Follow-Up to Dr. Nasca’s June 13 Letter to the Community after Supreme Court Decision Regarding College Admissions and Race

This is a follow-up to the June 13 Letter to the Community addressing the accreditation implications of the Students for Fair Admissions, Inc v. President and Fellows of Harvard College Supreme Court case.

Dear Members of the Graduate Medical Education Community,

On June 29, 2023, the United States Supreme Court issued its decisions in Students for Fair Admissions, Inc. v. President and Fellows of Harvard College, addressing the consideration of race-based affirmative action in university admissions. Since that decision and the passage of certain state laws that limit diversity, equity, and inclusion activities, the ACGME has received inquiries relating to the accreditation standards that require engaging “in practices that focus on mission-driven, ongoing, systematic recruitment and retention of a diverse and inclusive workforce of residents, fellows (if present), faculty members, senior administrative GME staff members, and other relevant members of its academic community.” (Common Program Requirement I.C.). The ACGME reaffirms its commitment to its requirements as a way to help eliminate health care inequities and disparities, to assist Sponsoring Institutions and programs in achievement of their mission, and to develop a diverse physician workforce to provide care that meets the needs of marginalized patients in particular, and all patients in general.

It is important to note that the ACGME standards do not require race-based affirmative action to achieve diversity, and this decision does not require programs and institutions to change their resident selection practices. There are numerous strategies and tools available that can be utilized in institutions’ achievement of their mission-oriented workforce plans. Some of these alternative strategies can be found in the ACGME Equity Matters^TM Equity Practice Toolkit.

Research confirms that being treated by a racially diverse care team, or by physicians with exposure to diverse professional or educational environments, greatly increases the likelihood of positive medical outcomes, particularly for patients from minoritized backgrounds. The ACGME, for its part, remains committed to a diverse and inclusive workforce that meets the health care needs of the American public, and addresses implicit and explicit discrimination and bias in health care through its mechanisms of education and accreditation.

ACGME-accredited Sponsoring Institutions and programs must equip residents and fellows with the knowledge, skills, and attitudes to recognize and address the systemic, structural, institutional, and interpersonal factors that result in inequitable health care. In addition, the ACGME supports its accredited Sponsoring Institutions and programs as they: (1) strive to eliminate discrimination and bias in the recruitment, selection, evaluation, and retention of residents/fellows and faculty members; (2) identify and nurture appropriate role models for residents/fellows; (3) establish and maintain fair and equitable learning environments; (4) support pathway programs that encourage greater diversity of the profession; and, (5) hold themselves accountable for the specific health care needs of their patient communities.

Within the context of the current legal and political environment, the ACGME reaffirms its Mission and evidence-based requirements. The ACGME will continue to support Sponsoring Institutions and programs in achieving compliance with these requirements, which are designed to assist institutions and programs in creating a diverse and inclusive educational environment leading to better outcomes for all. 

Sincerely, 

Thomas J. Nasca, MD, MACP
President and Chief Executive Officer
ACGME