In early 2023, a wave of legislative activity emerged aimed at abolishing diversity, equity, and inclusion (DEI) practices in academic institutions. DEI initiatives are designed to address racism and discrimination and to provide support for historically marginalized communities. According to tracking efforts, at least 81 bills targeting DEI offices, initiatives, and personnel have been introduced across 28 states.
As a result of this legislative push, more universities have faced pressure to dismantle their DEI-related offices and roles. Some institutions, particularly those that gained national attention are redistributing responsibilities that were once centralized within their DEI divisions. Notably, some have eliminated offices, positions with affected staff being reassigned to other departments. Legislative efforts have led to significant changes across various higher education institutions, resulting in varied impacts nationwide. However, leaders in academic medicine continue to recognize the important link between DEI initiatives and health equity. Association of American Medical Colleges (AAMC)
The consequences of this legislative climate are already observable. For example, the Indiana University School of Medicine has reported a decline in admissions from historically underrepresented groups, according to the news, attributed in part to the U.S. Supreme Court's ruling barring the consideration of diversity in admissions. The percentage of incoming medical students from these groups fell from nearly 25% in 2023 to just 8.8% in 2024. As institutions navigate this complex landscape, many challenges will surface.
Faculty in academic medicine are encouraged to adopt proactive approaches rather than simply changing titles or relegating DEI work to strategic initiatives. Relying on students to advocate for inclusive educational practices places significant pressure on them and may undermine institutional responsibility. The history of DEI initiatives indicates that these efforts have often been implemented in response to student activism, which demanded accountability and representation in higher education. Over the past 50 years, formalized diversity initiatives have developed in response to federal legislation and student protests, contributing to enhanced campus diversity for various marginalized groups. Today's students, who are increasingly aware of the socio-political environment, continue to advocate for more inclusive educational settings. Organizations such as the Student National Medical Association (SNMA) and the Latino Medical Student Association (LMSA) exemplify the ongoing tradition of student activism aimed at supporting underrepresented communities in medicine. SACNAS National Hispanic Medical Association (NHMA) The Latino Medical Student Association
National Medical Association Student National Medical Association
Faculty and institutional leaders can learn from students and the historical context surrounding DEI initiatives, as many current faculty members were once involved in such movements.
To address the ongoing challenges to DEI initiatives, several strategies are suggested for faculty in academic medicine:
1. Align with Student Advocacy: Support student efforts to promote inclusivity and engage with institutional leaders regarding community needs.
2. Share Evidence-Based Information: Disseminate data on healthcare disparities and the benefits of a diverse healthcare workforce, while countering misinformation with factual evidence.
3. Engage with Patients and Communities: Inform the public about the relevance of medical education practices and advancements in diversifying the medical workforce, especially concerning population and rural health.
4. Participate in Advocacy: Support initiatives such as the Bipartisan Congressional Academic Medicine Caucus (CAMC), which aims to highlight the role of medical schools and teaching hospitals in enhancing public health.
These suggestions serve as a starting point for fostering meaningful dialogue and actions to protect and advance DEI initiatives in academic medicine. It is crucial for stakeholders to remain engaged in these discussions and work collaboratively to uphold the values of diversity, equity, and inclusion within healthcare and education. DEI is about health equity.