Exploring Race and Ethnicity Representational Inequities in Illinois Medical Schools.

Efforts to increase U.S. medical school student diversity have lagged behind the continued growth of racial/ethnic minorities in the population. A targeted, local approach may catalyze actionable change that holds schools accountable for addressing community needs through representation. The aims of our study are to (1) analyze the student racial/ethnic profiles of allopathic and osteopathic medical schools in the diverse state of Illinois and (2) compare student race/ethnicity with that of schools' local county and primary teaching hospital patient populations. Data from the Association of American Medical Colleges and American Association of College of Osteopathic Medicine were used to gather matriculated student race/ethnicity from the eight allopathic schools and one osteopathic medical school in Illinois. Representational inequity quotients (RIQs) were calculated to determine the proportion of Hispanic/Latinx, black/African American, and total underrepresented in medicine (UIM) individuals in three reference populations (U.S., county, and primary teaching hospital patient populations) relative to each medical school's student racial/ethnic profile. Across Illinois schools, mean RIQs were highest (showed greater inequity) when county demographics were used as the reference population as opposed to U.S. or hospital populations. For all schools individually, Hispanic county-student RIQs were higher than RIQs based on hospital population. For a majority of schools with primary teaching hospital in Cook County, hospital-student RIQs magnified representational inequity for the black population. Using county data to evaluate medical school representation inequities may better reflect UIM representation goals than the U.S. population. Examining hospital demographics may further reveal other structural inequities relevant to medical education, such as primary teaching hospitals that are not adequately serving their surrounding communities. By evaluating RIQs on a local and hospital-population level, schools can periodically assess to what degree their student body and hospital populations represent their communities and adjust recruitment, retention, and service efforts.