Efforts in Undergraduate Medical Education to Improve Socioeconomic Status Diversity

Abstract

Purpose: Despite the importance of socioeconomic status (SES) diversity within the health care workforce, little progress has been made toward this elusive goal. Although centuries of structural disadvantage underlie this stagnation, medical schools are well positioned to increase enrollment and retention of students from low-SES backgrounds. In this research report, the authors investigate existing efforts in undergraduate medical education to improve SES diversity.

Method: The authors analyzed the Association of American Medical Colleges Medical School Admissions Requirements database, the American Association of Colleges of Osteopathic Medicine Choose DO Explorer tool, and official medical school websites from December 2022 to May 2023 to examine undergraduate medical education initiatives across 156 allopathic and 56 osteopathic medical schools. They searched for SES diversity efforts in 4 domains: publication of student body demographics (including low-SES or first-generation status), need-based financial aid, low-SES support or affinity groups, and faculty or alumni mentorship programs for low-SES students.

Results: The authors found that 18 medical schools (8.5%) publicly report SES demographic information, 33 (15.6%) report having mentorship programs for low-SES students, 52 (24.5%) report having support or affinity groups for these students, and 154 (72.6%) report offering some level of need-based financial assistance. A greater proportion of MD and public medical schools (128 [82.1%] and 84 [80.0%], respectively) had any kind of SES initiative when compared with DO schools and private medical schools (40 [71.4%] and 84 [78.5%], respectively).

Conclusions: Medical schools can support students from lower-SES backgrounds by publicly reporting classwide SES demographics; dedicating staff and faculty to diversity, equity, and inclusion efforts; measuring and reporting debt burden by stratified student demographics; and introducing innovative financing solutions.