Are students who are underrepresented in medicine more likely to struggle in medical education?

Underrepresented in Medicine Students Face Significant Barriers in Medical Education

Students who are underrepresented in medicine (URM) are more likely to struggle in medical education due to systemic barriers, discrimination, and lack of institutional support. 1 These challenges affect their academic performance, timely progression, and retention in medical school.

Key Challenges Faced by URM Medical Students

Social and Learning Environment Barriers

• URM students experience less supportive social environments and less positive learning environments compared to their non-URM peers 1
• They are more likely to be subjected to discrimination and racial harassment during their medical education 1
• URM students often report that their race has a negative impact on their medical school experiences 1

Academic Performance and Progression

• Research shows that URM students demonstrate worse performance on standardized exams 1
• Their academic progress is less timely, and they experience higher attrition rates than non-URM students 1
• These academic challenges are not inherent to the students but rather reflect systemic barriers in medical education 1

Isolation and Resource Limitations

• First-generation medical students, who are often from underrepresented backgrounds, report significant isolation and exclusion related to being newcomers to medicine 2
• They face difficulties accessing basic resources (food, housing, transportation) as well as educational resources 2
• Many URM students report an overall lack of faculty or institutional support to address these challenges 2

Specific Barriers in Academic Medicine Pathways

• URM faculty are less likely to get promoted even when controlling for scholarly output 3
• Hostile work environments may exacerbate attrition of URM individuals from academic medicine 3
• The proportion of URM students in medicine is smaller than in the general population, and these numbers worsen with each step up the academic medicine ladder 3

Effective Support Strategies

Mentorship and Community Building

• Creating communities with shared values around diversity, equity, and inclusion can foster belonging for URM students 4
• Structured mentorship programs specifically designed for URM students can significantly improve their experience 4
• Allies play an important role in supporting URM students through medical education 4

Faculty Development

• Faculty workshops focused on understanding challenges faced by URM students can improve mentorship 5
• Training can increase faculty confidence in recognizing and addressing issues URM students experience 5
• Faculty development should include building awareness, comfort, and skills regarding engaging in meaningful discussions about race 5

Institutional Approaches

• Multi-pronged approaches that change every step of recruitment and promotion processes are most effective 3
• Institutions should apply holistic models not just to admissions but to the entire educational process 2
• Targeted and flexible initiatives should be created so all students can achieve professional actualization regardless of background 2

Common Pitfalls to Avoid

• Relying solely on URM students' "grit and resilience" as survival strategies rather than providing adequate institutional support 2
• Expecting URM students to be the sole representatives of their identity group, which creates additional burden (minority tax) 5
• Failing to address stereotype threat, which can negatively impact academic performance 5
• Ignoring the "chilly climate" and hostile work environments that contribute to attrition 3

The current environment of healthcare reform presents an opportunity for institutions to implement strategies to make medicine a more inclusive profession and improve the experiences of URM students 1.