Letter

Reclaiming Merit in Medical Education

  • By Kurt Miceli, MD
  • September 12, 2025

[Note: The full version of this article originally appeared as a comment to “Medical School Admissions After the Supreme Court’s 2023 Affirmative Action Ruling” by Nguyen, et al and published in JAMA Network Open. You can read Dr. Miceli’s article in its entirety here.]

The study by Nguyen, et al. ignores a fundamental question: What is the true purpose of medical education? Rather than engaging in social engineering, medical schools need to focus on identifying and training the most qualified individuals to become physicians. Patients rightfully expect—and deserve—the highest standard of care. Yet, the study neglects to consider merit-based factors and thus the quality of applicants.

Data from the AAMC reveals persistent differences in academic performance among matriculants even post-Students for Fair Admission (SFFA). In the ‘24-25 academic year, Asian matriculants scored 513.9 on the MCAT, compared to 512.2 for White matriculants, 506.4 for Black matriculants, and 505.9 for Hispanic matriculants—figures nearly unchanged from the year prior and where a single point difference on the MCAT equals ~3 points in percentile rank. [1 2 3] If race-neutral admissions policies had been meaningfully implemented following SFFA, one would expect these gaps to have narrowed. They haven’t.

The organization for which I work, Do No Harm, analyzed admissions data from 23 public allopathic medical schools. In all but one, accepted Asian and white applicants had, on average, higher MCAT scores than accepted black applicants. At 13 schools, the average MCAT score of rejected Asian or white applicants was higher than the average MCAT score of accepted black applicants. And, at Eastern Virginia Medical School, for example, black applicants had up to an 11-fold higher chance of acceptance compared to GPA- and MCAT-matched Asian or white peers. These patterns suggest that, even after SFFA, many medical schools may still be prioritizing racial considerations over academic merit in their admissions decisions.[4]

Read Dr. Miceli’s full comment at JAMA Network Open here.

  1. https://www.aamc.org/data-reports/students-residents/data/facts-applicants-and-matriculants ↩︎
  2. https://www.aamc.org/media/6066/download?attachment ↩︎
  3. https://students-residents.aamc.org/media/15781/download ↩︎
  4. https://donoharmmedicine.org/wp-content/uploads/2025/07/Skirting-SCOTUS-III-Racially-Conscious-Admissions-1.pdf ↩︎