What medical schools can do following SCOTUS' ruling

In its ruling, SCOTUS said affirmative action programs violate the Equal Protection Clause of the Constitution, but clarified that if applicants wish to write about how their racial identity "affected the applicant's life, so long as that discussion is concretely tied to a quality of character or unique ability that the particular applicant can contribute to the university," that would be acceptable.

According to Dayna Matthew, dean of the George Washington University Law School who specializes in healthcare law, it's "possible to adjust to this new law and continue to serve the absolutely critical goal of a diverse workforce."

While medical schools cannot consider race in admissions, they can still consider criteria like economic status and the education level of an applicant's parents, whether the applicant was raised by a single parent, or attended public schools in certain cities.

"There are other ways you might say are proxies for race and ethnicity you can use to the maximum," said Joseph Flaherty, president of Western Atlantic University School of Medicine.

This is what's known as following a "holistic review" model, according to Erica Johnson, a physician at Johns Hopkins Bayview Medical Center who works in graduate medical education.

"It pushes all of us to move in a direction that these selection decisions have steadily been heading in any way," she said. "One of the key features is identifying key experiences and attributes that are relevant to the training experience."

How UC Davis has diversified its student body

Some medical schools have already been working around laws blocking affirmative action, including in California, where affirmative action was banned in 1996 by Proposition 209.

According to Matthew, schools in California almost immediately saw a significant drop in the total numbers of Black and Hispanic students after Prop 209 took effect. "Then came the innovation, the persistence of law-abiding California schools," she said.

One of those schools is the University of California, Davis, which ranks as the most diverse medical school in the country after Howard University — a historically Black university — and Florida International University — a Hispanic-serving research university.

Mark Henderson, who runs the admissions process for UC Davis's medical school, started to work to increase the diversity of the school's student body through "the slow building of things under the radar."

Specifically, he started by diversifying the school's admissions committee and staff. "The reason things stay the same is because everyone involved is the usual suspects," he said.

And instead of focusing on race for admissions, Henderson focused on economics. "I'd call it class-based affirmative action," he said. "Class struggles have a huge overlap with race — that's how we skirted the issue."

"We look for attributes or experiences or commitment to work in areas that are likely to serve society's needs." Henderson added.

For example, if applicants had a "socioeconomic disadvantage score," they received high marks, Henderson said, shifting the application criteria away from MCAT scores and GPAs. UC Davis also provides $12 million in scholarships each year to economically disadvantaged students.

Henderson added that he believes only a handful of medical schools are doing the necessary work to diversify their classes.

"There will be ways to look like you are closing the gaps, but aren't really," he said. "The fear I have is that institutions will take the path of least resistance." (Reed, Axios, 6/30; McFarling, STAT, 3/7; Janse et. al., NPR, 6/12)

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