Affirmative action in medical education: a legal perspective

The use of affirmative action programs as part of the effort to increase the presence of minorities in medical education and the physician workforce has come under greater legal scrutiny. The authors describe the history of the legal theory behind affirmative action, giving examples from the evolving case law and from Department of Education guidelines. They identify legal pitfalls in the areas of admission and financial aid, including the categorization of students by race, racially disproportionate financial aid awards after accounting for need, racially disproportionate amounts of scholarships as opposed to loans, and, for public medical schools, differential treatment of out-of-state students based on race. Medical schools should be aware of this legal framework so that they can construct affirmative action programs that comply with the law while maintaining momentum toward diversification.