As Alabama grapples with a persistent physician shortage, the University of Alabama at Birmingham has terminated a privately funded scholarship for high-performing Black medical students in response to threats from the Trump administration.
The Herschell Lee Hamilton, M.D., Endowed Scholarship in Medicine was created in 2013 to provide medical school tuition for Black students who maintained a 3.0 GPA and demonstrated financial need. The Hamilton family and other private donors funded the annual scholarship; the recipients were selected by UAB.
On February 14, the Trump administration issued a “Dear Colleague” letter warning that, under its interpretation of federal law, schools are prohibited from using race in decisions about scholarships, among other things. A month later, the Department of Education announced it was investigating UAB and six other universities for what it called “impermissible race-based scholarships.”
On April 11, UAB’s Office of Advancement and Strategic Initiatives told donors that “UAB has made the decision to discontinue awarding the scholarship(s) and to return the scholarship funds to you.” Citing the Education Department’s February letter, UAB said it had “determined that the criteria for the scholarship could not be amended to comply” with the law and the scholarship’s intent.
Supporters of the scholarship, including Dr. Hamilton’s family, said the cancellation undermines much-needed efforts to support Black medical students and betrays Dr. Hamilton’s legacy.
A Legacy of Excellence
Herschell Lee Hamilton was a veteran of World War II who, like many Black veterans, returned home to face a country that, even as it claimed victory for freedom and democracy abroad, was still denying freedom and justice to its own citizens.
“He felt the country owed him and other veterans and other Black people the rights he and others went and fought for,” his son, Herschell Lanier Hamilton, told the Birmingham Times. “He couldn’t sit around passively and do nothing.”
When he heard about nonviolent civil rights protestors being met with violent opposition from segregationists in Birmingham, his son said, he “felt he needed to come and lend a hand.”
When Dr. Hamilton arrived in Birmingham in 1959, he recognized health disparities rooted in Jim Crow laws that, as John Archibald wrote in AL.com, “made it illegal for Black and white people to even socialize”—and barred Black patients from receiving even emergency medical care in “white” hospitals. That year, he noted, a pregnant Black woman was denied entry at Birmingham’s Hillman Hospital and was forced to deliver her baby on the lawn in the freezing cold.
Dr. Hamilton established his office in the historic Ballard House, less than two blocks from Kelly Ingram Park and Sixteenth Street Baptist Church, where firemen attacked children with firehoses and police unleased dogs on peaceful protestors.
The office became a triage station, where “The Dog Bite Doctor,” as he became known, treated children, women, and men injured by police dogs and firehoses. “Those people pinned against the wall of the building [by firehose blasts] were the ones who were most seriously injured,” Dr. Hamilton said. “They were brought to my office in severe pain and crying and screaming and yelling.”
He also treated marchers on the Selma-to-Montgomery route in 1965. “He treated everybody,” said Rachel Kersey, his oldest daughter. “He treated patients regardless of their ability to pay. People would pay him with cakes, with collard greens from their garden. He would never turn anybody down.”
Dr. Hamilton became the city’s first Black general surgeon to be certified by the American Medical Association, AL.com reported. He let his work speak for him, his son told the Birmingham Times. He had privileges at several Birmingham hospitals, where other physicians recognized his skill in the operating room. “He established a reputation as an outstanding surgeon in the community broadly, not just in the Black community,” his son said.
But despite his excellence as a surgeon, Dr. Hamilton was not allowed to ride in the elevator in white hospitals. “He would be making rounds with residents,” his son recounted. “His white residents could go on the elevators, but he had to take the steps.”
Dr. Hamilton was dedicated to recruiting doctors to come to Birmingham and encouraging young people to become physicians. After he died in 2003, his family—including his children, all of whom graduated from Howard University, earned advanced degrees, and excelled in medicine, law, or business—approached UAB about establishing a scholarship in his name to support Black medical students.
Alabama Needs More Black Doctors
“The purpose of the scholarship was to honor and continue the advocacy my father promoted when he was alive,” Mr. Hamilton told the Birmingham Times. “In a state like Alabama that has a disproportionately low number of African American physicians, it’s important to have more—and more diverse—physicians. Studies have shown that African American people have better health outcomes when they are tended to by African American physicians.”
Recent research also shows that counties with more Black doctors have better health outcomes for Black residents and others marginalized by poverty.
Researchers analyzed data at discrete time points of 2009, 2014, and 2019 from 1,618 U.S. counties that had at least one Black primary care physician. They found that a 10% increase in Black primary care doctor representation was associated with an extra month of life expectancy—and lower mortality—for Black patients.
Despite these robust findings, more than half of U.S. counties did not have a single Black primary care physician. In Alabama, where about 26% of residents are Black, only 7% of doctors are Black.
The findings were strongest in counties with higher rates of poverty.
Citing a Michigan study showing that Black physicians were more likely than doctors of any other racial or ethic group to accept new Medicaid patients, Dr. Monica Peek posited in JAMA Network Open that the researchers’ findings may reflect that, compared with non-Hispanic white doctors, Black physicians disproportionately care for patients who are uninsured and underinsured—exactly what Alabama needs, as one of the 10 states that have refused to expand Medicaid.
Many Alabama counties have no physicians and access to health care is extremely limited. The state consistently ranks in the bottom five states on indicators like infant mortality, overall child well-being, and life expectancy. The United Health Foundation, which conducts the longest running annual assessment of the nation’s health, ranked Alabama 45th in its 2024 annual report.
Alabama is facing a widespread health care shortage, Dr. Hernando Carter from the Medical Association of the State of Alabama told WVTM. The state needs 600 more family doctors by 2030, he said.
“There are large swaths of the state that are health care deserts,” Dr. Brian Stone, chief of staff at Walker Baptist Hospital in Jasper, told AL.com. “A lot of the rural hospitals have closed. A lot of the health care centers have closed. So the only way that we’re going to fix this is we’ve got to recruit kids from the state from all social backgrounds into medicine.”
Dr. Stone is among members of the Birmingham medical community who have expressed concern that cancelling scholarships like the Herschell Lee Hamilton, M.D., Endowed Scholarship in Medicine will negatively impact Alabama’s healthcare workforce.
Denying History
“Why would you end a program that focuses on the development and training of Black physicians who are more likely to set up practices in those communities that have the worst health outcomes?” Herschell Hamilton said.
“The UAB School of Medicine has really been committed to producing [a] merit-based, ethnically diverse crop of physicians,” he said, adding that the medical school has been “outstanding” in its administration of the scholarship program. The family thought there was a way to maintain the program in accordance with state and federal laws, he explained, and they were disappointed that UAB instead decided to “just pull the plug” on the scholarship.
The Department of Education’s description of programs like this scholarship as discriminatory amounts to denying history, Mr. Hamilton explained: “It’s an indication that the secretary of education is not a student of U.S. history or race relations and the construct of race in the United States. She doesn’t recognize that the disparities that exist are the result of historic practices, policies, and laws in generations past.”
“These schools are trying to divorce themselves from these programs as if society self-corrects. It doesn’t. American society as it relates to race or inclusion or health outcomes has never self-corrected. You have to have intentional programs of inclusion in order to change the outcomes.”