Friendly reminder that over 1/2 of medical student’s parents make at or above 80% of American income bracket.

1 in 4 med student’s parents are >95%ile for income. (>225,000 annually)

Only 5% of med student’s parents make the lowest income quintile.

I can’t tell you how many ways this matters. Medicine selects for wealthy people because of the barriers needed to even get to apply.

Imagine taking the McAT amid covid, having to reschedule 4-5x. That’s what applicants did last year.

Quite literally: half med parents = rich

And there are so, so, so many expenses.

USMLE, moving, books, laptop, food.
Exam fees, cost of living, car, parking, insurance.

Even now: many MS4 colleagues rely on spouse or parent to help with costs of moving for residency, onboarding, etc.

Especially amid covid these costs have only risen. I spent a lot of time in the library in MS1/2. That’s not an option now amid covid.

Main point: the lack of economic diversity in medicine is basically atrocious. And it has been the same for over a decade.

Source: https://www.aamc.org/media/9596/download

This has been tweeted so many times. But i believe it is a paper that warrants discussion until change is made.

Last year the @AAMCtoday bragged about the massive number of medical school applications per place. I couldn’t help but think about WHO was applying and the privilege that they had in doing so. And who couldn’t afford to apply. And how much the MCAT cost both emotionally & price.

Final final thing: the “American dream” or whatever people say happens is very difficult for achieve in medicine.

This is parental post secondary education.

Notice: 93% of those in the top 5% parents are in a “executive” role. Think about this.

Think about who we select.

So while this is slightly exaggerating the data, 93% of the top 5% of income in med student parents are executives.

This means approximately 1 in 4 med students legitimately have parents making >225,000 per year AND are executives or managers.

Important to note a ton of caveats:
1) many are not close with nor financially related to their parents but are still forced to put their income.

2) this is just one marker of assets.

3) Some students - like myself - have spouses that help & assist.

Oh final note: this is also why I get so annoyed when people expect medical students to pay for conferences. Like just say you only want rich students to attend. Or consider who WILL NOT attend.

now consider how less than 4% of med students are from rural places and how only n=97 BIPOC + rural students were accepted into med school in 2017 in this country. Then you will realize why I continue to tweet.

Medicine = rich city students wanting to stay in cities

This will make some people uncomfortable and I know some people do not consider 225,000 to be “wealthy”, which I was told last time I tweeted this

OTHER CAVEAT: this is for US MD schools!!! Very important because DO schools are slightly better in terms of economic & rural

please read this VERY short abstract showing how in a sample of 564 medical students, 22% had physician parents. In this sampling, having a physician parent was NEGATIVELY associated with going into primary care or working w underserved.

https://www.mededpublish.org/manuscripts/1434

While more studies are needed, we do know that rural students are more likely to work in rural areas as physicians.

We also know those from low SES are more likely to go into primary care and/or work in underserved areas.

Yet. We. Select. Against. These. Applicants.

Just popping back in to say that @AAMCtoday released a new report of data showing education debt. Wouldn’t you know it, half of those in top 5% graduating debt free while only 10% of those in lowest quintile of parental income graduating debt free.

Link: https://store.aamc.org/physician-education-debt-and-the-cost-to-attend-medical-school-2020-update.html

Based on AAMC self-reported Grad questionnaire, 91% of Black students vs 75% of white students grad w debt. Black med grads have highest median debt: $230,000.

Look at parental income column and indebtedness. This is self-reported.

Link: https://store.aamc.org/physician-education-debt-and-the-cost-to-attend-medical-school-2020-update.html

So what do we do about this:
1) Increase financial need-based scholarships, by a ton.

2) Ask if med school looks like patients we serve both in appearance and geography. (We need more rural MD students. It’s a travesty.)

3) reduce the barriers to mcat. Hint @AAMCtoday

Finally: please for the love of God stop upholding the biased trope that Black & Brown medical students are there on scholarship and therefore going for free or whatever other racist things are implied.

The facts show Black med students have more median debt than anyone.