High Court Affirms Value of Diversity in Meeting Educational Mission

Carefully Tailored Nod to Race in Med School Admissions Benefits Patients, Say AAFP Experts

July 06, 2016 02:56 pm Cindy Borgmeyer

In a 4:3 decision, the U.S. Supreme Court has upheld the constitutionality(www.supremecourt.gov) of the University of Texas at Austin's use of race as one of many factors in its undergraduate admissions process. The AAFP had twice joined numerous other groups in submitting amicus curiae (friend-of-the-court) briefs supporting the university's policy, which -- according to the high court's June 23 ruling -- aims to achieve "the educational benefits that flow from student body diversity."

[Supreme court building at night]

The case, Fisher v. University of Texas at Austin, dates back to 2008, when petitioner Abigail Fisher was denied admission to the university as an undergraduate. Fisher, who is white, sued the institution, claiming that her Fourteenth Amendment rights to equal protection regardless of race had been violated.

Fisher's claim arose from the university's use of an admissions process that includes two primary components. The first of these is known as the "Top Ten Percent Rule," passed by the Texas Legislature and enacted in 1997. The law guarantees that any Texas student who graduates in the top 10 percent of his or her high school class will be automatically admitted to a state-funded university. In practice, about 75 percent of incoming freshmen at the University of Texas at Austin are admitted under this rule.

The remaining 25 percent of each freshmen class is evaluated for admission based on an "Academic Index" that includes students' Scholastic Aptitude Test scores and high school performance, along with a "Personal Achievement Index," a holistic review that comprises numerous factors, including race.

Story Highlights
  • The U.S. Supreme Court recently upheld the constitutionality of the University of Texas at Austin's use of race as one of many factors in its undergraduate admissions process.
  • The AAFP had twice joined numerous other groups in submitting amicus curiae (friend-of-the-court) briefs supporting the university's policy as a means of fostering future workforce diversity.
  • AAFP medical education experts welcomed the decision, saying it acknowledges the importance of building a diverse physician workforce to serve an increasingly diverse patient population.

Because Fisher did not graduate in the top 10 percent of her class, her only possible path to admission was through this second component. Her failure to qualify for admission via this route led her to file suit against the school, claiming that its consideration of race in making admissions decisions disadvantaged her and other white students.

Previous Proceedings

The case was first heard in 2009 by the U.S. District Court for the Western District of Texas, which upheld the legality of the university's admissions policy in a summary judgment. Fisher appealed to the U.S. Court of Appeals for the Fifth Circuit, which affirmed the lower court's ruling in 2011.

In its decision, the three-judge circuit court panel held(cases.justia.com) that under Grutter v. Bollinger, a 2003 case in which the U.S. Supreme Court upheld an affirmative action admissions policy at the University of Michigan Law School, courts are required to give significant deference to the university's "experience and expertise" in furthering "its compelling interest in securing the educational benefits of a diverse student body."

The circuit court's ruling further noted that the admissions policies used by the Texas school, which were modeled after Grutter, were sufficiently narrowly tailored as to survive any challenge of being motivated by "illegitimate" racial stereotyping.

In 2013, however, the Supreme Court(www.supremecourt.gov) vacated the appellate court's decision and remanded the case to the Fifth Circuit. In its 7:1 decision, the court stated that both the district and appeals courts used an incorrect standard of review and so failed to "hold the University to the demanding burden of strict scrutiny articulated in Grutter" and other settled law.

"Strict scrutiny does not permit a court to accept a school's assertion that its admissions process uses race in a permissible way without closely examining how the process works in practice, yet that is what the District Court and Fifth Circuit did here," wrote Justice Anthony Kennedy for the majority.

AAFP Workforce Policies Reflect importance of, Need for Diversity

The Academy has a number of policy statements that focus on various aspects of the family physician workforce and how it should be optimized, including specific views on fostering workforce diversity and boosting the number of minorities and women who embrace careers in family medicine.

It should be noted that Justice Elena Kagan, who was serving as solicitor general at the time the Department of Justice filed an amicus curiae brief supporting the university when the case was pending in the circuit court, recused herself from all proceedings in the case.

After applying the proper standard, the circuit court again sided with the university(www.ca5.uscourts.gov) in a June 2014 decision, holding that a university "may use race as part of a holistic admissions program where it cannot otherwise achieve diversity" and setting the scene for a second hearing by the nation's highest court.

Current Ruling

With Justice Kagan again recusing herself, Justice Kennedy for a second time delivered the court's majority opinion.

Finding that the university had amply demonstrated its compelling interest in realizing the educational benefits associated with fostering student diversity and that no "available" and "workable" means existed through which the university could have otherwise met the educational goals it set out at that time, "The University has thus met its burden of showing that the admissions policy it used at the time it rejected petitioner's application was narrowly tailored," Kennedy wrote.

Moreover, the court found, "Considerable deference is owed to a university in defining those intangible characteristics, like student body diversity, that are central to its identity and educational mission."

It was, in fact, recognition of the critical importance of diversity in fulfilling that mission that drove the AAFP and other groups to support the university's policies, arguing that student diversity is a key component in the educational mission of medical schools because physicians' education must enable them to serve diverse populations and communities.

AAFP Experts' Take

Clearly, it's a view shared by other academic institutions across the country, said Stan Kozakowski, M.D., director of the AAFP Division of Medical Education, in acclaiming the high court's ruling.

"More and more medical schools are adopting holistic review of student applicants and are finding that the outcomes from their students are at the same or higher levels than with the traditional admission process," he said. "At a recent national presentation on the subject, the speaker said that the key to success is understanding the social mission of the medical school and identifying those students who are most likely to achieve those outcomes after graduation."

AAFP Senior Vice President for Education Clif Knight, M.D., also was quick to welcome the court's decision.

"It is gratifying to have the Supreme Court agree with our belief that multiple factors should be taken into consideration when admitting students into educational programs," he told AAFP News. "Grades and test scores are not enough to decide who should be admitted into educational programs working to meet the needs of diverse populations to be served by their graduates.

"In family medicine, we understand that diversity in the physician workforce is critical to better meeting the needs of an ever more diverse general population and will result in improved health care and health," he added.

Citing a report(bhpr.hrsa.gov) from HHS' Bureau of Health Professions, Kozakowski said the evidence showing the relationship between positive population health outcomes and increasing diversity in the physician workforce continues to grow.

"Building the physician workforce to achieve optimal health for our nation depends on having the right numbers of physicians, of the right racial and ethnic mix, in the right geographic locations," he said. "This reaffirmation by the Supreme Court is critical to the future health of our nation."

Related AAFP News Coverage
Fresh Perspectives: Fake Teen Doc Reflects Need for Real Minority Physicians
(3/15/2016)

Fresh Perspectives: Key to Boosting Access Is Expanding the Pipeline
(9/1/2015)


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