H.B. No. 291 introduces new regulations regarding medical school admissions, coursework, academic standards, and employment decisions in Texas. The bill mandates that each medical school must ensure that at least 50% of the coursework required for a medical degree or certificate is graded on a letter scale from A to F or a similar tiered system. Additionally, any revisions to academic standards for awarding degrees or certificates must be submitted to the legislature and the Texas Higher Education Coordinating Board, including a copy of the proposed standards, a statement of reasons for the changes, and the effective date of the new standards.

Furthermore, the bill prohibits medical schools from granting admission or employment preferences based on race, sex, color, ethnicity, or national origin, while allowing for bona fide qualifications based on sex that are necessary for the operation of the school. The new requirements for coursework and admissions will apply to students enrolling in medical schools starting in the fall semester of 2026, with the previous laws remaining in effect for admissions prior to that date. The act will take effect immediately if it receives a two-thirds vote from both houses; otherwise, it will take effect on September 1, 2025.

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