The relationships among self-designated disadvantage, socioeconomic disadvantage, and academic performance in medical school: A multi-institutional study

Mark C. Henderson, Anthony Jerant, Jonathan Unkart, Erin J. Griffin, Andres F Sciolla, Carolyn J. Kelly, Ellena M. Peterson, Theodore Hall, David Wofsy, Tonya L. Fancher

Research output: Contribution to journalArticlepeer-review

Abstract

As medical schools seek to address the growing disparity between the socioeconomic makeup of their students and the general population, it is important to understand the academic trajectory of disadvantaged students. We used a locally-developed multicomponent socioeconomic disadvantage (SED) measure and the self-designated disadvantaged (SDA) question [“yes” (+) or “no” (–)] from the American Medical College Application Service application to examine academic performance of students from three disadvantaged categories (high SED/SDA+, high SED/SDA–, and low SED/SDA+); with low SED/SDA– as the reference group across five California schools. Compared with reference, the DA+ subgroups scored lower on USMLE Step 1 and Step 2 Clinical Knowledge examinations and received fewer clerkship Honors. After adjustment for academic metrics and sociodemographic variables, high SED subgroups performed similarly to reference, but performance gaps for low SED/SDA+ students persisted. Medical schools must better understand the institutional and other drivers of academic success in disadvantaged students.

Original languageEnglish (US)
Pages (from-to)208-222
Number of pages15
JournalJournal of Health Care for the Poor and Underserved
Volume31
Issue number4
StatePublished - Nov 2020

Keywords

  • Health disparities
  • Medical licensing examinations
  • Medical school academic performance
  • Physician workforce diversity
  • Self-designated disadvantage
  • Socioeconomic disadvantage

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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