When I applied to medical school in the midst of the pandemic and in the wake of the death of George Floyd, I had reason to think I was a competitive applicant, particularly for my state’s public medical school, which favors in-state candidates with strong academic records. I didn’t assume I was entitled to admission, but I thought I would get in somewhere. I didn’t.

So I did what failed applicants are told to do: I sought feedback. Eventually, I spoke with an admissions officer at one of the schools that rejected me. He told me that I was extremely qualified and had everything the school looked for in an applicant. He said he couldn’t give me a concrete reason I wasn’t accepted, other than that I didn’t fit the demographic the school was prioritizing, and that other applicants were viewed as having “traveled a longer distance” to medicine. My application, he said, was evaluated through that lens.

That conversation unsettled me in a way I didn’t immediately recognize. I was being told I was qualified, capable, and deserving but simultaneously that those qualities were not enough due to certain immutable characteristics. I had spent years learning about discrimination as something that happened to other people. Nothing in my education had prepared me to think that it could happen to people like me.

Then it did.

Perhaps I should have seen it coming. The requirements for admission into medical school vary markedly depending on who the applicant is. According to data from the Association of American Medical Colleges (AAMC), the academic thresholds required for acceptance differ substantially between racial groups. The average MCAT score of a white applicant who is accepted into a medical school is 512.4, approximately the 85th percentile nationally. By contrast, the average MCAT score for accepted American Indian applicants is 502.2 (56th percentile), for accepted black applicants 505.7 (67th percentile), and for accepted Hispanic applicants 506.4 (69th percentile).

The disparities are even more pronounced when we look at the applicant pool as a whole. White applicants overall, including those who are rejected, have an average MCAT score of 507.8, roughly the 73rd percentile. In other words, accepted black, Hispanic, and American Indian medical students matriculate with lower MCAT scores, on average, than white applicants who have not yet been accepted to medical school. The same pattern appears when we turn to undergraduate GPA. White applicants apply with an average GPA of 3.7, but require an average GPA of 3.8 to gain admission, while accepted black, Hispanic, and American Indian applicants matriculate with average GPAs of 3.59, 3.66, and 3.64, respectively.

I ended that phone call with a realization: If I wanted to succeed in medicine, I couldn’t leave room for doubt. So I pursued a NIH research fellowship, received research training, published scientific papers, and obtained letters of recommendation from prominent virologists. When I reapplied, I was accepted to multiple medical schools and received significant scholarship offers to many of them. But once again, my state’s flagship institution rejected me. I don’t claim to know precisely why. But patterns are hard to ignore.

When I arrived at medical school, it became clear that admissions were only the beginning. The same ideological framework that governed entry into the system shaped the culture inside it. Orientation included an entire day devoted to diversity, equity, and inclusion (DEI). We were asked, and even pressed, to publicly recount moments of discrimination from our lives. The exercise assumed a shared framework of identity and victimhood. At one point, a student asked the DEI instructor to explain the meaning of “demisexual,” which was written next to the “Gender Unicorn” they were teaching us about. After a long pause, the instructor admitted she didn’t know how to define it.

Similar things were happening at medical schools nationwide. The same year, students in the first-year cohort at the University of Minnesota were presented with an “anti-racism” pledge during their White Coat Ceremony that went well beyond traditional professional oaths. The pledge, read aloud by the entire incoming class, included a formal land acknowledgment and required students to affirm a recognition of “inequities built by past and present traumas rooted in white supremacy, colonialism, the gender binary, ableism, and all forms of oppression.”

In 2021, the Department of Medicine at Georgetown held a grand rounds lecture on anti-racism in medical education in which the invited speaker framed our healthcare system as operating within a “culture of white supremacy.” Residents and attending physicians were given an online document outlining the features of this culture. Traits such as “objectivity,” “perfectionism,” “a sense of urgency,” “worship of the written word,” and an emphasis on “measurable outcomes” are labeled as manifestations of white supremacy and presented as aspects of our society that must be dismantled. In the context of medicine, one might assume that objectivity, rigorous documentation, timely decision-making, and high standards of care are central to patient safety and clinical competence rather than expressions of racism. Yet a suspicion of these principles was being instilled into future physicians.

“Faculty members made sweeping, negative statements about ‘old white men in medicine.’”

As my preclinical years unfolded, faculty members made sweeping, negative statements about “old white men in medicine,” often pausing mid-sentence to add “no offense” while glancing in my direction. When classmates learned that my family lives in rural Montana and that my adopted sister is Asian, one student remarked that she couldn’t imagine how my sister could “feel safe” living around “that many white people.”

Even scientific language became a site of moral enforcement. In anatomy, we were instructed to avoid long-established eponyms, such as the “fallopian tube” (named after Italian anatomist Gabriele Falloppio) not because they were unclear or outdated, but because they were named for historical white figures, now deemed unacceptable. On examinations, points were deducted for using the “wrong” term.

During this same period, our faculty held a mandatory session where they openly criticized the Supreme Court’s 2023 decision to overturn race-conscious admissions in higher education, presenting it not as a contested legal ruling but as a moral failure. In the lecture, a senior faculty member on our school’s Diversity & Inclusion Team referred to the Tuskegee Syphilis Study as the “Tuskegee Ai...

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