One Reason the Push for Diversity in Medicine is Lagging

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For decades, leading medical organizations have been trying to diversify the ranks of physicians, where Black and Hispanic doctors remain vastly underrepresented relative to their proportion of the U.S. population. That matters, because research has shown that people from underrepresented racial and ethnic groups can have better health outcomes when their doctors look like them.

But a recent study in the journal JAMA Health Forum highlights the factors, including financial pressures and discrimination, that can keep determined students of color from actually making it to medical school. The study looked at responses from more than 81,000 students who took the Medical College Admission Test. The standardized exam is grueling: People study for it for months, if not years, says the study’s first author, Dr. Jessica Faiz of the University of California Los Angeles. “You paid for the test. You took all that time to study. You are definitely quite committed to applying to med school”, says Faiz, an emergency physician and fellow with the National Clinician Scholars Program at UCLA.

Even so, Faiz and her colleagues found that Black and Hispanic test takers were significantly less likely to go on to apply and enroll in med school than white test takers. Not only that, but Black, Hispanic and Native American students were more likely to say they faced financial barriers, such as difficulty affording test prep materials and already having large student loans.

“Even further, they’re more likely to face discouragement from advisors when applying to medical school compared to their white counterparts,” says study co-author Dr. Utibe Essien, an assistant professor of medicine and health equity researcher at UCLA.

Another key finding: Black, Hispanic and Native American students were more likely to have parents without a college degree and more likely to go to a low-resourced college, which the researchers defined as a college with a less-selective admissions process and a majority of students living off campus. Those factors “really trickle down to your social networks that are really integral in succeeding as a medical student,” Faiz says. For instance, the study found that students of color were less likely to have shadowed a physician – an experience that can burnish a med school application. Faiz says that likely reflects a lack of the kinds of connections that make it easier to set up that kind of experience.