Xavier Ochsner College of Medicine: A New Medical School for Black Students

In the state of Louisiana, 32.6 percent of the population identify as Black, while 8.3 percent of the state’s physicians identify as Black. Across the nation, 13.7 percent of the population identify as Black, while 5.7 percent of physicians identify as Black. Not all persons prefer to have a physician of their own race, but some do, and Louisiana and the nation require a diverse physician workforce to serve the healthcare needs of an increasingly heterogeneous, multicultural society. Empirical studies have found that racial correspondence between patient and physician may confer benefits to patient care, which include improved communication, a more trustful physician-patient relationship, and improved health outcomes. The U.S. is facing a significant shortage of physicians, which is likely to worsen in future years. Simply put, Louisiana and the nation need more physicians, including more Black physicians.

An editorial in JAMA in 2021 proposed that creation of greater diversity in medical schools required a new bold approach, and that bold approach is now being pursued. To educate more Black physicians in Louisiana, a new medical school has emerged. Xavier Louisiana University, a historically Black college and university (HBCU) with a strong premedical program, has partnered with Ochsner Health in New Orleans to develop the Xavier Ochsner College of Medicine, a school designed principally for the education of Black physicians. The school has ample space at Ochsner; a dean has been appointed; and the school plans to enroll 50 students in the first class, increasing to 100 students per class in subsequent years. In time, the school will significantly enhance the number of Black physicians in Louisiana and across the nation.

However, the Xavier Ochsner College of Medicine has not yet begun accepting students because it has not been accredited by the Liaison Committee on Medical Education (LCME). All new allopathic medical schools must be accredited, and re-accreditation must be granted on an eight-year cycle. The accreditation of a new medical school is typically a demanding and protracted process, requiring three to five years to accomplish.

As a result of the release of the Flexner Report in 1910, a report that set new standards for scientific rigor and clinical training in U.S. medical schools, five predominantly Black medical schools closed, leading to the virtual disappearance of Black physicians across the country. Currently, the four predominantly Black medical schools (Howard, Meharry, Morehouse, and Charles R. Drew) graduate a substantial percentage of the nation’s Black physicians. The addition of a fifth mostly Black medical school stands to significantly increase the overall number of Black physicians.

Several of Louisiana’s national political officeholders have provided strong support for the new Xavier Ochsner Medical College. Louisiana has two Black members of the House of Representatives, Rep. Troy Carter (Democrat, District 2) and Rep. Cleo Fields (Democrat, District 6). Rep. Carter is an alumnus of Xavier University and has worked tirelessly to generate federal funding for the new medical college. Rep. Fields has also diligently backed the college.

Following the Supreme Court’s recent decision in a landmark Voting Rights Act case, Louisiana v. Callais, the political landscape has changed, and it may affect the future of the new medical college. Louisiana’s congressional district map was reconfigured to eliminate a majority Black district. The new map, which resulted from the Court’s ruling that race can only be used as a factor in drawing electoral maps when racial discrimination in map drawing has been proved, reduced the number of majority Black districts to one, eliminating Rep. Field’s original district. It is likely that Rep. Fields will lose his seat in the upcoming election, because his newly drawn district is a majority white, and predominantly Republican, district.

Depending on who is elected in the newly drawn District 6, the anticipated loss of Rep. Fields may diminish political support for the new medical school. In addition, Louisiana Senator Bill Cassidy, a Republican physician who has also been a strong supporter of the medical school, recently lost his primary election and will leave the Senate. 

Rep. Carter is likely to keep his seat and continue to support the new medical school. But opening a new medical school requires state and local political backing, and it is unclear what the potential losses of Rep. Fields and Senator Cassidy would mean for the prospects of the new medical school to achieve accreditation by the LCME. 

As part of the accreditation requirements for medical schools, the LCME previously mandated a set of stipulations to promote racial and ethnic diversity, equity, and inclusion in medical schools. The LCME placed particular emphasis on student education addressing health care disparities and health inequities. In response to pressure from the Trump administration, however, the LCME recently eliminated the racial and ethnic diversity, equity, and inclusion provisions. It is currently unknown what the Trump administration’s position will be on the accreditation of the Xavier Ochsner College of Medicine. The administration has not directly interfered with the accreditation process, but its action against the LCME’s diversity, equity, and inclusion requirements raises concern whether the administration will support the accreditation of a new predominantly Black medical school.

It is also noteworthy that the Department of Justice (DOJ) has sent a letter to the UC Davis School of Medicine requesting information about its holistic admissions practices, as described in a JAMA article. Similar letters have been sent to other medical schools. The focus of the DOJ inquiries is on its allegation that the schools’ admission practices are discriminatory against white and Asian students, while favoring Black students. It is not known if the DOJ action will affect the accreditation of Xavier Ochsner School of Medicine.

Accreditation of the new Black medical school is essential, given that the potential contribution of the school to the Black physician workforce is substantial. Considering the inadequate number of U.S. physicians, and especially the woefully inadequate number of Black physicians, there is a critical need for the Xavier Ochsner College of Medicine to be accredited.