U.S. medical schools have fully embraced affirmative action in student admissions but not yet for faculty promotions, according to a first-ever diversity report card.
All 101 medical schools that completed a self-audit have “admissions policies and practices for encouraging a diverse class of students,” the Association of American Medical Colleges (AAMC) reported this month.
But only 43% “have promotion and tenure policies that specifically reward faculty scholarship and service” on diversity topics, according to the report card.
The report builds on a framework the association passed in October 2020 to eliminate systemic racism in U.S. health care.
“Studies have shown that health inequities along racial and ethnic lines persist in nearly every aspect of human health and that increased racial diversity in the health professions can help close that gap,” said Dr. Alison J. Whelan, AAMC chief academic officer.
She pointed to research showing that Black mothers are three times more likely than White mothers to die of pregnancy-related complications, Black men are twice as likely as men of other races to die from prostate cancer, and Blacks and Hispanics are roughly twice as likely as others to be hospitalized or die from COVID-19.
“These health outcomes cannot generally be explained by socio-economic status, access to health care, or education alone, and effective interventions to address these health inequities are a focus of nearly every major health care organization,” Dr. Whelan said in an email.
Do No Harm, a conservative medical group, slammed the report, saying it assumes a connection between poor health outcomes among minorities and racial discrimination.
“Merit and complete commitment to caring for patients as individuals have given way to a focus on social justice, group identity and diversity of the physician workforce,” said board Chair Dr. Stanley Goldfarb, a former associate dean for curriculum at the University of Pennsylvania’s medical school. “This emphasis poses a real risk for the American people.”
The AAMC report card found that most U.S. medical schools have “holistic admissions” policies; mention diversity, equity and inclusion (DEI) in mission statements; and have discrimination, bias and harassment policies.
It also found that few reward faculty and staff for their work to advance DEI goals, have institutional plans to promote DEI initiatives, or make their DEI data broadly available to the campus community.
Just 35% “have performance incentives for schools or departments to achieve diversity, inclusion, and equity goals,” according to the report. It colored this part red to suggest a “failing” grade.
Medical schools and teaching hospitals that belong to the association are obliged to “address the factors that drive racism and bias in health care and prepare physicians who are culturally responsive,” said Dr. David A. Acosta, AAMC chief diversity and inclusion officer.
“These inequities are often rooted in systemic discrimination, including racism within the nation’s health systems, that contributes to lower quality care,” Dr. Acosta added.
The report reinforces the need for medical professionals to look like their patients, said Dr. Panagis Galiatsatos, a professor and health equity lead at the Johns Hopkins School of Medicine.
“We must do better to assure the doctors who serve the patients can also be representative of that community,” Dr. Galiatsatos said.
Howard Fields III, an adjunct professor of ethics at the University of Missouri, said affirmative action policies “are not inherently discriminatory” for seeking that goal.
“However, when a system has always benefited your social group, the moment it does not could feel discriminatory, I suppose,” Mr. Fields said.
But Gregory Quinlan, president of the conservative Center for Garden State Families in New Jersey, said health inequities likely arise from an increasing focus in U.S. health care on money over patients.
“In my 30 years as a practicing nurse, I never saw a health care professional or institution mistreat a patient based on race,” Mr. Quinlan said. “This push to remake medical schools sounds more like politics than health care.”