Why Does the Harvard Case on Asian American Discrimination in Admissions Matter for Academic Medicine?

In 2014, Students for Fair Admissions (SFFA), led by activist Edward Blum, filed a suit against Harvard University, contending that the Harvard admissions process unfairly discriminates against Asian American applicants. The SFFA further argued that to remedy this outcome, Harvard must remove considerations of race and ethnicity in its holistic admissions approach.

In a recent Academic Medicine Perspective, we summarized the arguments made by both the SFFA and Harvard in the case and discussed the implications for medical education admissions. We clarified the difference between claims of anti-Asian American discrimination, known as negative action, and the use of race and ethnicity in admissions. We also reviewed the literature on Asian Americans, showing there is no evidence to suggest anti-Asian American discrimination in medical school admissions and that some evidence from undergraduate admissions suggest that the removal of race and ethnicity would lower admission rates for several minority groups, including Asian Americans.

In the time since we wrote our Perspective, two new key developments have emerged. First, on October 1, 2019, Federal District Court Judge Allison D. Burroughs issued a ruling finding no evidence that Harvard engages in discriminatory admissions practices against Asian Americans. As expected, the SFFA has indicated that they will file an appeal with the First Circuit Court of Appeals and, if necessary, the United States Supreme Court. Judge Burroughs restricted her ruling to the claims of anti-Asian American discrimination and whether Harvard places too much emphasis on race; she disagreed with the plaintiff’s arguments that race-blind alternatives would meet the university’s diversity objectives. The next step to watch is whether the First Circuit Court of Appeals adopts Judge Burroughs’ approach or broadens the scope to rule on the latter argument. As we note in our Perspective, Justice Samuel Alito has raised concerns in prior decisions that race-conscious admissions policies will disadvantage Asian Americans.

Second, a recent study of Harvard’s admissions data, by Arcidiacono and colleagues (made possible by the data released for this case) quantified the extent to which whites receive advantages in admissions. Because white students are overrepresented in certain key groups that are given preference—children of former Harvard alumni and faculty and staff, those on the dean’s interest list (likely relatives of donors), and student-athletes—the authors found that nearly three quarters of white students in these groups would not have been admitted under the school’s standard admissions process.

In other words, the authors have found what proponents of affirmative action have argued all along—we need policies to support racial and ethnic minorities because we have systems that privilege white applicants over other groups at every step of the way. The Harvard case is a clear example of the concerns raised by Lucey and Saguil in another recent Academic Medicine Perspective—structural racism becomes embedded in our decisions over who can enter the medical profession.

Whether or not Harvard or other elite institutions discriminate against Asian Americans is an important issue to resolve, and the evidence to date is not conclusive. The SFFA plaintiffs could use the findings from the Arcidiacono and colleagues study to argue that use of legacy, donor, and other criteria result in a discriminatory outcome. But this is unlikely as the plaintiffs are focused on removing considerations of race and ethnicity, not addressing the processes by which admissions actually produces inequitable outcomes by race and ethnicity. A ruling in favor of the plaintiffs, while also maintaining the current privileges in admissions that disproportionately favor white applicants, will deliver yet another setback to medical schools that aim to improve racial and ethnic diversity of the health care workforce and, therefore, to ensure that all communities have access to care.

By: Michelle Ko, MD, PhD, and Hendry Ton, MD

Michelle Ko is assistant professor of health policy and management in the Department of Public Health Sciences, and Hendry Ton is interim associated vice chancellor of diversity and inclusion, the associate dean for faculty development and diversity, and professor, in the Department of Psychiatry and Behavioral Sciences, both at the University of California, Davis.

Further Reading

  1. Ko M, Ton H. The not underrepresented minorities: Asian Americans, diversity, and admissions [published online ahead of print October 1, 2019]. Acad Med. doi: 10.1097/ACM.0000000000003019
  2. Lucey CR, Saguil A. The consequences of structural racism on MCAT scores and medical school admissions: The past is prologue [published online ahead of print August 13, 2019]. Acad Med. doi: 10.1097/ACM.0000000000002939