WASHINGTON, D.C. — The Justice Department sent a letter to Yale School of Medicine on Thursday alleging that the school illegally discriminated against applicants who are not Black or Hispanic. The letter accused the school of continuing discriminatory practices despite a 2023 Supreme Court ruling that prohibited the use of affirmative action in admission decisions, citing differences in average test scores and GPAs between students of different racial groups over the past three admissions cycles. According to the letter, Black and Hispanic applicants in 2023 had median MCAT scores of 517 and 518, respectively, compared with a median score of 523 for white and Asian applicants.

In recent months, the Justice Department asked medical schools for information from student applications, including test scores, race, ZIP codes, and alumni ties. The Trump administration has embraced disparate impact theory to target diversity initiatives, including claims that race-neutral admissions policies at medical schools create discriminatory outcomes. On his first day in office, President Trump signed an executive order targeting diversity, equity, and inclusion programs described as "radical and wasteful." The administration also terminated federal research grants for work mentioning health disparities or intended to diversify the scientific workforce, and signed an executive order targeting the main medical school accrediting body, which subsequently removed requirements to teach health equity.

"We will carefully review the Department of Justice's letter. Yale School of Medicine is confident in the rigorous admissions process we follow." said Karen Peart, associate vice president for communications at Yale.

Carson Byrd, sociologist at the University of Michigan, said: "The position taken by the DOJ in their letter is similar to other Trump administration statements that they are attempting to reassert the importance of merit for higher education and society as a whole. One problem is that such a meritocracy has never existed, and it's ahistorical to believe that one could exist in the U.S., particularly by dismantling race-conscious policies. However, the only era that existed before then was Jim Crow and its highly segregated educational opportunities — hardly an era of colorblind meritocracy."

After Students for Fair Admissions v. Harvard was finalized, medical schools saw reduced diversity in their admitted classes. A study found that the percentage of applicants from underrepresented backgrounds admitted into medical school decreased from 24% before the ruling to 20% in the year after.

Over the past two decades, medical schools have broadened the criteria they use to assess applicants. Some have adopted holistic admissions that consider interviews, work experiences, and community engagement. The Association of American Medical Colleges developed the PREview Exam, which assesses applicants on situational judgment to measure empathy and professionalism.

"There is sort of a general correlation between MCAT scores and success in medical school, but it's a crude metric. People who may not have the top MCAT scores but get into medical school, they move through medical school, and they get better and better." said Gregory Curfman, professor at Harvard Medical School. According to 2019 data, medical students who scored between 510 and 513 on the MCAT had a 98% chance of completing their first year of medical school, while those who scored between 498 and 501 had a 94% chance.

Public universities in California have not been able to consider race in admissions for decades under state law. Some have adopted a holistic, race-neutral admissions approach that yielded a diverse student body at one school.