New data from the Association of American Medical Colleges (AAMC) show a concerning decline in medical school diversity for the 2024-25 academic year, despite an overall increase in first-year enrollments. The number of students from historically underrepresented groups—including Black, Hispanic, and Indigenous applicants—dropped significantly, with some groups experiencing double-digit declines. This downturn follows the 2023 Supreme Court decision restricting race-conscious admissions, along with state and federal policies limiting or eliminating DEI (diversity, equity, and inclusion) policies and programs.
Enrollment Figures
While total first-year medical school enrollments increased by 0.8%, the number of applicants declined by 1.2% to the lowest level since the 2017-18 academic year. Notably, Black and Hispanic matriculants fell by 11.6% and 10.8%, respectively, marking the third consecutive year of declines for both groups and returning them to pre-pandemic figures. American Indian or Alaska Native students saw an even steeper drop of 22.1%, while Native Hawaiian or Other Pacific Islanders decreased by 4.3%.
The impact of these decreases is significant, given the well-documented correlation between a diverse medical workforce and improved health care outcomes for underrepresented communities.
“In the wake of the 2023 U.S. Supreme Court decision on the consideration of race in admissions and state-level policies ending funding for diversity, equity, and inclusion programs, medical schools are operating in a new environment,” David A. Acosta, MD, AAMC’s chief diversity and inclusion officer, said upon the release of the association’s new data. “In order to continue to recruit and matriculate strong classes, it is critical that schools support pathways programs and use effective race-neutral admissions practices and tools, such as holistic review.”
Holistic Admissions as a Solution
To counteract these downward trends, many medical schools are turning to holistic admissions practices. This approach evaluates applicants based on a broad set of criteria, including life experiences, service commitments, leadership qualities, and resilience, rather than relying solely on standardized test scores and GPAs.
Drexel University College of Medicine is one institution emphasizing holistic review in its admissions process. The school considers not only academic performance but also personal characteristics, volunteer involvement, and leadership potential. According to university guidelines, “consideration is given to the experiences, attributes, and academic metrics of the applicant.” The goal is to recruit and educate a class that will serve a diverse patient population.
Drexel’s approach appears to be making an impact, with 17% of its incoming class identified as underrepresented and another 17% classified as nontraditional. Additionally, the school has implemented programs to encourage applications from students from diverse socioeconomic backgrounds and experiences outside of traditional academic pathways.
University of California, Davis (UC Davis) School of Medicine has adopted a similar strategy designed to prioritize diversity. Despite California’s ban on race-conscious admissions under Proposition 209, the school has tripled enrollment of Black, Latino, and Native American students since 2006 by prioritizing mission-fit, lived experience, and socioeconomic background in admissions. During that year, underrepresented students made up less than 10% of the entering class, even though these groups represented a majority of California’s high school graduates.
To counteract disparities in medical education, UC Davis’ holistic review process places less emphasis on traditional metrics like MCAT scores and GPA and instead, evaluates applicants based on their potential contributions to the physician workforce, considering factors such as military service, personal adversity, and community engagement. The school also developed the UC Davis Scale, a measure of socioeconomic disadvantage that contextualizes academic performance and serves as a proxy for resilience.
Broader Implications for Health Care
The decline in diversity among medical school applicants and enrollees raises concerns about equitable health care access. Studies have shown that physicians from underrepresented backgrounds are more likely to serve minority and underserved populations, contributing to better health outcomes for those communities. A lack of diversity could also exacerbate existing disparities in health care availability and quality.
Looking Ahead
Moving forward, medical schools must continue developing strategies to attract a diverse applicant pool while navigating legal and policy restrictions. Strengthening pipeline programs, increasing outreach efforts, and refining holistic processes will be critical to ensuring that the medical field remains representative of the population it serves.
The coming years will be crucial in determining whether these efforts can successfully reverse the current enrollment trends. As the AAMC and medical institutions push for new ways to maintain diversity, the effectiveness of holistic admissions will be closely watched as a potential model for equitable medical education.
