Diversity in medicine: how do underrepresented minority medical students select their specialty? A cross-sectional survey study - PubMed (original) (raw)

Diversity in medicine: how do underrepresented minority medical students select their specialty? A cross-sectional survey study

Autumn L Saizan et al. BMC Med Educ. 2025.

Abstract

Background: As the diversity of the U.S. population increases, it is important to reflect this racial/ethnic diversity across all specialties in medicine. The primary objective of this study was to identify factors influencing specialty decision-making amongst underrepresented in medicine (URM) medical students. The secondary objectives were to identify biases and stressors experienced by URM medical students and to understand perceived support in specialty decision-making.

Methods: In this cross-sectional survey study, a 55-item questionnaire was distributed electronically to the national and local email lists for the Student National Medical Association (SNMA) and Latino Medical Student Association (LMSA). Eligibility criteria included U.S. medical students self-identifying as URM.

Results: Among the 257 respondents, the top five desired specialties were obstetrics and gynecology (11.7%), emergency medicine (10.1%), pediatrics (9.3%), internal medicine (8.2%), and orthopedics (6.6%). When stratified by gender and race/ethnicity, differences were observed in desired specialties among Hispanic and Black males and females. The top three characteristics with a major or significant influence on specialty choice included the nature of patient care (94.1%), patient population (78.6%), and working hours/lifestyle (70.4%). Over half of respondents (55.9%) reported that mentorship within their chosen specialty had a significant or major influence on their specialty choice. Additionally, the majority (69.9%) agreed or strongly agreed that racial/ethnic concordant mentorship was likely to influence their specialty decision.

Conclusions: Larger and specialty-focused studies, particularly for the least diverse specialties in medicine, are needed to characterize the facilitators and barriers that influence URM students in their specialty choice. Ultimately, these efforts may help reduce barriers to matriculation of URMs in their desired specialty and also foster a more representative physician workforce, and in the long-term, advance health outcomes for diverse patient populations.

Keywords: Career choice; Diversity; Medical student; Underrepresented in medicine.

© 2025. The Author(s).

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was determined exempt by the University of Southern California (USC) Institutional Review Board. IRB #UP-20-01249. All participants were informed of the research study, confidentiality of the data, and minimal risk associated with participation. Participants were informed that the survey was voluntary, anonymous, with no responses linked to any identifiable information. Written informed consent documents were not required according to the USC IRB guidelines for determination of exemption. The study was conducted in accordance with institutional guidelines, and the principles of the Belmont Report were followed. Consent for publication: Not applicable. Competing interests: Dr. Elbuluk has served as a consultant, advisory board member, and/or speaker for Avita, Incyte, VisualDx, Beiersdorf, Unilever, Eli Lilly, Galderma, Pfizer, La Roche Posay, L’Oreal, McGraw Hill, Dior, Medscape, Abbvie, Takeda, Sanofi, Janssen, Canfield. She has received royalties from McGraw-Hill. She has stock options in VisualDx. The remaining authors have no disclosures to report.

Figures

Fig. 1

Fig. 1

Desired specialty choice amongst URM medical students (_n_=257)

Fig. 2

Fig. 2

Specialty characteristics and academic background factors with “significant or major” influence in medical student specialty choice (_n_=257)

Fig. 3

Fig. 3

Specialty characteristics and academic background factors with “none to moderate” influence in medical student specialty choice (_n_=257)

References

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