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The Trump administration isn’t giving Duke University a break.
Just weeks after the Justice Department said Duke discriminated based on race in its law school admissions, a near-identical finding by the Department of Health and Human Services was announced Tuesday about the elite university’s medical school.
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But this isn’t about the well-documented history of anti-Black racism in American higher education. The federal government is repeatedly accusing Duke of discriminating against white and Asian people.
HHS says its finding means Duke violated Title VI of the Civil Rights Act of 1964 in its medical school admissions. Vinay Harpalani, a law professor at the University of New Mexico who specializes in race and university admissions, calls the Trump administration’s interpretation of the law “an ironic inversion of the way we look at history.”
“All these laws that were intended to break down Jim Crow, break down that legacy of racism are now being inverted to challenge race-conscious policies or racial diversity,” Harpalani said.
HHS accuses Duke medical school of using racial proxies that still allow reviewers to consider race, despite the 2023 U.S. Supreme Court decision that struck down affirmative action in college admissions. In its letter, HHS also quotes a medical school admission committee member lamenting the end of affirmative action.
The result of Duke’s admissions process, HHS said, is that Black admitted students had statistically lower Medical College Admission Test, or MCAT, scores and GPAs than admitted white and Asian students. HHS also said Duke failed to produce explanations for the deviations when asked about them.
The Duke Chronicle first reported this story.
Experts who spoke to The News & Observer question the legitimacy of such statistical conclusions based on standardized test performance.
“We know that just because of the way opportunity is structured in the U.S. that white and Asian students everywhere tend to have higher test scores than other racialized minority students,” said UNC-Chapel Hill education professor Daniel Klasik.
But HHS said it accounted “for available academic, application, and admissions-stage variables” in its analysis of 2024-25 applicant data and that “race remained associated with statistically significant advantages or disadvantages at key stages of the medical school admissions process.”
Duke is part of a swath of medical schools under scrutiny by the federal government for racial discrimination in admissions, including East Carolina University’s Brody School of Medicine.
Paula Stannard, director of the HHS Office for Civil Rights, said in a statement about the Duke finding that the Trump administration is “committed to ensuring that every applicant at a medical school is treated equally. Any kind of discrimination through the admissions process is unacceptable.”
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There are a number of things that make medical schools more vulnerable to this kind of scrutiny, Harpalani said.
One is the large amount of federal funding medical schools receive. That funding is “all leverage that the Trump administration can use against Duke,” Harpalani said. In its letter to Duke, HHS points out that Duke received more than $3.4 billion from HHS during fiscal years 2021 through 2026 — and implies that continued funding is subject to revocation if Duke doesn’t comply.
The second thing that makes medical schools more susceptible, Harpalani said, is the admissions interview process. That’s a relatively unique characteristic of medical school admission, he said.
The interview gives admissions officers “more of a subjective dimension that comes from interpersonal interaction,” Harpalani said. “You can see somebody and assess their racial background. So medical schools are an easy target for accusations that race is coming in surreptitiously.”
“I view all of these Trump investigations [in higher education] as the way the Trump administration and Trump himself does a lot of things: ‘let’s make a deal,’” Harpalani said. “Ultimately, they want to settle with these universities and get them to voluntarily agree to do certain things.”
Those things, Harpalani said, could include ending remaining diversity initiatives or barring applicants from talking about their race in admissions essays.
The Trump administration, Klasik said, is “trying to create an environment of doubt, uncertainty, and fear among admissions officers so they overcorrect, and make it more likely that the administration gets the outcomes they want.”
The letter gives Duke 10 business days to contact HHS about a “voluntary resolution agreement.” If the school doesn’t respond, or refuses the terms of the agreement, HHS says it will refer the case to the Justice Department.
A Duke spokesperson told The N&O that the school is “reviewing the letter and its conclusions carefully” and “is committed to complying with the law and will continue to do so in a manner that is consistent with our academic mission.”
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This story was originally published September 11, 2026 at 11:29 AM.