The Society of Hospital Medicine Responds to Recent Supreme Court Decision on Affirmative Action

The Society of Hospital Medicine (SHM), representing the Nation’s more than 40,000 hospitalists, is firmly committed to fostering the growth of a diverse and inclusive hospital medicine workforce which includes individuals from traditionally underrepresented groups in medicine. While the U.S. Supreme Court’s recent decision to limit the consideration of an applicant’s racial or ethnic background in the admissions process for higher education may be viewed by some as a setback, we will move forward to address the undeniable ongoing problem of limited pathways for traditionally underrepresented groups in both higher and medical education. SHM intends to redouble our efforts to develop pathways to enhance the hospital medicine workforce so that it is representative of the patients and communities hospitalists care for every day in our country.

While the racial and ethnic diversity of the U.S. population continues to increase, the physician workforce has been diversifying at a much slower speed and uneven course.^[1] There is a persistent deficient representation of medical students from traditionally underrepresented groups.^[2] A physician workforce that is more representative of the U.S. population will help address inequities in healthcare and support improved access and better quality of care for underserved populations.^[3] There is evidence that, for example, more African American physicians in a predominantly African American community results in better health outcomes.

Unfortunately, the educational system in the United States (including undergraduate and graduate medical education) often disadvantages underrepresented or marginalized racial groups. For example, Black Americans are currently 13.4% of the US population, but few apply (8.4%), matriculate (6.2%), or match into residency programs (5.1%). From 1970 to 2020, the percentage of Black Americans graduating from US medical schools did not change, whereas, by comparison, women represented only 8.4% of medical school graduates and rose to 49.6% during this same timeframe.

SHM reaffirms its commitment to strengthening the diversity and inclusivity of the hospital medicine workforce. We will advocate for policies and programs to advance this objective while standing with and partnering with like-minded medical organizations and other stakeholders to facilitate the realization of a more diverse healthcare workforce overall.

1. Xierali IM, Nivet MA. The Racial and Ethnic Composition and Distribution of Primary Care Physicians. J Health Care Poor Underserved. 2018;29(1):556-570.
2. Lett LA, Murdock HM, Orji WU, Aysola J, Sebro R. Trends in Racial/Ethnic Representation Among US Medical Students. JAMA Netw Open. 2019;2(9):e1910490.
3. Marrast LM, Zallman L, Woolhandler S, et al. Minority physicians’ role in the care of underserved patients: diversifying the physician workforce may be key in addressing health disparities. JAMA Intern Med. 2014;174(2):289-291.