Affirmative Action and Holistic Review in Medical School Admissions: Where We Have Been and Where We Are Going.

Current challenges to affirmative action policies are cause for concern for medical schools that employ holistic admissions processes, which consider an applicant's race, ethnicity, gender, status as a first-generation college student, educational and socioeconomic status, geographical location, past experiences with minority and underserved populations, social capital, and immigration status. Students from minority and underserved communities bring with them experiences and perspectives that may enhance the care they provide to underserved patients, improving patient outcomes. Student body diversity is also associated with increases in students' academic performance, retention, community engagement, cooperation, and openness to different ideas and perspectives, and institutions that foster diversity tend to be nurturing places where all students and faculty can thrive.The use of race as a factor in admissions has been upheld in three Supreme Court decisions. Yet, the Supreme Court likely will rule again on this issue. In the meantime, medical schools must maintain or increase support for science, technology, engineering, and math academic enrichment programs at all levels, stay informed about their institutional climate, and support a holistic admissions process that considers race and socioeconomic status. Doing so will help disadvantaged students overcome the intergenerational barriers created by race, ethnicity, and poverty and help grow a culturally competent health care workforce, which is essential to improving individual and population health and narrowing racial and ethnic health disparities.