One man’s quest to diversify our doctors — without considering race — made UC Davis a model for a post-affirmative action world

When Dr. Mark Henderson took over admissions at UC Davis School of Medicine in 2007, about 15% of incoming students were Black, Hispanic or Indigenous, groups that are historically underrepresented in medicine.

Since then, that number has more than tripled, climbing to 53% — a remarkable turnaround that could inspire other medical schools as they navigate a future post-affirmative action world.

The U.S. Supreme Court is poised to rule this spring on a case that challenges race-based admissions programs, jeopardizing affirmative action at public colleges and universities around the nation.

California hasn’t allowed affirmative action in admissions since voters approved Proposition 209 in 1996. But a strategy crafted by Henderson, whose commitment to diversity was forged by his working-class childhood in San Jose, shows that it’s possible to create a multiracial campus using alternative means. His team has transformed the university’s School of Medicine into what U.S. News & World Report ranks as the most diverse in the nation after Howard, a historically Black university, and Florida International, a Hispanic-serving university.

By comparison, Black, Latino and Indigenous students represent 32% of UCSF’s class, 30% of UCLA’s School of Medicine, and 22.4% of Stanford’s School of Medicine, according to U.S. News & World Report data.

Eight out of 10 UC Davis med students come from economically disadvantaged backgrounds. Four out of 10 are the first in their family to have attended college.

To provide the best patient care to an increasingly multicultural state, California’s future doctors must come from diverse backgrounds, said Henderson. Unable to rely on racial preferences, “we have to look at candidates differently,” he said.

A career in medicine seemed far out of reach for Henderson during his youth in San Jose’s Cambrian Park neighborhood. His mother was a teacher but there were no doctors in the family. Money was tight, so he worked after school as a busboy at Stickney’s Restaurant.

“My dad was absent a lot. So I hung out in the family circles of my friends,” who were Mexican-American, said Henderson, who is White. “They had jobs that were just … normal. It exposed me to different cultures, different foods, a different language.”

When his father overcame alcoholism, then helped others do the same, “I could see that people who had struggles brought something important to the table.”

At Stanford on a work-study scholarship, Henderson felt like an outsider. He focused on electrical engineering, thinking it was the best route to a secure financial future. But his future wife Dr. Helen Chew, a fellow work-study student born into a Chinese immigrant family on the Texas-Mexico border, could tell he was unhappy and urged him to consider a career helping people. He landed at UCSF’s prestigious School of Medicine, setting his eventual path to UC Davis.

UC Davis, whose students are dubbed “Aggies” to honor its agricultural heritage, has long had a lily-white reputation.

Henderson was recruited to the school’s Sacramento campus in 2000 from the University of Texas with a mandate to increase diversity.

To avoid race-based assessments, he focuses on finding students who have faced socioeconomic adversity, grading them on personal “distance traveled” based on such criteria as parental occupations, family income, geography and whether the family was on federal assistance. This gives context to their grades and test scores, he said, and serves as a proxy for grit, resilience and perseverance.

He also has diversified the medical school’s admissions committees, adding nonphysicians to the interview teams. He helped the school adopt a new mission statement, better tech tools, an accelerated three-year pathway, more financial aid and curriculum “tracks” that focus on tribal, urban, rural and agricultural populations.

Meanwhile, he’s expanded recruitment, enlisting a program called “Avenue M” to identify students at 20 community colleges in 14 rural counties who are interested in studying health sciences. They get academic support and are steered toward four-year universities, then the UC Davis School of Medicine.

“California doesn’t have doctors where it needs them, and we wonder: ‘Why?’ ” said Henderson, 60, an internist. “Well, it’s because we don’t take any kids that grow up in those areas.”

His strategy reduces the number of slots available for typical medical school students, including the offspring of physician colleagues, he concedes. This has made for some uncomfortable conversations.

“I respect his courage and commitment,” said Geoffrey Young, who directs the Association of American Medical Colleges’ efforts to transform the health care workforce. “He is diversifying the health care workforce in a state that bans the consideration of race in admissions. … In the admissions community, we recognize that it reflects a very effective and fair process.”

Students say they came to UC Davis because of programs designed by Henderson’s team.

Dr. Rosa Magana, 35, applied after reading the school’s mission statement. An immigrant from Mexico, her early education was in a tiny town on a Colorado River Indian reservation in Arizona, where her family worked in the fields. They moved to Oakland for medical care, where she lost friends to jail and gun violence. She plans to practice family medicine.

“It resonated with me,” she said. “I didn’t really pay attention to the numbers — GPAs and MCATs — because if I did, they were intimidating.”

Dr. Brandon Coleman, 30, now stands proudly in a crisp, white doctor’s coat. But there were years spent selling cotton candy and snow cones at Six Flags amusement park, then grading tests at the DMV, to put himself through school. A Vallejo native, the son of a bus driver and a truck driver, he got started at Napa Valley Community College.

He applied after volunteering at the school’s Imani Clinic in a low-income neighborhood of south Sacramento. “It was the first time I saw medical students and physicians that look like me,” said Coleman, who is Black and has been accepted into Kaiser Sacramento’s family practice residency program.

Among the school’s recent graduates are Dr. Duy Nguyen, a child refugee from Vietnam, now practicing psychiatry. Dr. Luis Godoy, who came to the U.S. across the Rio Grande on his father’s back, is a cardiothoracic surgeon. Dr. Mona Abutouk, the Arabic-speaking daughter of a Palestinian immigrant mother who grew up in South Central Los Angeles, is a pediatrician.

“The mission of UC Davis — primary care and serving the underserved — aligned with my concept of what health care should look like,” said Dr. Maria Garnica Albor, 32, who grew up in an adobe home in a small farming town in central Mexico before moving to the Modesto area. She is now on the UC Davis faculty. “I remember thinking: ‘Those are the kind of doctors I want to be like — their passion, their commitment and their humanity.’ ”

Efforts to increase diversity in medicine are not new. In 2010, the Association of American Medical Colleges established “holistic” review practices to help schools assess candidates based on experiences and personal attributes in addition to traditional metrics, such as grades and Medical College Admissions Test (MCAT) scores.

But there’s been little progress nationwide. Blacks accounted for 6.3% of the nation’s medical students in 2010; now they’re 7.1%. Native American students increased from 0.1% to only 0.2%. The percentage of Latino students fell from 8.2% to 6.2%.

That’s because there is wide variation in the implementation of “holistic review,” and little accountability for outcomes, according to a study led by Henderson. Schools still rely too heavily on MCAT scores, which are easy to assess and influence U.S. News and World Report rankings, he said.

It was at the UC Davis School of Medicine that affirmative action was first challenged. Ruling in favor of 35-year-old White applicant Allan Bakke in 1977, the U.S. Supreme Court concluded that schools could use race as a factor in admissions, but not quotas — a decision that had a chilling effect on institutions fearing they might be charged with reverse discrimination.

A new U.S. Supreme Court decision, expected in June, could ban all race-conscious admissions policies. During last fall’s hearing, the conservative majority of justices asked questions about programs at Harvard and the University of North Carolina that reflected skepticism about the practice.

With schools braced for a setback, Henderson finds himself on the cusp of modest celebrity. For years, he kept a low profile. Now he’s a public ambassador, leading discussions to share his strategy with other admissions officers.

“He has big ideas,” said Magana, “and he’s been fighting tooth and nail to make those ideas happen.”