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美国最高法院与平权行动:对医师队伍的负面影响。

The US Supreme Court and Affirmative Action: The Negative Impact on the Physician Workforce.

机构信息

Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA.

Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts.

出版信息

Clin Ther. 2023 Oct;45(10):1004-1007. doi: 10.1016/j.clinthera.2023.08.008. Epub 2023 Sep 3.

Abstract

PURPOSE

Maintaining admissions of underrepresented students to medical schools is essential to securing a diverse health care workforce. Empirical evidence indicates that minority patients may prefer practitioners of their own race. The recent US Supreme Court decision concerning affirmative action makes this goal more difficult, but medical schools can still work within the language of the law to redouble their efforts to seat a diverse class of medical students.

METHODS

We examined the literature correlating the availability of minority physicians and the health outcomes of the patients they serve. We also examined the literature on race-conscious policies of medical schools intended to address the shortage of minority physicians considering the benefits achieved through a diverse field of health care workers. We also examined the law and the recent US Supreme Court opinion, including the application of equal protection principles, to suggest strategies to seat a diverse class of students within the scope of the law.

FINDINGS

Institutions have maintained the status quo of disparate distributions of professions by race through structural biases that also limit access to medical schools. The new US Supreme Court decision is expected to exacerbate this disparity unless medical schools engage in admissions protocols that actively solicit the character and unique abilities that each of the applicants can offer to contribute to the medical school and the health care profession.

IMPLICATIONS

The new US Supreme Court mandate is likely to create challenges for medical schools in their efforts to recruit and seat minority applicants. The mandate provides little discussion, suggesting a lack of understanding of the downstream public health consequences to patients if medical school applicants are denied the benefits of race-conscious admissions policies. Nevertheless, the language of the US Supreme Court's opinion may provide a viable path forward, at least with respect to medical schools where the need for a diverse pool of health care practitioners is particularly compelling.

摘要

目的

维持医学专业院校中代表性不足的学生的入学率对于确保医疗保健工作者队伍的多样化至关重要。实证证据表明,少数民族患者可能更倾向于选择与自己种族相同的医生。最近美国最高法院关于平权行动的裁决使得这一目标更加困难,但医学院仍然可以在法律的框架内加倍努力,招收多样化的医学生群体。

方法

我们查阅了文献,这些文献将少数族裔医生的数量与他们所服务的患者的健康结果进行了关联。我们还研究了医学院为解决少数族裔医生短缺问题而采取的种族意识政策的文献,这些政策考虑到通过多样化的医疗保健工作者群体所取得的收益。我们还研究了法律和最近的美国最高法院意见,包括平等保护原则的适用,以提出在法律范围内招收多样化学生群体的策略。

发现

机构通过结构性偏见维持了职业分布不均的现状,这种偏见也限制了进入医学院的机会。除非医学院采用积极征求每位申请人的个性和独特能力的招生方案,以促进医学院和医疗保健行业的发展,否则新的美国最高法院裁决可能会加剧这种差异。

影响

新的美国最高法院指令可能会给医学院在招募和录取少数族裔申请人方面带来挑战。该指令几乎没有讨论,这表明如果拒绝少数族裔申请人的平权行动招生政策所带来的好处,可能会对患者的下游公共卫生后果产生影响。然而,美国最高法院意见的措辞可能为前进提供一条可行的道路,至少对于那些特别需要多样化的医疗保健从业者群体的医学院来说是如此。

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