The current lack of diversity in our medical workforce was not accidental. In addition to segregation and lack of access to quality education, the Flexner report led to the closure of historically Black medical schools which has continued impact today.12 As such, a passive approach toward righting this problem will not solve it. Just as policies have created the current inequities that we see today, it is imperative that support for new programs to correct the issue be generated. Affirmative action has been viewed as a positive force moving our entire medical system closer to diversity and increasing racial and ethnic representation in the medical workforce.13 However, given persistent disproportionate underrepresentation of HUGs, one might argue that though beneficial, affirmative action has not been sufficient to bring accurate representation of the US population to the medical workforce.

Recognizing diversity as a priority, the National Institutes of Health issued the “Notice of Interest in Diversity” encouraging diversification of the workforce in biomedical and social sciences with respect to race/ethnicity as well as other underrepresented populations (i.e., individuals with disabilities and/or lower socioeconomic status).14 The bodies that oversee the education of medical students and residents not only support but require diversity in our schools and training programs. The Liaison Committee on Medical Education mandates, “A medical school recognizes the benefits of diversity, and promotes students’ attainment of competencies required of future physicians. A medical school has effective policies and practices in place, and engages in ongoing, systematic, and focused recruitment and retention activities, to achieve mission-appropriate diversity outcomes among its students, faculty, administrative staff, and other relevant members of its academic community”.15 The Accreditation Council for Graduate Medical Education requires that residency programs engage in practices that focus on mission-driven, ongoing, systematic recruitment and retention of a diverse and inclusive workforce of residents, fellows, faculty, and other relevant members of its academic community. It also mandates that residents demonstrate competence in respect and responsiveness to diverse patient populations.16

With these varied mandates and the larger cultural dialog around race in the USA, many medical schools and residency training programs had moved toward a “race-conscious” recruitment and enrollment process so that HUG trainees are more equitably represented in the physician training pathway.

The benefits of wider representation of HUGs in medicine are clear; patient-physician concordance improves communication, quality of care, and adherence to treatment plans.17,18,19 Students from HUGs are more interested in practicing in geographic areas underserved in healthcare and underserved groups are more likely to be cared for by physicians that identify as HUGs.20, 21 In addition, diverse teams produce better science, which furthers technological advances in healthcare.22 Diversity in medical student bodies benefits patients from backgrounds that are congruent with HUGs in medicine. Also, students trained at schools with diverse student bodies are more comfortable treating patients from different racial and ethnic backgrounds, therefore improving care for all patients that they encounter.23 Moreover, white students who train in schools with more diverse student bodies are more prepared to provide equitable care to patients.24

In addition to improved clinical care of patients, racial diversity positively impacts the students’ educational experience. For instance, students from top medical schools report that diversity in their classmates improved their educational experience, and their ability to treat patients with diverse backgrounds within clinical settings. Importantly, medical students surveyed anonymously strongly supported affirmative action policies to admit more underrepresented students.23