In light of these data, Horn and Flores (2003) conclude that “ … in all three states, the gap between the racial distribution of college-freshman-age population and that of the applications, admissions, and enrollments to the states’ university systems and to their premier campuses is substantial and has grown even as the states have become more diverse…. [I]n California in particular, proportional representation of applied, admitted, and enrolled blacks and Hispanics on the flagship campuses has decreased since the end of race-conscious policies” (p. 50).


Given the barriers that “race-neutral” and heavily quantitatively weighted admissions policies pose to achieving racially and ethnically diverse classes, many leaders in the academic health professions have begun to reconceptualize admissions policies and practices in an attempt to enhance both the diversity and quality of admitted students. Increasingly, these needs are seen as linked. As Edwards, Elam, and Wagoner (2001) note:

Complex societal issues affect medical education and thus require new approaches from medical school admission officers. One of these issues—the recognition that the attributes of good doctors include character qualities such as compassion, altruism, respect, and integrity—has resulted in the recent focus on the greater use of qualitative variables, such as those just stated, for selected candidates … [t]he second and more contentious issue concerns the system used to admit white and minority applicants. Emphasizing character qualities of physicians in the admission criteria and selection process involves a paradigm shift that could serve to resolve both issues (p. 1207).

The trend toward emphasizing professionalism and “humanistic” factors is also reflected in recent efforts by licensing and accreditation bodies to assess these qualities among both trainees and training institutions (see also chapter on accreditation and diversity). The Liaison Committee on Medical Education, for example, is reviewing efforts by medical schools to teach professionalism and demonstrate the effectiveness of these efforts. Similarly, the NBME will require that examinees pass measures of professionalism, communication, and interpersonal skills, while the Accreditation Council on Graduate Medical Education and the American Board of Medical Specialties have defined several areas of professional competency that include among them communication and interpersonal skills and understanding and sensitivity to diversity. Specialty groups such as the American Board of Internal Medicine (ABIM) are adapting similar approaches; ABIM now requires physicians seeking board certification to demonstrate integrity, respect, and compassion in their relationships with patients and their

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