The future of diversity in medical schools is under threat


The recent decision by the University of Pennsylvania (Penn) to remove diversity, equity, and inclusion (DEI) initiatives from its website has sparked a significant debate within the academic community. This move, aimed at complying with an executive order from President Donald Trump, highlights the tension between institutional values and political mandates. This essay explores the implications of Penn’s actions, contrasting them with responses from other universities, and examines the broader impact on diversity efforts in higher education, especially its impact on medical schools, as they, too, will be affected by the executive order.

Penn’s response to political pressure

Penn’s decision to dissolve diversity committees and review DEI-related content on its websites reflects a response to Trump’s executive order, which threatened federal funding for institutions employing DEI strategies. The order argued that such policies undermine traditional American values and promote an identity-based spoils system. Despite being a private institution, Penn relies heavily on federal grants for research, making it susceptible to such political pressures.

Additionally, some of Penn’s deep-pocket donors are Wharton Business School graduates and strong supporters of Trump’s policies, raising concerns among faculty and students that outside financial interests undermine the university’s commitment to diversity and equity. “I feel like the University of Pennsylvania has no values other than the value of its endowment. What’s next? Are they going to say we have to stop doing vaccine research because RFK doesn’t believe in it?” an anonymous source asked The Philadelphia Inquirer.

Faculty and institutional reactions

The swift removal of DEI efforts has not gone unchallenged. Many faculty members have voiced their opposition, arguing that academic programming decisions should remain within their purview. The sentiment resonates with the broader academic community, which sees these changes as a threat to the democratic purposes of higher education. The American Association of University Professors (AAUP) has even joined a lawsuit opposing Trump’s executive order, emphasizing the importance of DEI initiatives as integral to higher education’s public mission.

Contrasting approaches from other institutions

In contrast to Penn, other local Philadelphia institutions like Temple and Drexel Universities have chosen to uphold their commitment to DEI values. Temple University, for example, has reiterated its dedication to diversity and inclusion, aligning with its historical mission to provide opportunities to marginalized groups. This mission has not wavered since I matriculated in Temple’s medical school in 1976. Temple’s Katz School of Medicine has consistently ranked among the top 10 most diverse medical schools in the U.S.

This steadfastness in the face of political directives underscores a divide in how universities are dealing with policy challenges. Nationally, reactions have varied, with some institutions like North Carolina’s public university system, Vanderbilt University, and Northeastern University taking steps similar to Penn, while others maintain their DEI commitments.

The broad impact on higher education

The controversy at Penn is part of a larger national discourse on the role of DEI in higher education. Institutions are grappling with balancing federal compliance and their foundational values. This tension is evident in the actions of other universities, such as Penn State, which faced backlash for withdrawing support for a Center for Racial Justice while antiracist research and policy centers have continued, for example, at Temple, Drexel, Rutgers, American, and Boston Universities. These decisions impact the academic environment, influencing faculty morale and student perceptions of inclusivity.

Trickle-down effect

The dismantling of DEI initiatives at universities is not merely an administrative exercise. It causes a widespread trickle-down effect at undergraduate, graduate, and professional levels, impacting various programs and demanding attention and compliance across the entire university curriculum. At Penn’s Perelman School of Medicine and others, the broader institutional changes have significant implications for medical education and the training and development of future health care professionals.

Diversifying the medical workforce

One of the key roles of DEI initiatives in medical education is to diversify the workforce, ensuring that health care professionals reflect the communities they serve. Pipeline programs that bring candidates from diverse backgrounds into medical schools are crucial in this regard. These programs help address the underrepresentation of minority groups in medicine, which can improve cultural competence and patient outcomes. The potential dissolution or modification of such programs at Penn—a national leader in outreach programs serving high school students from backgrounds underrepresented in medicine—could hinder these efforts, reducing opportunities for disadvantaged groups to enter the medical field and ultimately affecting the diversity of the health care workforce.

Cultural competency and patient care

DEI initiatives play a critical role in enhancing cultural competency among medical students. A diverse educational environment exposes students to a variety of perspectives and experiences, preparing them to provide more empathetic and effective care to patients from different backgrounds. The removal of DEI programs may limit students’ exposure to these essential learning experiences, potentially impacting their ability to understand and address the unique needs of diverse patient populations. This could worsen disparities in health care delivery and outcomes, undermining efforts to achieve health equity.

Research and innovation in medicine

Diversity in medical education also drives research and innovation. Diverse teams bring a wide range of ideas and approaches, which can lead to more comprehensive research and innovative solutions to complex health problems. Penn’s medical school has always ranked high in medical research capabilities, according to U.S. News & World Report (Penn now declines to be ranked). However, succumbing to ideological mandates and ignoring its focus on DEI can diminish the quality and extent of research endeavors. By potentially curtailing DEI efforts, Penn and other medical schools risk stifling the creativity and collaboration that are not only hallmarks of successful research but are embraced by the FDA.

Professional development and leadership

DEI initiatives are instrumental in fostering professional development and leadership opportunities for minority students and faculty. These programs often provide mentorship, networking, and career advancement resources that are crucial for developing leaders in medicine who can advocate for and implement inclusive practices. The reduction or elimination of such initiatives at Penn could limit these opportunities, affecting the career trajectories of minority individuals in medicine and reducing their representation in leadership roles, which is already severely compromised.

Conclusion

Penn’s decision to align with political mandates at the expense of its DEI initiatives illustrates the complex interplay between higher education institutions and political forces. While some universities have chosen to comply, others stand firm in their commitment to diversity and inclusion, highlighting the varied responses within academia. This ongoing debate underscores the importance of maintaining institutional integrity and the role of universities as bastions of diversity and equity, even amid external pressures. As the landscape of higher education continues to evolve, these decisions will shape the future of academic values and societal progress, with significant portents for the medical profession.

Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA. He is the author of several books on narrative medicine, including Medicine on Fire: A Narrative Travelogue and Story Treasures: Medical Essays and Insights in the Narrative Tradition.


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