HHS’ Civil Rights Office Clarifies Race-Based Prohibitions for Medical Schools to Advance Values of Initiative, Hard Work, and Excellence

Guidance Addresses Federal Prohibitions on Explicit and Pretextual Race-Based Discrimination and Transparently Identifies Investigation Priorities

Today, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) clarified in a “Dear Colleague” letter its interpretation of what constitutes race-based discrimination under Title VI of the Civil Rights Act of 1964 (Title VI), Section 1557 of the Affordable Care Act (Section 1557), and the Equal Protection Clause of the United States Constitution. The interpretation applies not only to student admissions at HHS-funded institutions but also to academic and campus life, including the operations of university hospitals and clinics.

The Dear Colleague letter reinforces that relying on race-based criteria, racial stereotypes, and facially neutral criteria that operates as a pretext for race are all prohibited under Title VI and Section 1557, including when diversity and racial-balancing are the aims. The Department advised medical schools to:

• Ensure their policies and procedures comply with existing federal civil rights laws;
• Discontinue criteria, tools, or processes that serve as substitutes for race or are intended to advance race-based decision-making; and
• End reliance on third-party contractors, clearinghouses, or data aggregators that engage in prohibited uses of race.

“Today’s announcement protects students and patients by ensuring health care providers, and those in the health professions pipeline, are selected based on merit and clinical skills, not race,” said the Office for Civil Rights Acting Director, Anthony Archeval.

The letter identifies the leading U.S. Supreme Court case on the issue, Students for Fair Admissions v. Harvard, 600 U.S. 181 (2023), and applies the case’s holding to Title VI and Section 1557. OCR enforces Title VI and Section 1557 with respect to institutions of higher education, such as medical schools, that receive HHS funding.

As part of its enforcement, OCR articulates in the letter that it will prioritize investigations of institutions that:

• Use race as part of their application or employment processes;
• Require diversity, equity, and inclusion statements in connection with hiring or promotion; or
• Lack clear policies demonstrating compliance with Students for Fair Admissions v. Harvard.

The Dear Colleague letter is available here: https://www.hhs.gov/sites/default/files/guidance-med-schools-dear-colleague-letter.pdf

During the second term of the Trump Administration, OCR has initiated seven investigations under federal civil rights law to promote merit-based opportunity.

National policy under Executive Order 14173, Ending Illegal Discrimination and Restoring Merit-Based Opportunity, directs federal agencies to enforce long-standing civil rights laws and “to combat illegal private sector [diversity, equity and inclusion] DEI preferences, mandates, policies, programs, and activities.”

If you believe that you or someone else has been discriminated against because of race, color, national origin, disability, age, sex, or religion in programs or activities that HHS directly operates or to which HHS provides federal financial assistance, you may file a complaint with the HHS Office for Civil Rights at: https://www.hhs.gov/civil-rights/filing-a-complaint/index.html

Follow HHS OCR on X (formerly Twitter) at @HHSOCR.