Story at a glance
- Researchers at Yale University found that non-white medical students were more likely to drop out in comparison to their white counterparts.
- Students of color who also grew up in a low-income household and in an under-resourced neighborhood had an even higher chance of dropping out.
- They attributed the high dropout rates to implicit biases and lack of diversity with medical school faculty.
Medical students who are low-income and identify as non-white are more likely to leave medical school, a pattern that researchers say has implications for health care access for patients and the overarching medical workforce.
Researchers at Yale University analyzed enrollment data from 2014 to 2016 and found that of around 33,000 students about 3 percent experienced attrition from medical school within five years — meaning they dropped out of their programs.
Their study found that Hispanic students were about 5 percent more likely to drop out of medical school, while American Indian/Alaska Native/ Pacific Islander students were 11 percent and Black/African American students were about 6 percent.
That’s in comparison to white students who were found to only have a 2 percent chance of dropping out.
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Growing up in a low-income household and an under-resourced neighborhood increased chances of attrition by about 4 percent.
“It’s an accrual of disadvantage,” explained Dowin Boatright, assistant professor of emergency medicine at Yale and a senior author of the study, in a statement.
Students who identified with multiple marginalized identities — like having low-income households and coming from under-resourced neighborhoods — had even higher attrition rates.
Researchers discussed multiple potential causes for the stark differences in dropout rates, from implicit biases to lack of diversity within medical faculty.
They also outlined how most medical schools use deficit-based learning models that focus on what students are missing or need to catch up on — rather than promoting characteristics, skills and talents that schools want to amplify.
“Implicit in the deficit-based model is something being wrong with an individual or students from a marginalized community, which already signals a perception of inferiority,” said Boatright.
Mytien Nguyen, a student a Yale School of Medicine and lead author of the study, also explained that medical school admissions offices have already determined that admitted students are “fit to be doctors and are academically ready,” which indicates that the attrition rates identified in the study speak to the medical school environmental not adequately supporting students from marginalized backgrounds.
Nguyen said it could simply come down to nurturing versus surviving.
“I think students from non-marginalized backgrounds are really being nurtured while students from marginalized backgrounds are surviving,” she said. “And biologically, when you’re surviving and managing stress, you’re not able to perform at your best. With every student that leaves, it’s not just a loss for the health care industry, but a loss for our patients as well.”
Minority health professionals are critical as they can reduce the disproportionate burden of diseases, including COVID-19, among communities of color.
That could be in jeopardy, as a separate study from 2018 by the Association of American Medical Colleges found that racial and ethnic minority physicians are more likely to practice primary care and serve in underserved communities. But the physician workforce has been diversifying at a much slower pace than that of the entire U.S. population.
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