Nguyen Mytien, Mason Hyacinth R C, Fancher Tonya, Chaudhry Sarwat I, Tran-Reina Melody L, Havemann Catherine, Venkataraman Shruthi, Webber Alexis, Boatright Dowin
Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut.
Office of Student Affairs and Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts.
JAMA Netw Open. 2025 May 1;8(5):e2511063. doi: 10.1001/jamanetworkopen.2025.11063.
Personal and professional development are integral to students' professional identity formation.
To examine the association between race, ethnicity, family income, and growing up in an underresourced neighborhood with perception of medical school support of professional and personal development.
DESIGN, SETTING, AND PARTICIPANTS: Retrospective cross-sectional study using deidentified data of medical graduates who completed the Association of American Medical Colleges Graduation Questionnaire in 2018 to 2022. Statistical analysis was performed from October 1 to November 1, 2024.
Perception of medical school support of professional and personal development. Multivariate logistic regression models to assess the association of family income, race, ethnicity, and underresourced neighborhood status with perception of medical school support of professional and personal development during medical school, adjusting for students' sex, age at graduation in quartiles, and clustered by school to account for school-to-school variability.
Among 66 898 respondents in the study cohort, 34 731 identified as female (51.9%), 14 100 as Asian (21.1%), 3594 as Black or African American (5.4%), 3419 as Hispanic (5.1%), and 38 483 as White (57.5%). The mean (SD) age of respondents was 27.5 (2.6) years and 10 088 were from households with incomes less than $50 000 a year (15.1%). Students from families with incomes in the lowest 2 quintiles were significantly less likely to report medical school support of professional and personal development than students from household incomes of more than $200 000 (less than $50 000: 69.5% vs 75.1%; relative risk [RR], 0.96; 95% CI, 0.94-0.98; $50 000-$74 999: 71.0% vs 75.1%; RR, 0.96; 95% CI, 0.94-0.98). Compared with White students, Asian students (aRR, 0.97; 95% CI, 0.96-0.98) and Black students (adjusted relative risk [aRR], 0.97; 95% CI, 0.95-0.99) were less likely to report medical school support of professional development, and Black students were less likely to report medical school support of personal development (aRR, 0.93; 95% CI, 0.89-0.97). Compared with their peers, students who reported growing up in an underresourced neighborhood were significantly less likely to report medical school support of professional and personal development. Intersectionality analysis of family income, race, ethnicity, and underresourced neighborhood status suggested that perception of medical school support of professional and personal development decreased with increasing number of minoritized identities, with students who were URIM, from a low-income family, and reported growing up in underresourced neighborhoods the least likely to report medical school support of professional and personal development.
In this cross-sectional study of medical graduates, students who were URIM, low-income, and students who reported growing up in underresourced neighborhood were significantly less likely to report medical school support of professional and personal development. It is therefore critical for medical schools and accreditation bodies to evaluate current curriculum and practices to foster professional and personal development that are equitable for all students.
个人和职业发展是学生职业身份形成的组成部分。
研究种族、族裔、家庭收入以及在资源匮乏社区成长与医学院对职业和个人发展支持的认知之间的关联。
设计、背景和参与者：采用2018年至2022年完成美国医学院协会毕业调查问卷的医学毕业生去识别化数据进行回顾性横断面研究。统计分析于2024年10月1日至11月1日进行。
医学院对职业和个人发展支持的认知。多变量逻辑回归模型，用于评估家庭收入、种族、族裔和资源匮乏社区状况与医学院在学生医学院学习期间对职业和个人发展支持的认知之间的关联，同时对学生的性别、毕业年龄四分位数进行调整，并按学校聚类以考虑学校间的差异。
在研究队列的66898名受访者中，34731人认定为女性（51.9%），14100人为亚洲人（21.1%），3594人为黑人或非裔美国人（5.4%），3419人为西班牙裔（5.1%），38483人为白人（57.5%）。受访者的平均（标准差）年龄为27.5（2.6）岁，10088人来自年收入低于50000美元的家庭（15.1%）。家庭收入处于最低两个五分位数的学生比家庭收入超过200000美元的学生报告医学院对职业和个人发展支持的可能性显著更低（低于50000美元：69.5%对75.1%；相对风险[RR]，0.96；95%置信区间，0.94 - 0.98；50000 - 74999美元：71.0%对75.1%；RR，0.96；95%置信区间，0.94 - 0.98）。与白人学生相比，亚洲学生（调整后相对风险[aRR]，0.97；95%置信区间，0.96 - 0.98）和黑人学生（调整后相对风险[aRR]，0.97；95%置信区间，0.95 - 0.99）报告医学院对职业发展支持的可能性更低，黑人学生报告医学院对个人发展支持的可能性也更低（aRR，0.93；95%置信区间，0.89 - 0.97）。与同龄人相比，报告在资源匮乏社区成长的学生报告医学院对职业和个人发展支持的可能性显著更低。家庭收入、种族、族裔和资源匮乏社区状况的交叉性分析表明，医学院对职业和个人发展支持的认知随着少数族裔身份数量的增加而降低，其中URIM学生、来自低收入家庭且报告在资源匮乏社区成长的学生报告医学院对职业和个人发展支持的可能性最低。
在这项针对医学毕业生的横断面研究中，URIM学生、低收入学生以及报告在资源匮乏社区成长的学生报告医学院对职业和个人发展支持的可能性显著更低。因此对于医学院和认证机构来说，评估当前课程和实践以促进对所有学生公平的职业和个人发展至关重要。
