Programmes to build a more representative US health-care workforce are under attack, despite the long-standing under-representation of health-care providers from racially and ethnically minoritised groups and evidence that a representative health-care workforce produces superior outcomes.1,2 The US Supreme Court’s 2024 decision to ban race-based admissions in higher education, including health professional education, has already resulted in the intake of students at major universities in autumn, 2024 being less racially and ethnically representative than it was the previous year.