Assessment of Diversity Outcomes in American Medical School Admissions: Applying the Grutter Legitimacy Principles

In the last 30 years, except for female participation, the enrollment of Latinx, African Americans, Native Americans, Alaskan natives, and disadvantaged students in medical school has been constant; however, increasing enrollment of these minority populations is feasible, if admissions committees make two changes in approach. First, the traditional belief that matriculation merit is a linear function of past academic performance must be rejected. Second, once the threshold needed to complete medical school in four years and to pass licensing examinations at the first attempt has been met, all candidates are equally qualified, and matriculation decisions must be based, in part, on societal interests. In Grutter vs. Bollinger, the United States Supreme Court determined that graduate admission committees can and should consider societal interests. Each admission decision represents a substantial government investment in each student, as the Medicare Act directly subsidizes much of the cost of medical education. As Grutter explained, there is a societal interest in the public having confidence in, and access to, the medical school training that will prepare tomorrow’s medical, professional, and political leaders. Our analysis suggests that medical school admissions are biased towards academic achievement in matriculants, beyond acceptable thresholds for graduation and licensure. We believe medical schools must shift their admissions strategies and consider noncognitive factors in all candidates as determinative once minimum acceptable academic standards have been met.