AAMC’s President and CEO Addresses Top Challenges Facing Academic Medicine

Last weekend, the President and CEO of the American Association of Medical Colleges (AAMC), David Skorton, MD, addressed over 4,200 leaders in academic medicine on the “four things that keep me up at night.” These include structural and cultural inequities in academic medicine, deteriorating student wellbeing, external threats to the doctor-patient relationship, and a lack of mutual respect. On these challenges, Skorton called for collective action. “The health and mental well-being of our communities and our colleagues are at stake. Through meaningful, open, and honest dialogue, partnership, and collective action, we can and will tackle these problems in service of the greater public good,” he said. Below, we summarize his concerns. 

Diversity, equity, and inclusion and anti-racism. Within academic medicine, Skorton noted that this work includes diversifying medical schools’ student populations, faculty, and staff. It also goes further. Each academic institution should review their culture to ensure that the climate supports every student with the “opportunity to excel.” 

Student well-being and mental health. Skorton notes that medical students show higher rates of depression and risk of suicide than their age-matched peer populations, and that the comparisons have worsened in recent years. He encouraged academic leaders to prioritize the mental health and wellbeing of students by understanding their existing stressors (financial, academic, and social) and reducing them, as possible. Medical school faculty and staff should also ensure that they make mental health and wellbeing resources accessible to students. 

External threats to the doctor-patient relationship. While not speaking to abortion rights specifically, Skorton spoke to the more generalized threat that legislation and/or judicial opinions can impose on a physician’s ability to exercise clinical judgment in partnership with the patient. He encouraged leaders to “stand firm” against such external action in order to protect the doctor-patient relationship.

Humility and mutual respect. While Skorton emphatically noted that physicians are duty-bound to speak out against racism or hate speech, he called for greater mutual respect. He noted that leaders in academic medicine should show humility in their interactions and discourse, and called for physicians to model using an open-mind and empathy in encounters with those holding differing viewpoints or conflicting ideologies. 

AMA and AAMC Urge Supreme Court to Continue Allowing Medical Schools to Consider Race/Ethnicity in Admissions Decisions

The U.S. Supreme Court is taking two cases that could prevent medical schools’ current practice of considering race/ethnicity in admissions decisions: Students for Fair Admission Inc. v. President and Fellows of Harvard College and Students for Fair Admission Inc. v. University of North Carolina et al. The first considers if Harvard’s admissions processes penalize Asian Americans and in turn violate Title VI of the Civil Rights Act. The second North Carolina case asks if the Supreme Court should overturn a 2003 decision, Grutter v. Bollinger, which allows race to be used as a component of admissions decisions. 

In response to the Supreme Court’s review of the upcoming cases, the AMA and AAMC, along with 40 other organizations, submitted an amicus brief urging the court to “take no action that would disrupt the admissions processes the nation’s health-professional schools have carefully crafted in reliance on this court’s longstanding precedents.” The brief notes the key role that diversity in medical school admissions plays in reducing health disparities by increasing the number of minority practitioners, who are more likely to serve in minority communities, and also by increasing the effectiveness of all physicians through a more diverse learning and training environment. The brief points to scientific research and studies showing the benefits of diversity, saying that “Preventing medical educators from continuing to consider diversity in admissions … would literally cost lives and diminish the quality of many others.” The brief also suggests the possibility that overruling the use of race in admissions decisions may, “...potentially trigger a spiral of severe and self-reinforcing decreases in diversity in the health care professions. States that have banned race-conscious admissions have seen the number of minority medical school students drop by roughly 37% as a result.”

Temple’s Katz School of Medicine Incorporates Local Community Into Medical School Admissions

For the selection of the Class of 2026 at Temple University’s Lewis Katz School of Medicine, the admissions team included members of the surrounding community. This made Katz one of the first medical schools to incorporate the opinions of local residents in admissions decisions. Among the five community members, all of whom live and/or work in the neighborhoods surrounding the medical school and hospital, one served as a voting member of the admissions committee (alongside medical school faculty and physicians) and the others interviewed and evaluated prospective students. 

The community members, who mostly hailed from social service backgrounds, received interview training prior to spending about four hours per week facilitating 30-minute interviews and writing evaluations for hundreds of candidates. The community member interviews, which included two to three prospective students at a time, engaged interviewees on topics such as: Why Temple? What does community mean to you? How would you engage with marginalized groups and groups that suffer disparate access to care? How would you handle a sensitive clinical conversation?

While the idea of incorporating local community members into the admissions team had been discussed previously, according to Jacob Ufberg, Associate Dean of Admissions, it was the medical school’s Student Diversity Council—a group of 60 students—who was responsible for implementing the plan. Randolph Lyde, MD, PhD, and Student Diversity Council Chair (at the time of implementation) described the Council’s work, “We feel it makes our admissions process better. It makes our school community better, and it makes us a better steward and partner in our community,” he said. “And hopefully, it will allow us to bring more culturally sensitive and culturally aware students into our medical school.”

Prospective students also found their interview experience meaningful. In a post-interview survey, 90 percent of the interviewees said that the community members had added value to their experience and given them a better understanding of the community and of the medical school’s values.