Students at U.S. medical schools disproportionately hail from high-income households, a report appearing today in JAMA Network Open has found.
“The underrepresentation of low-income groups was nearly ubiquitous across race and ethnicity groups,” wrote Arman A. Shahriar, B.S., of the University of Minnesota Medical School, Jonathan M. Miller, Ph.D., M.P.H., of Hennepin Healthcare Research Institute in Minneapolis, and colleagues.
The researchers examined data collected through the Association of American Medical Colleges Matriculating Student Questionnaire (AAMC-MSQ) between 2017 and 2019. As part of this survey, matriculating medical students were asked to estimate their parents’ combined income for the last year. This income data were compared with data reported by households who responded to the Census Bureau’s Current Population Survey Annual Social and Economic Supplement between 2016 and 2018.
A total of 30,373 AAMC-MSQ respondents reported parental income; of these, 21.3% were non-Hispanic Asian students, 6.4% were non-Hispanic Black students, 10.9% were Hispanic students of any race, and 54.0% were non-Hispanic White students. More than half of the respondents belonged to households in the top 20% income bracket, including 24.0% in the top 5%. In comparison, only about 6% of students reported belonging to households in the bottom 20% income bracket.
The researchers next calculated the representation index (RI) for each subgroup of students by dividing the percentage of the population in each household income bracket represented in the medical student body by those in the general population. (For example, 9.1% of Black medical students came from households in the top 5%, compared with just 1.7% of Black individuals in the United States overall, which results in a RI of 5.3.) RI values above and below 1.0 indicate overrepresentation and underrepresentation in the medical student body, respectively, the authors noted.
The researchers found that the top 5% of households were consistently overrepresented in medical schools compared with the general population across all four racial and ethnic groups (all medical students: RI, 4.8; Asian: RI, 2.3; Black: RI, 5.3; Hispanic: RI, 6.6; White: RI, 4.8).
“Achieving demographic representation among physicians is a widely accepted ideal, but recent studies have shed light on the absence of progress with respect to race and ethnicity,” Shahriar, Miller, and colleagues wrote. “Long-term solutions will require upstream engagement, including community partnerships and targeted investments in pipeline programs.”
They continued, “Matriculants who come from low-income households should be monitored for financial health and the accumulation of unexpected expenses, given that they do not have the family support of their peers from high-income households.”
For related information, see the Psychiatric News article “Minority Students Lead Surge in Medical School Applicants.”
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