The number of American Indian/Alaska Native, Black, and Latinx medical students declined substantially in 2024, the first year in which the ban on race-conscious admissions policies took effect nationwide. This decline in diversity, observed in recent data from the Association of American Medical Colleges (AAMC), will result in fewer choices for some patients who seek a provider of the same race or ethnicity, which could worsen racial and ethnic health care inequities.

In 2023, the US Supreme Court prohibited the consideration of an applicant’s race or ethnicity, among other factors, in higher education admissions decisions. The next year, the AAMC data show decreases in students of color who are underrepresented in medicine:

• American Indian/Alaska Native students—many from some of the communities experiencing the worst health in the United States—declined 22.1 percent.
• Black and Hispanic or Latino medical school students declined by more than 10 percent (11.6 percent and 10.8 percent).
• Native Hawaiian or other Pacific Islander students declined 4.3 percent.

These challenges are not likely to improve in the near term, given that President Trump has issued numerous executive orders prohibiting diversity, equity, and inclusion initiatives in federally funded higher education and health care settings. Among the initiatives that may be at risk are training programs that help current providers identify and mitigate personal biases that may affect health care and “pathway programs” designed to increase the share of students from underrepresented racial and ethnic groups entering health professions.

To help medical schools, policymakers, researchers, and advocates understand the complex policy landscape and identify solutions, we offer evidence of the importance of having access to a provider of the same race or ethnicity and discuss race-neutral applicant attributes medical schools could consider to ensure they’re admitting students with wide-ranging experiences that create beneficial educational environments and make them well suited for medical careers.

Why is diversity among medical school students and health care providers important?

A diverse health care workforce, in which patients can access providers of their same racial or ethnic background, has benefits for individual patients as well as society.

Research shows that having access to a provider of the same racial or ethnic background is associated with positive health care experiences. This is especially important given that people of color generally experience a higher burden of disease and disability than white people.

When patients of color have a provider of the same race or ethnicity, they report better communication with their provider, greater adherence to treatment regimens, and greater trust of health care systems overall. Studies also increasingly suggest that patients of color experience better clinical outcomes when their provider shares the same race or ethnicity, though more research is needed to fully understand the mechanisms driving those improved outcomes.

Providers of color often are able to overcome language and culture barriers that may emerge when patients have a provider of a different racial or ethnic background. Such providers are also more likely to want to work in medically underserved communities or work in disciplines with critical shortages, such as primary care. Medical students who work with diverse students and faculty report being better prepared to serve a diverse range of patients in their clinical practice.

Still, many patients of color struggle to find providers of their same racial or ethnic background. New Urban Institute research finds that people of color are more likely than white people to prefer a provider of the same race, yet white patients are more likely than people of color to have a provider of the same race. For example, Black adults were over four times more likely than white adults to report preferring a provider of the same race (32 percent versus 7 percent), but white patients were over four times more likely than Black patients to report having a provider of the same race (76 percent versus 18 percent).

We also found that people of color who anticipated experiencing unfair treatment in health care settings were much more likely than those who did not anticipate unfair treatment to prefer a provider of the same race. This suggests a more diverse health care workforce may help many adults feel safer when seeking care.

In addition, the lack of diversity in the US health care workforce is costly. That the diversity of health professionals hasn’t kept pace with the increasing diversity of the population could be among the reasons why racial and ethnic inequities in health care access, quality, and outcomes have persisted over the past two decades. These disparities place a significant burden on the country: not only do families suffer financially when adults are too sick to work, but business productivity and tax revenue at all levels decrease also. In 2018, racial and ethnic health disparities were estimated to cost the US economy $451 billion. Deploying comprehensive strategies to reduce these inequities, including efforts to diversify the health care workforce, is in the nation’s best interest.

How can medical schools admit students with wide-ranging experiences that improve educational environments and make them well suited for medical careers?

The Supreme Court’s 2023 decision did not end opportunities for medical schools, as well as other health professions education institutions, to admit diverse classes of students. The Supreme Court majority said the ban on considering applicants’ races or ethnicities should not prevent higher education institutions from considering other important attributes that can enhance the overall learning experience for all students, such as the degree to which students have overcome barriers to academic achievement and their commitment to service. These attributes can help cultivate empathy, compassion, and bedside manner, which can be as important to the quality of care health professionals deliver as their grades or standardized test scores.

This approach can work. California has barred higher education institutions from considering applicants’ races or ethnicities since it enacted Proposition 209 in 1993. The University of California, Davis, medical school admissions committees began using a race-neutral measure of the social and economic barriers an applicant had overcome to predict their future effectiveness as a clinician. It supports students who are from and aspire to work in medically underserved communities and offers accelerated and culturally sensitive training for students who will work in primary care fields. Today it’s nationally ranked among the best medical schools and is the third most diverse medical school in the country.

Similar strategies will be needed to ensure the US has a health care workforce prepared to meet the nation’s needs and that all people have access to their choice of provider.