Published in JAMA Network Open, research by the University of Minnesota Medical School is the first to take a detailed look at the socioeconomic diversity of the national medical student body. This population represents the future physician pool in the U.S.

“In recent years there has been a significant focus on the diversity of medical students, but to date, most work has focused on ‘visible’ forms of diversity; such as race, ethnicity and gender,” said lead author and U of M Medical School student, Arman Shahriar. “This paper is the first to describe the socioeconomic diversity of the medical student body in the U.S., which is a more hidden form of diversity.”

In across medical schools nationally, the study found that:

• High-income students are overrepresented in medical school, both overall and within each racial and ethnic group;
• Black and Hispanic students remain underrepresented overall in medical schools, but high-income Black and Hispanic students are markedly overrepresented—even more so than their high-income white and Asian counterparts; and,
• Low-income students are underrepresented across the board, with the exception of select subgroups of Asian-identifying students.

“There is an urgent need to diversify the physician workforce in the U.S.,” said Shailey Prasad, a professor in the U of M Medical School and executive director for the Center for Global Health and Social Responsibility. “This study clearly shows that we have a long way to go to achieve that in terms of socioeconomic diversity. I hope this study will prompt changes in administration processes lest our field continues to be primarily for those with financial means.”

In the U.S., low-income households are disproportionately Black and Hispanic for a myriad of reasons, most of which are rooted in structural racism. This reality poses a significant challenge given the high price of pursuing careers in medicine and the compelling national interest in creating a more diverse physician workforce.

“In our paper we discuss tools for assessing socioeconomic disadvantage that admissions departments across the nation should all be using,” said Shahriar. “The long-term path toward workforce diversity will require bringing socioeconomics into the spotlight, and more aggressive and upstream interventions by medical schools and organized medicine.”

The research team recommends future studies to examine the medical school pipeline and using these results to advocate nationally for better assessment of socioeconomic disadvantage in the admissions process.