Burwell Julian Michael, Lobo Sonia
Department of Medical Education, Geisinger Commonwealth School of Medicine, Geisinger College of Health Sciences, 525 Pine Street, Scranton, PA, 18509, USA.
BMC Med Educ. 2025 Jul 1;25(1):955. doi: 10.1186/s12909-025-07417-y.
First-Generation (FG) medical students face significant challenges that can hinder their academic success and well-being. Our study aimed to quantify the disparities between FG and Continuing-Generation (CG) students across four domains including: resilience, social isolation, unmet basic needs, and perception of institutional support.
An anonymous survey was administered to all four classes of medical students at Geisinger Commonwealth School of Medicine. Students had four weeks to complete the voluntary, 30-question survey which included 29 close-ended questions and one open-ended question to assess challenges in each domain. Survey data were collected in Qualtrics and analyzed using R Epi for R 4.4.1 GUI 1.80 Big Sur Intel build (8416). Primary analysis was performed using Students T-test to evaluate difference in means between cohorts, and one-way ANOVA was used in secondary analysis to correct for confounders between student attitudes across year in school. FG status was defined as having no parent with a 4-year college degree. Seventy-two students responded, and 62 completed surveys were included in the analysis.
Among the 62 respondents (15 FG, 47 CG), FG status predicted increased resilience (p = 0.01), feelings of social isolation (p = 0.005), and unmet basic needs (p < 0.001). Key disparities included food/housing insecurity, affordability of educational resources, and access to visiting student learning opportunities. There were no significant differences in resilience (p = 0.656), social isolation (p = 0.656), basic needs (p = 0.07), or perception of institutional support, (p = 0.651) based on year of training. The findings highlight FG students' financial strain, disconnection from peers, and desire for targeted support. Institutional scholarships received by 47% of FG and 53% of CG students (χ2 = 8.4e-31, p = 1.0) mitigated but did not eliminate these disparities.
Our data reveal substantial, ongoing challenges faced by FG medical students and support the previous findings identified by Havemann et al. We suggest that by enhancing healthcare access, grants for educational expenses, subsidized study materials, and fostering peer networks, medical schools can proactively address these gaps in medical student success to build a physician workforce equipped to serve all patients and communities.
第一代医学生面临着重大挑战，这些挑战可能会阻碍他们的学业成就和幸福感。我们的研究旨在量化第一代医学生和连续代医学生在四个领域的差异，包括：复原力、社会孤立感、未满足的基本需求以及对机构支持的认知。
对盖辛格联邦医学院的所有四个班级的医学生进行了一项匿名调查。学生们有四周时间完成这项自愿的、包含30个问题的调查，其中包括29个封闭式问题和1个开放式问题，以评估每个领域的挑战。调查数据在Qualtrics中收集，并使用R Epi for R 4.4.1 GUI 1.80 Big Sur Intel build (8416)进行分析。主要分析使用学生t检验来评估不同群体之间的均值差异，次要分析使用单因素方差分析来校正不同年级学生态度之间的混杂因素。第一代医学生的定义是父母双方均无四年制大学学位。72名学生做出了回应，62份完整的调查问卷被纳入分析。
在62名受访者（15名第一代医学生，47名连续代医学生）中，第一代医学生的身份预示着更强的复原力（p = 0.01）、社会孤立感（p = 0.005）和未满足的基本需求（p < 0.001）。关键差异包括食品/住房不安全、教育资源的可承受性以及获得访问学生学习机会的情况。根据培训年份，在复原力（p = 0.656）、社会孤立感（p = 0.656）、基本需求（p = 0.07）或对机构支持的认知（p = 0.651）方面没有显著差异。研究结果凸显了第一代医学生的经济压力、与同龄人脱节以及对针对性支持的渴望。47%的第一代医学生和53%的连续代医学生获得了机构奖学金（χ2 = 8.4e - 31，p = 1.0），这减轻了但并未消除这些差异。
我们的数据揭示了第一代医学生面临的重大且持续存在的挑战，并支持了哈弗曼等人之前的研究发现。我们建议，通过增加医疗服务可及性、提供教育费用助学金、补贴学习材料以及建立同伴网络，医学院校可以积极解决医学生学业成就方面的这些差距，以打造一支有能力为所有患者和社区服务的医生队伍。
