In May, the Justice Department announced its findings that the Yale School of Medicine uses race in admissions reviews despite the Supreme Court’s 2023 ruling striking down those race-based programs. After a nearly yearlong investigation, the department claimed that a Black or Hispanic student had “a substantially higher likelihood of being offered admission than a White or Asian student with the same academic credentials.” Yale recently announced that the university plans to negotiate changes with the Trump administration. (It’s worth noting that the department only looked at grade point averages and standardized test scores, not any of the several other parts of the medical school’s applications.)
Over the past year, higher-education giants like Harvard and Columbia have made headlines for their tussles with Trump’s Department of Justice. The administration contends that these schools weave DEI frameworks into their admissions reviews, grant programs, and other policies. But the Trump administration intended to make an even bigger splash by going after the nation’s top medical schools.
Yale wasn’t the only medical school subject to federal scrutiny: Over a dozen others are having their admissions practices probed to find any evidence of race-based affirmative action policies. Research on the benefits of DEI has shown that the policies which open doors for African Americans and other racial groups who’ve been historically excluded from colleges and universities do not lower academic standards—nor do those programs take away opportunities from “higher qualified” candidates.
Modern medicine advanced through the exploitation of Black people, but the breakthroughs in effective care do not necessarily reach Black patients.
In fact, disrupting the decades of progress that has diversified medical schools and trained doctors from a wide range of backgrounds arguably is the ultimate goal. What federal officials have actually done is underline the profoundly racist basis of their assault on these schools. In defining anything related to DEI as being anti-merit, the Trump administration has effectively concluded that accomplished individuals from historically marginalized backgrounds have no place in these institutions.
BLACK PEOPLE HAVE LONG been subjugated and harmed by the nation’s views on race and health. Modern gynecological practices originated in horrific experiments on enslaved Black women by white doctors: Between 1845 and 1849, Dr. J. Marion Sims, an Alabama-based physician, performed vaginal surgeries without anesthesia. For decades after enslavement, nonconsensual and dangerous medical research was done on Black Americans. Surgeons sterilized many Black women in the 1900s. U.S. Public Health Service researchers conducting the Tuskegee Syphilis Study from 1932 to 1972 examined untreated syphilis in Black men who believed they were receiving treatment. Doctors facilitated the nonconsensual removal of cancer cells from a Black woman named Henrietta Lacks in 1951 for vaccine and other research. The racist lines of thinking that facilitated these experiments still run through American health care today.
Modern medicine advanced through the exploitation of Black people, but the breakthroughs in effective care do not necessarily reach Black patients. Health disparities occur along racial lines. In medical settings, Black patients are more likely to be mis- or underdiagnosed and experience discriminatory treatment by health care providers. Mistrust in the health care system has long been prevalent among African Americans: A 2024 Pew Research Center poll found that over half of Black adults believe that “the U.S. health care system was designed to hold Black people back a great deal or fair amount.”
For decades, medical schools, hospitals, and professional associations barred Black people from practicing or teaching medicine. During the late 1800s, when the American mainstream medical system, particularly its medical schools, was taking shape, Black people were prevented from becoming doctors and nurses. Eugenicists, for example, argued that Black people were less intelligent than whites—which closed off medicine as a career.
These beliefs still permeate medicine today, says Harriet Washington, a bioethics professor at Columbia University: “Initially, there was no data offered to support that. But this had implications for how African Americans were viewed in medicine because the thought was that African Americans were constitutionally unsuitable for medicine. They weren’t intelligent enough. They weren’t moral enough. They weren’t disciplined enough.”
In 1910, the Flexner Report, one of the first reports on the state of medical education in the U.S., was published. Abraham Flexner, the white author, argued that most historically Black medical schools (many of which were established during Reconstruction) should be closed, Black doctors should only treat Black patients, and that they should be trained in “hygiene rather than surgery.” Black students were not admitted to most U.S. medical schools for the next half-century after the report was published. Those who were studying when the report was published were forced to leave medical school due to closures.
But Black people have long had to create and maintain their own institutions so that their communities could receive comprehensive health care. When organizations such as the American Medical Association banned Black doctors from becoming members, those doctors established the National Medical Association. Community health care centers remained open. Holistic treatments that were rejected by mainstream medicine continued to be used, some of which had, and have, been practiced for centuries by African Americans.
“It’s a testament to the values, resourcefulness, and energy of African Americans,” says Washington. “They were able to build their own schools and their own hospitals and maintain them for any period of time. It was a significant resource that are necessary not only in money but in expertise. Black people saw it as important enough that they devoted these resources and expertise.” Black doctors don’t just improve the health and address the concerns of Black patients; they ensure health care equity across the board by raising patient trust and lowering mortality rates.
PRIOR TO THE SUPREME COURT’S 2023 decision, the number of Black medical students was slowly trending upward. In 2024, however, the enrollment of Black medical school students fell nearly 12 percent. The Trump administration’s assault on medical school admissions practices that encouraged enrolling students from diverse racial and ethnic backgrounds will only compound this decline.
The country’s ugly history of closing off medicine from African American physicians often makes medical schools and professional settings hostile and uncomfortable for Black people. When Ashley Jeanlus, a fellow with Physicians for Reproductive Health, was in medical school, she experienced imposter syndrome.
“You think it’s [imposter syndrome] just a problem in your head. But now I’m recognizing accurately that I was fighting to be in a room that wasn’t built to have me in it, and that recognition in itself lets me fight back,” says Jeanlus, now a New York–based obstetrician/gynecologist. “But I didn’t have that insight when I was a medical student. I only have it now because I understand all the barriers that it took me to overcome to finally become a physician.”
Black medical students are twice as likely as their white peers to leave medical school. Discrimination, repeated microaggressions, and financial constraints are often cited as reasons. Unfortunately, these statistics have been used to support the racist trope that Black people are unequipped to practice medicine. Yet targeting admission practices, changing how student loans are repaid, and pulling funding to schools is a recipe for disaster not just for Black students and patients, but for anyone seeking care.
“They’re eliminating the holistic approach of understanding that having a diverse patient and a diverse physician population is actually a benefit to the whole country at large,” says Jeanlus.
After years of progress, the Trump administration has walked back the federal government’s acknowledgment of medical racism and health inequities and stalled further advances. “We have this recidivism going on after all these inspiring messages about what we admit we’ve done wrong. We’re hearing the exact opposite,” says Washington. “It’s something that Black people in medicine have been fighting for and continue to fight for.”
