CoChat
Sign Up
Cited by 28Diversity and Career in MedicineInnovations in Medical EducationCareer Development and Diversity

The DOI matches its Crossref record; 2 of the 2 references it cites were found in a registry or an index.

The impact of underrepresented minority or marginalized identity status on training outcomes of MD-PhD students

Open access
Torres Acosta, Manuel A., Chandra, Sidhanth, Li, Sophia, Yoon, Esther, Selgrade, Daniel, Quinn, Jeanne, Ardehali, Hossein·2023·BMC Medical Education
DOI 10.1186/s12909-023-04399-7PMC PMC10251672
Open this paper in CoChat — free accountOpen PDF

Abstract

Dual-degree MD-PhD programs have historically lacked diversity of race, ethnicity, gender, sexual orientation, and other facets of identity. Like MD- and PhD-granting programs, MD-PhD program training environments are also marked by structural barriers that negatively impact measurable academic outcomes of underrepresented and/or marginalized students in academic medicine (racial and ethnic minority groups considered underrepresented by the National Institute of Health, sexual and gender minorities, individuals with disabilities, and individuals of low socioeconomic status). In this article, we review the existing literature on MD-PhD program disparities affecting students from these groups and provide recommendations grounded on the reviewed evidence. Our literature review identified four generalizable barriers that can impact the training outcomes of students from these marginalized and/or underrepresented groups: 1) discrimination and bias, 2) impostor syndrome and stereotype threat, 3) lack of identity-similar mentors, and 4) suboptimal institutional policies and procedures. We propose goal-oriented interventions that may begin to ameliorate the disparities present in MD-PhD program training environments that affect students from marginalized and/or underrepresented groups in academic medicine.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1186/s12909-023-04399-7

Cites

2 of 2 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Barriers that hinder training success for underrepresented students include limited access to mentors with similar identities, insufficient institutional policies involving maternity leave or protected disabilities, stereotype threat, imposter syndrome, and experiences of bias and discrimination.

    “Barriers that hinder training success for underrepresented students include limited access to mentors with similar identities, insufficient institutional policies involving maternity leave or protected disabilities, stereotype threat (fear of confirming negative stereotypes about their group), imposter syndrome, and experiences of bias and discrimination [33].”

    From Efficacy of Early Exposure Medical Programs for Underrepresented Students: A Systematic Review (2026) · cites this paper as [33]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Flagged first, then by citations

Research works printed but not linked: 79

  1. Feldman AM. The National Institutes of Health Physician-Scientist Workforce Working Group report: a roadmap for preserving the physician-scientist. Clin Transl Sci. 2014;7(4):289–90. · DOI
  2. Alsan M, Garrick O, Graziani G. Does Diversity Matter for Health? Experimental Evidence from Oakland. American Economic Review. 2019;109(12):4071–111. · DOI · Paper page
  3. Garcia AN, Kuo T, Arangua L, Perez-Stable EJ. Factors Associated With Medical School Graduates’ Intention to Work With Underserved Populations: Policy Implications for Advancing Workforce Diversity. Acad Med. 2018;93(1):82–9. · DOI
  4. Bailey JA, Willies-Jacobo LJ. Are disadvantaged and underrepresented minority applicants more likely to apply to the program in medical education-health equity? Acad Med. 2012;87(11):1535–9. · DOI
  5. Freeman RB, Huang W. Collaborating with people like me: ethnic co-authorship within the US. NBER Working Paper No. 19905. 2014. · DOI
  6. Campbell LG, Mehtani S, Dozier ME, Rinehart J. Gender-heterogeneous working groups produce higher quality science. PLoS ONE. 2013;8(10):e79147. · DOI
  7. Page SE. The diversity bonus: how great teams pay off in the knowledge economy. Princeton: Princeton University Press; 2017. · DOI
  8. Green M, Wayne DB, Neilson EG. Medical Education 2020-Charting a Path Forward. JAMA. 2019;322(10):934–5. · DOI
  9. Jeffe DB, Andriole DA, Wathington HD, Tai RH. Educational outcomes for students enrolled in MD-PhD programs at medical school matriculation, 1995–2000: a national cohort study. Acad Med. 2014;89(1):84–93. · DOI
  10. Blish CA. Maintaining a Robust Pipeline of Future Physician-Scientists. J Infect Dis. 2018;218(suppl_1):S40-S43. · DOI
  11. Harding CV, Akabas MH, Andersen OS. History and Outcomes of 50 Years of Physician-Scientist Training in Medical Scientist Training Programs. Acad Med. 2017;92(10):1390–8. · DOI
  12. Rodriguez JE, Lopez IA, Campbell KM, Dutton M. The Role of Historically Black College and University Medical Schools in Academic Medicine. J Health Care Poor Underserved. 2017;28(1):266–78. · DOI
  13. Akabas MH, Brass LF. The national MD-PhD program outcomes study: outcomes variation by sex, race, and ethnicity. JCI Insight. 2019;4(19):e133009. · DOI
  14. Brass LF. Is an MD/PhD program right for me? Advice on becoming a physician-scientist. Mol Biol Cell. 2018;29(8):881–5. · DOI
  15. Young SN, VanWye WR, Schafer MA, Robertson TA, Poore AV. Factors Affecting PhD Student Success. Int J Exerc Sci. 2019;12(1):34–45. · DOI
  16. Chakraverty D, Jeffe DB, Dabney KP, Tai RH. Exploring Reasons That U.S. Md-Phd Students Enter and Leave Their Dual-Degree Programs. Int J Dr Stud. 2020;15:461–483. · DOI
  17. Rubright JD, Jodoin M, Barone MA. Examining Demographics, Prior Academic Performance, and United States Medical Licensing Examination Scores. Acad Med. 2019;94(3):364–70. · DOI
  18. Roksa J, Wang Y, Feldon D, Ericson M. Who is publishing journal articles during graduate school? Racial and gender inequalities in biological sciences over time. Journal of Diversity in Higher Education. 2022;15(1):47–57. · DOI
  19. Przedworski JM, Dovidio JF, Hardeman RR, Phelan SM, Burke SE, Ruben MA, Perry SP, Burgess DJ, Nelson DB, Yeazel MW, et al. A Comparison of the Mental Health and Well-Being of Sexual Minority and Heterosexual First-Year Medical Students: A Report From the Medical Student CHANGE Study. Acad Med. 2015;90(5):652–9. · DOI
  20. Mansh M, White W, Gee-Tong L, Lunn MR, Obedin-Maliver J, Stewart L, Goldsmith E, Brenman S, Tran E, Wells M, et al. Sexual and gender minority identity disclosure during undergraduate medical education: “in the closet” in medical school. Acad Med. 2015;90(5):634–44. · DOI
  21. Madrigal J, Rudasill S, Tran Z, Bergman J, Benharash P. Sexual and gender minority identity in undergraduate medical education: Impact on experience and career trajectory. PLoS ONE. 2021;16(11): e0260387. · DOI
  22. Teherani A, Papadakis MA. Clinical performance of medical students with protected disabilities. JAMA. 2013;310(21):2309–11. · DOI
  23. Meeks LM, Herzer KR. Prevalence of Self-disclosed Disability Among Medical Students in US Allopathic Medical Schools. JAMA. 2016;316(21):2271–2. · DOI
  24. Perry SP, Hardeman R, Burke SE, Cunningham B, Burgess DJ, van Ryn M. The Impact of Everyday Discrimination and Racial Identity Centrality on African American Medical Student Well-Being: a Report from the Medical Student CHANGE Study. J Racial Ethn Health Disparities. 2016;3(3):519–26. · DOI
  25. Siebert AL, Chou S, Toubat O, Adami AJ, Kim H, Daye D, Kwan JM. Factors associated with underrepresented minority physician scientist trainee career choices. BMC Med Educ. 2020;20(1):422. · DOI
  26. Hill KA, Samuels EA, Gross CP, Desai MM, Sitkin Zelin N, Latimore D, Huot SJ, Cramer LD, Wong AH, Boatright D. Assessment of the Prevalence of Medical Student Mistreatment by Sex, Race/Ethnicity, and Sexual Orientation. JAMA Intern Med. 2020;180(5):653–65. · DOI
  27. Teshome BG, Desai MM, Gross CP, Hill KA, Li F, Samuels EA, Wong AH, Xu Y, Boatright DH. Marginalized identities, mistreatment, discrimination, and burnout among US medical students: cross sectional survey and retrospective cohort study. BMJ. 2022;376: e065984. · DOI
  28. Rodriguez SL, Perez RJ, Schulz JM. How STEM lab settings influence graduate school socialization and climate for students of color. J Diversity Higher Educ. 2022;15(1):58–72. · DOI
  29. Alexander QR, Hermann MA. African-American women’s experiences in graduate science, technology, engineering, and mathematics education at a predominantly white university: A qualitative investigation. J Diversity Higher Educ. 2016;9(4):307–22. · DOI
  30. Boatright D, Ross D, O’Connor P, Moore E, Nunez-Smith M. Racial Disparities in Medical Student Membership in the Alpha Omega Alpha Honor Society. JAMA Intern Med. 2017;177(5):659–65. · DOI
  31. Lapinski J, Sexton P. Still in the closet: the invisible minority in medical education. BMC Med Educ. 2014;14:171. · DOI
  32. Chester SD, Ehrenfeld JM, Eckstrand KL. Results of an Institutional LGBT Climate Survey at an Academic Medical Center. LGBT Health. 2014;1(4):327–30. · DOI
  33. Dimant OE, Cook TE, Greene RE, Radix AE. Experiences of Transgender and Gender Nonbinary Medical Students and Physicians. Transgend Health. 2019;4(1):209–16. · DOI
  34. Goldberg AE, Kuvalanka K. dickey l: Transgender graduate students’ experiences in higher education: A mixed-methods exploratory study. J Diversity Higher Educ. 2019;12(1):38–51. · DOI
  35. Nama N, MacPherson P, Sampson M, McMillan HJ. Medical students’ perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study. Med Educ Online. 2017;22(1):1368850. · DOI
  36. Stratton TD, McLaughlin MAW, Florence M, Fosson SE, Nora LM. Does Students’ Exposure to Gender Discrimination and Sexual Harassment in Medical School Affect Specialty Choice and Residency Program Selection? Acad Med. 2005;80(4):400–8. · DOI
  37. DeCastro R, Sambuco D, Ubel PA, Stewart A, Jagsi R. Mentor networks in academic medicine: moving beyond a dyadic conception of mentoring for junior faculty researchers. Acad Med. 2013;88(4):488–96. · DOI
  38. Carapinha R, Ortiz-Walters R, McCracken CM, Hill EV, Reede JY. Variability in Women Faculty’s Preferences Regarding Mentor Similarity: A Multi-Institution Study in Academic Medicine. Acad Med. 2016;91(8):1108–18. · DOI · Paper page
  39. Williams SN, Thakore BK, McGee R. Career Coaches as a Source of Vicarious Learning for Racial and Ethnic Minority PhD Students in the Biomedical Sciences: A Qualitative Study. PLoS ONE. 2016;11(7): e0160038. · DOI
  40. Santa-Ramirez S. Sink or swim: The mentoring experiences of Latinx PhD students with faculty of color. J Diversity Higher Educ. 2022;15(1):124–34. · DOI
  41. Odei BC, Jagsi R, Diaz DA, Addison D, Arnett A, Odei JB, Mitchell D. Evaluation of Equitable Racial and Ethnic Representation Among Departmental Chairs in Academic Medicine, 1980–2019. JAMA Netw Open. 2021;4(5): e2110726. · DOI
  42. Bennett CL, Ling AY. Proportions of Faculty Self-identifying as Black or African American at US Medical Schools, 1990–2020. JAMA. 2021;326(7):671–2. · DOI
  43. Beech BM, Calles-Escandon J, Hairston KG, Langdon SE, Latham-Sadler BA, Bell RA. Mentoring programs for underrepresented minority faculty in academic medical centers: a systematic review of the literature. Acad Med. 2013;88(4):541–9. · DOI
  44. Lehmann LS, Sulmasy LS, Desai S, Acp Ethics P, Human Rights C. Hidden Curricula, Ethics, and Professionalism: Optimizing Clinical Learning Environments in Becoming and Being a Physician: A Position Paper of the American College of Physicians. Ann Intern Med. 2018;168(7):506–8. · DOI
  45. Gabel R: The Hidden Curriculum: First Generation Students at Legacy Universities: Princeton University Press; 2021. · DOI
  46. Morgan AC, LaBerge N, Larremore DB, Galesic M, Brand JE, Clauset A. Socioeconomic roots of academic faculty. Nat Hum Behav. 2022;6(12):1625–33. · DOI
  47. Romero R, Miotto K, Casillas A, Sanford J. Understanding the Experiences of First-Generation Medical Students: Implications for a Diverse Physician Workforce. Acad Psychiatry. 2020;44(4):467–70. · DOI
  48. Sanchez JP, Peters L, Lee-Rey E, Strelnick H, Garrison G, Zhang K, Spencer D, Ortega G, Yehia B, Berlin A, et al. Racial and ethnic minority medical students’ perceptions of and interest in careers in academic medicine. Acad Med. 2013;88(9):1299–307. · DOI
  49. Rosenthal S, Schlussel Y, Yaden MB, DeSantis J, Trayes K, Pohl C, Hojat M. Persistent Impostor Phenomenon Is Associated With Distress in Medical Students. Fam Med. 2021;53(2):118–22. · DOI
  50. Ackerman-Barger K, Valderama-Wallace C, Latimore D, Drake C. Stereotype Threat Susceptibility Among Minority Health Professions Students. J Best Pract Health Prof Diversity. 2016;9(2):1232–46.
  51. Wyatt TR, Rockich-Winston N, Taylor TR, White D. What Does Context Have to Do With Anything? A Study of Professional Identity Formation in Physician-Trainees Considered Underrepresented in Medicine. Acad Med. 2020;95(10):1587–93. · DOI
  52. Sharpe EE, Ku C, Malinzak EB, Kraus MB, Chandrabose R, Hartlage SEH, Hanson AC, Schulte PJ, Pearson ACS. A cross-sectional survey study of United States residency program directors’ perceptions of parental leave and pregnancy among anesthesiology trainees. Can J Anaesth. 2021;68(10):1485–96. · DOI
  53. Powell K. Babies on board - Why US scientist-mums need support in the early years of parenthood. Nature. 2019;569:149–51. · DOI
  54. Zazove P, Case B, Moreland C, Plegue MA, Hoekstra A, Ouellette A, Sen A, Fetters MDUS. Medical Schools’ Compliance With the Americans With Disabilities Act: Findings From a National Study. Acad Med. 2016;91(7):979–86. · DOI
  55. Osseo-Asare A, Balasuriya L, Huot SJ, Keene D, Berg D, Nunez-Smith M, Genao I, Latimore D, Boatright D. Minority Resident Physicians’ Views on the Role of Race/Ethnicity in Their Training Experiences in the Workplace. JAMA Netw Open. 2018;1(5):e182723. · DOI
  56. Mahoney MR, Wilson E, Odom KL, Flowers L, Adler SR. Minority faculty voices on diversity in academic medicine: perspectives from one school. Acad Med. 2008;83(8):781–6. · DOI · Paper page
  57. Wilson MA, DePass A, Bean AJ. Institutional Interventions That Remove Barriers to Recruit and Retain Diverse Biomedical PhD Students. CBE Life Sci Educ. 2018;17(2):ar27. · DOI
  58. Dickins K, Levinson D, Smith SG, Humphrey HJ. The minority student voice at one medical school: lessons for all? Acad Med. 2013;88(1):73–9. · DOI
  59. Perez RJ, Motshubi R, Rodriguez SL. “We are a huge source of labor”: Exploring STEM Graduate Students’ Roles in Changing Departmental Climate. Rev Higher Educ. 2022;46(1):33–66. · DOI
  60. Nakae S, Martinez S, Juarez JJ, Beltran Sanchez C. The Impacts of Engagement in the Latino Medical Student Association. Health Equity. 2023;7(1):109–15. · DOI
  61. McGaghie WC, Cohen ER, Wayne DB. Are United States Medical Licensing Exam Step 1 and 2 scores valid measures for postgraduate medical residency selection decisions? Acad Med. 2011;86(1):48–52. · DOI
  62. Lantz MM, Fix RL, Davis BL, Harrison LN, Oliver A, Crowell C, Mitchell AM, García JJ. Grad students talk: Development and process of a student-led social justice initiative. J Diversity Higher Educ. 2016;9(3):290–306. · DOI
  63. Chu W, Hart MJ, Kirchner KN, Paton MJ, Black CJ. Addressing race and diversity in graduate education: Practices from student activism. J Diversity Higher Educ. 2022;15(1):7–11. · DOI
  64. Hung R, McClendon J, Henderson A, Evans Y, Colquitt R, Saha S. Student perspectives on diversity and the cultural climate at a U.S. medical school. Acad Med. 2007;82(2):184-192. · DOI
  65. Baumann N, Faulk C, Vanderlan J, Chen J, Bhayani RK. Small-Group Discussion Sessions on Imposter Syndrome. MedEdPORTAL. 2020;16:11004. · DOI
  66. Rivera N, Feldman EA, Augustin DA, Caceres W, Gans HA, Blankenburg R. Do I Belong Here? Confronting Imposter Syndrome at an Individual, Peer, and Institutional Level in Health Professionals. MedEdPORTAL. 2021;17:11166. · DOI
  67. Callahan EJ, Banks M, Medina J, Disbrow K, Soto-Greene M, Sanchez JP. Providing Diverse Trainees an Early and Transparent Introduction to Academic Appointment and Promotion Processes. MedEdPORTAL. 2017;13:10661. · DOI
  68. Mason BS, Landry A, Sanchez JP, Williams VN. How to Find an Academic Position After Residency: Who, What, When, Where, Why, and How. MedEdPORTAL. 2018;14:10727. · DOI
  69. Dickerman J, Sanchez JP, Portela-Martinez M, Roldan E. Leadership and Academic Medicine: Preparing Medical Students and Residents to Be Effective Leaders for the 21st Century. MedEdPORTAL. 2018;14:10677. · DOI
  70. Ortega G, Smith C, Pichardo MS, Ramirez A, Soto-Greene M, Sanchez JP. Preparing for an Academic Career: The Significance of Mentoring. MedEdPORTAL. 2018;14:10690. · DOI
  71. Christou H, Dookeran N, Haas A, Di Frances C, Emans SJ, Milstein ME, Kram KE, Seely EW. Establishing Effective Mentoring Networks: Rationale and Strategies. MedEdPORTAL. 2017;13:10571. · DOI
  72. Lucas R, Kothari P, Adams C, 3rd, Jones L, Williams VN, Sanchez JP. We are All Leaders: Introducing Self-Leadership Concepts Through the Lens of Improving Diversity in the Health Care Workforce. MedEdPORTAL. 2020;16:11011. · DOI
  73. Sotto-Santiago S, Mac J, Duncan F, Smith J. "I Didn't Know What to Say": Responding to Racism, Discrimination, and Microaggressions With the OWTFD Approach. MedEdPORTAL. 2020;16:10971. · DOI
  74. Acholonu RG, Cook TE, Roswell RO, Greene RE. Interrupting Microaggressions in Health Care Settings: A Guide for Teaching Medical Students. MedEdPORTAL. 2020;16:10969. · DOI
  75. Ackerman-Barger K, Jacobs NN, Orozco R, London M. Addressing Microaggressions in Academic Health: A Workshop for Inclusive Excellence. MedEdPORTAL. 2021;17:11103. · DOI
  76. Gacita A, Gargus E, Uchida T, Garcia P, Macken M, Seul L, Brucker J, Wayne DB. Introduction to Safe Space Training: Interactive Module for Promoting a Safe Space Learning Environment for LGBT Medical Students. MedEdPORTAL. 2017;13:10597. · DOI
  77. Tsouroufli M, Rees CE, Monrouxe LV, Sundaram V. Gender, identities and intersectionality in medical education research. Med Educ. 2011;45(3):213–6. · DOI
  78. Lett E, Dowshen NL, Baker KE. Intersectionality and Health Inequities for Gender Minority Blacks in the U.S. Am J Prev Med. 2020;59(5):639-647. · DOI
  79. Sotto-Santiago S. Time to Reconsider the Word Minority in Academic Medicine. J Best Pract Health Prof Diversity. 2019;12(1):72–8.

Cited by

Sorted by citations

Metadata

Authors
Torres Acosta, M. A., Chandra, S., Li, S., Yoon, E., Selgrade, D., Quinn, J., & Ardehali, H.
Affiliations
Northwestern University (US)
Corresponding author
Ardehali, Hossein
ORCID
Venue
BMC Medical Education
Publisher
Springer Science and Business Media LLC
Published
2023-06-08
Volume
23
Issue
1
Pages
428-428
ISSN
1472-6920 (ISSN-L)
DOI
10.1186/s12909-023-04399-7
PMC
PMC10251672
OpenAlex
W4379880336
Cited by
28
References
2
Citations by year
2026: 4 · 2025: 17 · 2024: 6 · 2023: 1
FWCI
1.83
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Medical Education (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Association of American Medical Colleges
  • National Institutes of Health
  • National Institute on Aging (F30AG079577)
  • National Heart, Lung, and Blood Institute (F31HL162490)
  • National Institute of General Medical Sciences (T32GM142604)
Topics
  • Social Sciences › Gender Studies › Diversity and Career in Medicine
  • Social Sciences › Education › Innovations in Medical Education
  • Social Sciences › Psychology › Applied Psychology › Career Development and Diversity
Keywords
MD-PhD programs, underrepresented minorities, marginalized students, diversity in medical education, training outcomes, impostor syndrome, stereotype threat, mentoring, institutional policy, structural barriers, sexual and gender minorities, low socioeconomic status, academic medicine
MeSH terms
Ethnicity, Female, Humans, Male, Medicine, Mentors, Minority Groups, Students, Biomedical Research

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review