“Medical schools, residencies, and fellowships will face new challenges in expanding the diversity of learners as a result of the Court’s ruling,” he continued. “The council will discuss ways that medical educators can continue to recruit diverse students through holistic review of applicants to medical school, residencies, and fellowships.”
He added that the council is partnering with the American Association of Directors of Psychiatric Residency Training, the Association of Directors of Medical Student Education in Psychiatry, and other organizations “to ensure that we are recruiting and training psychiatrists who are ready to care for our increasingly diverse nation.” ■
