A recent JAMA Network Open study found that medical students from underrepresented groups have an attrition rate that is over three times higher than other students. The study analyzed allopathic medical student cohorts in years 2014-2015 and 2015-2016, and divided students into groupings for analysis based on personal (race and ethnicity, family income) and structural (youth neighborhood resources) metrics.
The study showed:
Attrition was highest among students with all three “marginalized identities”—low income, under-resourced neighborhood, and identifying as a historically underrepresented race and ethnicity. The total attrition for this group was almost four times (3.7) higher than for students who did not report any of the three marginalized identities.
By race and ethnicity, students who identified as American Indian, Alaska Native, Native Hawaiian, and Pacific Islander had the highest attrition rate (11 percent), followed by Black students (5.7 percent), and Hispanic students (5.2 percent).
Students from under-resourced neighborhoods had almost double the attrition rate (4.6 percent) of those who were not from under-resourced neighborhoods (2.4 percent). Similarly, those with low family income had an attrition rate of 4.2 percent compared to 2.3 percent for those who did not.
The researchers noted a need for targeted, structural reforms in medical schools to improve retention rates among high-risk groups. “Given the higher attrition rate among marginalized student groups, medical schools should consider reforms that dismantle structural inequities in medical culture and training that equate privilege with merit and physicians as an elite class of citizens,” they wrote. “These reforms may begin with tuition and debt reform and purposeful partnership and support of local and national under-resourced communities.”