Medical schools, affirmative action, and the neglected role of social class

Medical schools' affirmative action policies traditionally focus on race an d give relatively little consideration to applicants' socioeconomic status or "social class". However, recent challenges to affirmative action have ra ised the prospect of using social class, instead of race, as the basis for preferential admissions decisions in an effort to maintain or increase stud ent diversity. This article reviews the evidence for class-based affirmative action in med icine and concludes that it might be an effective supplement to, rather tha n a replacement for, race-based affirmative action. The authors consider th e research literature on (1) medical students' socioeconomic background. (2 ) the impact of social class on medical treatment and physician-patient com munication, and (3) correlations between physicians' socioeconomic origins and their service patterns to the disadvantaged. They also reference sociol ogical literature on distinctions between race and class and Americans' dis comfort with "social class."