Michigan medical schools pursue diversity without preferences

Michigan medical school leaders are concerned that they will end up with fewer minority students after voters passed an affirmative action ban in November 2006.

"Students have the perception that a hostile atmosphere is being created," said Silas Norman Jr., MD, assistant dean for admissions at Wayne State University School of Medicine in Detroit. "If they get multiple acceptances, we don't know if they'll choose us."

Michigan joined California and Washington as states in which voter initiatives ended the use of racial and gender preferences in state employment, education and contracting. Florida has a similar ban made law by a governor's order.

Michigan's ballot initiative followed a 2003 U.S. Supreme Court decision that upheld the use of race as one of several admissions criteria at the University of Michigan Law School in Ann Arbor. The decision allowed the university to consider applicants' race, and it prompted schools in Louisiana, Mississippi and Texas to consider race in admissions after a decade-old 5th U.S. Circuit Court of Appeals decision out of New Orleans had prohibited them from using race-conscious admissions.

Representatives from Michigan's four medical schools said they hoped to maintain racial diversity as they remove racial preferences from admissions. Steven Gay, MD, interim assistant dean of admissions for the University of Michigan Medical School, said he was optimistic that they would maintain racial diversity, since it was one of several factors considered.

"Our definition of diversity includes artists, writers, those who volunteered in their community," Dr. Gay said. "Race was in the equation initially. Now with the vote of the people, we will take race and gender out of the equation."

After the Supreme Court decision gave the University of Michigan permission to consider race, its medical school revved up minority recruitment. It contacts minority students who score well on the Medical College Admission Test and invites them to apply. The 2006 ban on affirmative action is not expected to impact such recruitment efforts, educators said, and the efforts may offset any decline in minority applicants who are concerned that Michigan no longer is a welcoming state.

Dr. Gay said the idea that diversity means that qualified white applicants are pushed aside by less-qualified applicants of another race is wrong.

"We don't select individuals who do not meet the academic standards of this institution," he said.

Representatives from Michigan's other medical schools had similar views. Paulette Granberry Russell, director of the office for inclusion and intercultural initiatives for Michigan State University, said MSU began to recruit more aggressively from historically black and Hispanic universities after the Supreme Court decision. The school's two medical schools, one allopathic and one osteopathic, did not alter their admissions policies, she said.

"Our approach to admissions has not taken race or gender into consideration in ways that could be regarded as preferential," Russell said.

One way to pursue diversity without using racial preferences is to seek applicants from an underserved urban or rural area, find out where they have had clinical experiences and see what their career goals are, she said.

While Michigan's medical schools wait to see if the affirmative action ban will have a chilling effect on minority applicants, a group of 30 health profession organizations, hospitals and medical schools have formed the Health Professionals for Diversity coalition to actively support diversity in health care. Without a diverse health care work force, members of this group fear that the quality and quantity of health care for minorities will suffer.

"Our concern is that since [an affirmative action ban] has passed in three states, there will be a national problem," said Norma Poll, PhD, a coalition spokeswoman and senior research associate at the Assn. for American Medical Colleges.

The AMA supports efforts to increase diversity in the physician work force, including pipeline programs that prepare minorities for med school.