On July 30, Attorney General Pam Bondi issued a memo titled Guidance for Recipients of Federal Funding Regarding Unlawful Discrimination to all federal agencies, clarifying how federal anti-discrimination laws apply to programs that might involve discriminatory practices, including those that fall under the umbrella of diversity, equity and inclusion (DEI).
Per the memo, recipients of federal funds must ensure that their programs do not discriminate on the basis of race, color, national origin, sex, religion or other protected traits, regardless of a program’s label, objectives or good intentions. The memo includes non-binding recommendations to help institutions comply, such as incorporating explicit nondiscrimination clauses into grant agreements, monitoring third-party compliance and terminating funding when necessary.
Here is how the memo may impact the practice of rheumatology.
Hiring, Promotion & Fellowship Selection
Academic rheumatology divisions that use race or sex as a factor in hiring, promotion or fellowship admissions may need to stop or rework those practices to avoid legal exposure. ACR members who are seeking employment at academic institutions that receive federal money should expect more conservative selection criteria and more sign-offs from human resources and legal departments.
Outreach Programs
Programs that were explicitly targeted by race or gender, such as medical school, residency and pre-med pipelines, could be restructured into broader socioeconomic or geographic outreach to keep diversity goals while reducing legal risk. That may slow diversification efforts in the short term unless programs are redesigned.
Clinical Trial Recruitment & Health Disparities Work
Grants and initiatives aimed at reducing disparities (e.g., recruitment of under-represented patients into trials, community engagement) may face additional scrutiny, especially if federal funding is involved. Projects should document medical/scientific justification for any targeted approaches.
Training, Curricula & Mandatory Education
Implicit-bias trainings or curricular elements that are perceived as having race or sex-based preferences could be challenged. Institutions will likely review or reframe trainings to emphasize evidence-based, universal patient-care benefits and avoid language that could be read as discriminatory.
Operational & Reputational Consequences
Expect increased legal/compliance reviews, potential chilling effects on voluntary DEI efforts and possible internal friction as faculty and leadership balance mission-driven equity work with risk avoidance. News coverage and public debate around this guidance may also affect faculty recruitment and fundraising.
Conclusion
The guidance does not outlaw efforts to improve access to care or to study health disparities. However, it raises the bar on how such efforts must be designed and documented when federal funds are involved. Rheumatology leaders should proactively review DEI programs, consult counsel and reframe activities where needed so the work to reduce inequities can continue in a legally defensible way. The ACR fervently believes in the high value that diversity brings to the rheumatology workforce and its ability to provide high-quality care for all.
