Earlier this week, the UC San Diego School of Medicine made news for its use of what Assistant Attorney General Harmeet Dhillon is calling a “shadow application process” that “unlawfully judge[s] applicants for admission based on their race.”
Yet a wider look reveals that the centralized application service used by most U.S. medical schools may be committing a similar DEI-inflected error.
As reported in the New York Post and elsewhere, the U.S. Department of Justice Civil Rights Division’s July 20 letter to UC San Diego alleges that the medical school “intentionally discriminated against applicants by granting and denying admission based on their race.”
Specifically, the letter suggests that the School of Medicine used “applicant-submitted information related to overcoming a ‘hardship’” as a proxy for race and ethnicity. “Hardship categorization was used as a way to skirt [Students for Fair Admissions v. Harvard] by putting [underrepresented minorities in medicine] into their own subgroups and thus ensuring that more URMs received interviews.”
Disappointingly, the widely used American Medical College Application Service (AMCAS) employs similar “hardship” language in its 2027 application workbook.
There, in a section titled “Other Impactful Experiences,” applicants “provid[e] admissions officers with a snapshot of [their] lived experiences” and “provide additional context about the challenges they may have experienced during their lives.”
The section is explicitly intended to identify candidates who have “faced challenges in various areas such as family background … community setting … or other life experiences.”
Lest anyone miss the point, the instructions urge candidates to “consider whether this question applies to [them]” and reminds them that “[m]edical schools do not expect all applicants” to answer it.
Indeed, the section is intended only “for applicants who have overcome major challenges or obstacles.” Those who proceed have 1,325 characters — perhaps 200 words — to “[d]escribe the challenge(s) or hardship(s) [they] consider most impactful” in their lives.
AMCAS’s “hardship” question lets American medical schools clandestinely reintroduce race as a factor in admissions. And many medical schools are eager to take advantage. As Do No Harm’s Ian Kingsbury wrote last year, Freedom of Information Act requests to the nation’s 93 public medical schools produced the conclusion that “schools are at least skirting the Supreme Court’s [SFFA] decision, if not violating it outright.”
Now the U.S. Department of Education’s Office for Civil Rights is investigating five more medical schools over alleged violations of federal civil-rights law.
In a much-noted clause in the SFFA v. Harvard majority opinion, Chief Justice John Roberts declared that, while the affirmative-action regime long governing college admissions was no longer to be permitted, “nothing in this opinion should be construed as prohibiting universities from considering an applicant’s discussion of how race affected his or her life, be it through discrimination, inspiration, or otherwise.”
But Roberts went on: “[U]niversities may not simply establish through application essays or other means the regime we hold unlawful today.”
If medical schools are not honoring that fine distinction, the time has come to hold them accountable. No matter how it is disguised, racial discrimination in admissions cannot be tolerated.
