In this month’s installment of Dean Termuhlen’s Take On …, Dr. Paula Termuhlen discusses the recent U.S. Supreme Court's ruling on Students for Fair Admissions v. University of North Carolina and Students for Fair Admissions v. Harvard.
On June 29, the U.S. Supreme Court ruled that higher education institutions cannot consider an applicant’s racial or ethnic background during the admissions process. What does this ruling mean for medical schools across the country?
While this is a significant ruling for higher education, the Supreme Court’s decision has heightened importance for medical schools compared to undergraduate institutions. Part of what we know of health outcomes is that patients fare better when their health care is provided by someone of the same race or ethnicity – multiple studies have shown this. As such, I think the stakes are even higher for an institution like ours to make sure we have a wide variety of lived experiences among our students.
When a patient comes into the office, they’re going to make judgments about us and who we are based on how we talk, how we look and how we dress. It’s important that we figure out how to continue to build a physician workforce that provides the most diversity of life experience so patients can find someone to help them feel comfortable. The Supreme Court ruling is asking us to dig deeper than race and ethnicity in terms of the ways that people live their lives and understand their cultures. Schools nationwide will be forced to develop ways to understand more about how candidates will bring their own unique outlooks to providing care for patients and understanding how people live their lives, which is not necessarily a bad thing, assuming schools take this step.
But we here at WMed must do both. When someone walks into the surgical oncology office to see me, what they see is an older white woman. They don’t know that I was a first-generation college student, or whether my upbringing had challenges associated with it or what my sexual orientation might be. Typically, they have gone online to find out whether I know what to do to take care of their cancer. But very quickly, as soon as they start talking to me, I must be able to understand their identities and how those impact their lives because the care that I provide needs to be in the context of their daily lives and the resources they have available to manage their care.
Schools nationwide have been anticipating this decision and the challenges it may bring to our admissions processes. However, we’ve also been preparing for it. Michigan is one of the states that has not allowed the use of race as an explicit criterion in admissions for quite some time. So, we are very familiar with completing a holistic admissions review and that has been our norm. We are prepared to continue to do what we believe is right for patients and build a physician workforce reflecting the people we serve.
Will this U.S. Supreme Court ruling affect the admissions process at WMed? If so, how?
WMed uses a holistic review that incorporates the breadth and depth of life experiences and skills, personal attributes and characteristics and academic metrics. Fortunately, our admissions team is engaged with the Association of American Medical Colleges and had made some minor adjustments to our essay questions before this admissions cycle in anticipation of the ruling. The admissions team is digging deeper in a way to understand a person’s experience with community that will help inform their decisions. It’s not just about candidates’ grades, how well they do on tests, and their understanding of science. It’s also about the complete holistic people they are and what will equip them to take care of people in the future. An applicant's race and ethnicity are part of what creates their full individualized life experience, which is what a holistic evaluation of an applicant attempts to understand. This continues to be allowed by the U.S. Supreme Court decision as we understand it. We continue to try to gauge applicants' experiences with different communities as one of the many factors in an admission decision.
Why is attracting a diverse group of medical students to WMed important?
In addition to the improved health outcomes for patients in the long run, we also know it’s important because it genuinely helps everyone here understand the world better. We are all learning daily and we learn more when we have a variety of ideas and experiences at the table. The better we understand the world, the better we will be at developing the best-prepared physicians to serve our patients here in Southwest Michigan and around the world. After all, our goal is to create a physician workforce that is more reflective of the populations we serve.
Why is it important to have diversity represented in physicians and other healthcare providers?
Last month the AAMC had a great article about whether Black patients fared better with Black doctors. They noted “research shows that racial concordance can improve communication, trust, and adherence to medical advice.” They discussed all kinds of outcomes, from patients’ willingness to bring up specific health concerns to infant mortality rates.
We know that it is every physician’s responsibility to provide care in an equitable way. At the same time, we want to make sure patients have the opportunity to connect with physicians who may have shared experiences. Shared identities can provide a patient more comfort and can position a physician to better understand the challenges someone may face. With a deeper understanding of the patient’s life experiences, physicians can work together with patients to cocreate solutions to allow patients to take better care of themselves. This has been examined from several different identities including race and ethnicity, sexual orientation, and geographic location. I expect WMed graduates to be able to provide care for a wide variety of patients after they leave our doors, and interaction with other students from many different backgrounds during their time here will help them on that journey.
Dean's Hat Tip
I tip my hat to our Medical Student Admissions Committee and team, including Assistant Dean for Admissions Timothy Bauler, PhD, and our admissions team led by the director of Admissions Daniel Goodpaster. They have prepared to help us navigate the new expectations from the Supreme Court decisions and, thanks to their dedicated work in recruiting the very best students to WMed, last week we welcomed WMed’s 10th graduating class.
Dean Termuhlen’s Take On ... is a monthly message from our dean to discuss topics of importance to WMed, medical school stakeholders, and the communities that make up Southwest Michigan. Is there a topic you would like to hear Dean Termuhlen’s take on? Let us know by sending a message to office.dean@wmed.edu.