“The problem isn’t that we don’t have enough diverse applicants. It’s not about the pipeline but the selection process,” Aysola told Reuters Health by phone. “We want to combat that system-level implicit bias.”

“Understanding the barriers to change is critical to changing the structural factors that make it difficult to remediate decades of segregated and unequal care,” said Dr. Danielle Laraque-Arena of the New York Academy of Medicine, who wrote a commentary on Aysola’s paper.

“I commend the schools that took part (in this year’s Racial Justice Report Card) because unless we know what the starting point is, we cannot reach the destination of health equity,” she told Reuters Health by email.” It takes courage for schools to publish their report cards and then commit to improvement.”

Reuters Health contacted several institutions that participated in this year’s evaluation.

“We welcome the ongoing discussion with White Coats for Black Lives and take seriously our responsibility to champion social progress that will benefit our students and, through them, the people for whom they will ultimately care,” said Gina Vild, chief communications officer for Harvard Medical School, which earned an overall “C+.”

“In recent years, HMS has made significant advances in this area,” she said in an email. “We acknowledge that there is more work to be done, and we will be unwavering in our commitment to continuing the progress.”

Schools participating for a second year, such as the University of California, San Francisco, tended to earn the same grade or move down.

“We don’t think that the report fully reflects the considerable work and radical steps UCSF School of Medicine has taken to address these important issues. For example, in the issue of equity in grading, our score reflects the institution’s approach from several years ago,” said Dr. Catherine Lucey, vice dean for education. UCSF earned an overall “B-” both this year and last year.

“Since then we have redesigned our grading and selection system so that there is no longer any grade inequity,” she said by email.

The University of Colorado was a first-time participant this year. “Like so many physicians (and medical students for that matter) we are perfectionists, so grades lower than A+ are not going to make me happy,” said Dr. Shanta Zimmer, associate dean for diversity and inclusion.

“However, our reaction to the lower grade is tempered by the knowledge … that some of our data points were incomplete this first year,” she told Reuters Health by email. “We are motivated to improve in areas that the report recognizes as weaknesses.”