Last Updated March 27, 2025
The AAMC (Association of American Medical Colleges) developed this FAQ resource to support medical schools following the June 2023 decision by the U.S. Supreme Court in two cases seeking to end the limited consideration of race or ethnicity in college admissions (Students for Fair Admissions (SFFA) v. Harvard and SFFA v. University of North Carolina). The Supreme Court reversed the lower courts’ decisions in the Harvard and UNC cases, and ruled against both schools.
This document will be updated as more information is made available.
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Editor’s Note: Most of the material in this document tracks the Supreme Court’s decision in the SFFA v. Harvard and SFFA v. University of North Carolina cases and may reflect judicial findings specific to those two schools. To learn more about the specific implications of the court’s decision for your institution, please contact your institutional leadership, dean’s office, or legal counsel.
Scope of Ruling
What was the court’s core holding?
In the words of the majority opinion:
University programs must comply with strict scrutiny, they may never use race as a stereotype or negative, and—at some point—they must end. Respondents’ admissions systems – however well-intentioned and implemented in good faith – fail each of these criteria. They must therefore be invalidated under the Equal Protection Clause of the Fourteenth Amendment.
For medical schools, the takeaways are (1) an applicant’s race cannot be a factor in making admissions decisions for the purpose of increasing student body diversity; and (2) do not make decisions on the basis of racial stereotypes.
Was Grutter v. Bollinger explicitly overruled?
Grutter is the 2003 precedent that permitted the limited consideration of an applicant’s race if necessary to advance the educational benefits of a diverse student body. While the majority opinion does not explicitly overrule Grutter, it rejects Grutter’s core tenet of deferring to a school’s educational judgment regarding the educational benefits of diversity. It further departs from Grutter in finding that the schools’ consideration of race in relation to some applicants necessarily caused undue harm to other applicants and relied on "impermissible racial stereotypes."
Are there any scenarios under which a school could consider an applicant’s race when making admissions decisions?
The court does not go so far as to say that no compelling interest exists to consider a person’s race — it specifically identified diversity in the U.S. military as having "potentially distinct interests" — but concludes that the diversity-related educational goals articulated by Harvard and UNC were too imprecise, immeasurable, and unlimited in duration.
In addition, prior precedent allowed the limited consideration of race as a plus factor for some applicants and did not infer from aggregate numbers "undue harm" to other applicants. The majority opinion equates any distinctions among applicants based on their racial status as invidious discrimination and as resulting in unconstitutional harm to some applicants based on its conception of admissions as "zero sum."
Are medical schools still permitted to prioritize diversity and associated educational benefits as part of their academic mission?
While the majority opinion held that Harvard’s and UNC’s consideration of applicants’ racial or ethnic classifications in admissions could not be justified by their stated goals related to the educational benefits of diversity, the decision acknowledged that the goals themselves were “plainly worthy” and stated: "Universities may define their missions as they see fit."1 In other words, the court’s opinion permits continued pursuit of diversity-related goals, but not through the means of considering an applicant’s racial status or in a manner that discriminates against any applicant on the basis of their racial status.
In a 2024 survey of graduating medical students, the vast majority reported they agreed or strongly agreed "diversity within [their] medical school enhanced [their] training and skills to work with individuals from different backgrounds" and “their knowledge or opinion was influenced or changed by becoming more aware of the perspectives of individuals from different backgrounds.”
A diverse student body offers many benefits for future health care professionals and their patients. However, diversity must be the welcome result of equal opportunities for all applicants and students – not the outcome of treating applicants or students differently on the basis of their race or any other protected characteristic.
Are schools permitted to consider race in recruitment and outreach?
While the court did not address the consideration of race in identifying prospective applicants through recruitment and outreach, Justice Sonia Sotomayor’s dissenting opinion observed that "today’s decision leaves intact holistic college admissions and recruitment efforts that seek to enroll diverse classes without using racial classifications." Further, the decision focused on benefits that were provided on a limited basis such that the provision of the benefit to one individual necessarily deprives that same benefit to another (a "zero sum game"). Schools may undertake recruitment activities designed to ensure that all potential applicants have an equal opportunity to apply. This could include steps to widely disseminate information about a medical school and its admissions process or otherwise removing barriers to equal opportunity in the admissions process.
Schools should be cautious in treating prospective applicants differently on the basis of racial status. According to a February 14, 2025, Dear Colleague Letter (DCL) from the Acting Director of the Office of Civil Rights (OCR) at the Department of Education,2 the Department interprets the case’s holding more broadly to apply to not only admissions, but "all other aspects of student, academic, and campus life." The DCL states: "if an educational institution treats a person of one race differently than it treats another person because of that person’s race, the educational institution violates the law." While the DCL is “directional guidance” and not law, it is a signal as to how OCR will approach questions on race-conscious activity outside of admissions. Schools are advised to work with their legal counsel to ensure that all applicants have an equal opportunity to apply and compete for admissions regardless of their racial status.
How does the court’s decision apply to financial aid and scholarships?
The majority opinion addressed only the question of “whether a university may make admissions decisions that turn on an applicant’s race.” However, the new legal framework embedded in the decision would likely govern decisions about scholarships and financial aid. The Department of Education’s Office of Civil Rights has cautioned in a February 28, 2025 FAQ guidance document that financial aid, scholarships, and prizes are akin to admissions because they are a limited or finite resource and thus caution that "a school may not legally take account of a student’s race in distributing those benefits or resources."
How does the court’s decision apply to pathway programs?
The court did not address the consideration of race in selecting a participant for a pathway program. However, if a pathway program has a nexus to the federal government, to the extent participation confers some benefit or preference in ultimate admissions decisions or opportunities, it would likely be subject to the same strict scrutiny as admissions decisions.
Are schools permitted to provide support services related to race or ethnicity (e.g., offices of diversity, student centers, mentors, affinity groups) to accepted applicants and matriculants?
The court did not address support services related to race or ethnicity. The Department of Education has recently interpreted the law to prohibit the consideration of racial status in providing “administrative support” and "in all aspects of student, academic, and campus life" to the extent that doing so requires that students be segregated by race or receive a benefit or burden based on racial status. While the Department of Education’s guidance is not law, it is a signal as to how it may enforce the law. Schools are advised to work with their legal counsel to review their student support services to ensure they are aligned with the school’s mission, goals, and state and federal law, and that each student has equal access to needed support regardless of the student’s racial status.
Did the court address legacy preferences and other discretionary factors applied in the admissions process?
The majority opinion did not discuss legacy preferences or other discretionary factors applied in the admissions process.
How might the decision impact consideration of membership in federally recognized American Indian or Alaska Native tribes or nations?
It is unlikely that the outcome will impact consideration of an applicant’s membership in a tribe (as differentiated from their self-identification as being a Native American or Alaska Native). In addition to Tribal member preferences protected by statute, the U.S. Supreme Court has upheld federal preferences in hiring to members of sovereign, federally recognized tribes by distinguishing between (1) tribal membership (a political categorization) and (2) self-identification as having descended from Indigenous peoples in the Americas prior to European settlement (a racial categorization) and concluding that political preferences are afforded a lower standard of judicial review. This analysis has not been applied to higher education admissions and was not raised for consideration in the Harvard or UNC cases.
Could the Harvard/UNC decision impact graduate medical education and residency program diversity efforts?
Medical resident selection is an employment practice covered by Title VII of the Civil Rights Act of 1964, which has long prohibited the consideration of an applicant’s race. Thus, the Harvard/UNC decision should not impact the way in which resident physicians are currently selected. Note that the Equal Employment Opportunity Commission issued guidance on March 19, 2025, on how it would apply the Harvard/UNC decision to employment issues.
Will the decision affect the racial diversity of biomedical postdocs or faculty?
Postdoctoral scholars who are considered employees are, like faculty, protected by Title VII of the Civil Rights Act, which has prohibited the consideration of an applicant’s race for decades. Thus, the Harvard/UNC decision should not impact how postdocs or faculty are selected.
Admissions Process
Did the court forbid any knowledge or consideration of an applicant’s racial background in the higher education admissions process?
The majority opinion distinguished between an applicant’s race or ethnicity as status — their membership in a racial or ethnic group -- and an applicant’s lived experience as it might be affected by their race or ethnicity. The court no longer permits consideration of an applicant’s race or ethnicity as status. An applicant may still discuss – and a school may consider — "how race affected his or her life, be it through discrimination, inspiration, or otherwise," and a school may still consider those experiences, so long as any beneficial consideration has a direct nexus to an individual’s specific, individualized attribute (e.g., courage or determination) or an individual’s personal goal (e.g., practicing in an underserved community).
The decision cautions against using an essay or other information in an application or interview to establish the applicant’s race and make decisions based on that information, stating: "what cannot be done directly cannot be done indirectly." Correspondingly, the Department of Education has issued guidance cautioning against "craft[ing] essay prompts in a way that require applicants to disclose their race."
Did the court identify any constraints on real-time tracking of aggregate applicant race/ethnicity data?
Yes. The majority opinion associated the universities’ numerical tracking using racial classifications during the admissions cycle with unconstitutional "racial balancing." It also characterized the specific racial and ethnic categories themselves used by the universities as "imprecise" and "arbitrary." The majority opinion requires that each "student must be treated based on his or her experiences as an individual — not on the basis of race."
What guidance should prehealth advisors provide to aspiring medical students?
Medical schools seek to understand applicants as individuals, including their identities, communities, and experiences, and how these relate to their motivation for pursuing a career in medicine and their career goals. Schools will continue to prioritize mission alignment when evaluating applicants. Each individual medical school is the authoritative source on what that school is looking for in its applicants, and admissions officers tend to look for candidates with experiences, attributes, metrics, and personal statements that align with the school’s mission. These areas can be an effective opportunity for applicants to provide concrete examples of how their "why" aligns with the mission of the schools to which they are applying.
An applicant may still discuss "how race affected his or her life, be it through discrimination, inspiration, or otherwise," and a medical school may still consider those experiences, so long as any beneficial consideration is concretely tied to an individual’s specific, individualized attribute other than race (e.g., courage or determination) or an individual’s personal goal (e.g., practicing in an underserved community) By law, an applicant’s identification with a racial group should have no impact – positive or negative – on their admissions prospects.