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Cited by 31Medical Education and AdmissionsDiversity and Career in MedicineCareer Development and Diversity

Factors and barriers that influence the matriculation of underrepresented students in medicine

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Tello, Cynthia, Goode, Christine A.·2023·Frontiers in Psychology
DOI 10.3389/fpsyg.2023.1141045PMC PMC10247986
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Abstract

Despite many initiatives over more than 4 decades, the diversity of United States physicians still does not reflect the diversity of the United States population. The present study undertakes a literature review of the last 30 years to investigate barriers and protective factors underrepresented college students encounter as applicants for medical school. Known barriers that influence matriculation into medical school were analyzed such as academic metrics and test scores. Additionally, elements that are less well studied were investigated such as factors perceived as barriers by underrepresented applicants in addition to protective factors that allow them to persist in their journey in the face of difficulties and adversity.

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Crossref · 10.3389/fpsyg.2023.1141045

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  • Ethnoracial concordance between physicians and their patients improves patient compliance, trust, communication, and health outcomes.

    “Furthermore, ethnoracial concordance between physicians and their patients has been shown to improve patient compliance, trust, communication, and health outcomes [1,2].”

    From Efficacy of Early Exposure Medical Programs for Underrepresented Students: A Systematic Review (2026) · cites this paper as [1]

    The Introduction states that patients are more likely to follow medications and health directives when their provider's race and experiences match their own, leading to improved health outcomes. It does not state that concordance improves trust or communication; those outcomes are not established by the cited paper's text. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Financial barriers, including the high cost of medical school, undergraduate debt for first-generation college students, and inability to pay for test-preparation materials and application fees, disproportionately affect URiM students.

    “Financial barriers are also a factor; the high cost of medical school, undergraduate debt for first-generation college students, and the inability to pay for test-preparation materials and application fees disproportionately affect URiM students [1].”

    From Efficacy of Early Exposure Medical Programs for Underrepresented Students: A Systematic Review (2026) · cites this paper as [1]

    The Introduction says medical-school costs disproportionately affect lower-income applicants who may already have undergraduate debt. Results > Included studies says URiM applicants may be unable to pay for MCAT preparation or the exam itself. The paper does not specifically link undergraduate debt to first-generation students or identify application fees as a barrier. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Medical school applicants from URiM groups do not fully reflect population diversity.

    “Although there is strong evidence of minority representation in medicine, medical school applicants from URiM groups do not fully reflect population diversity [1].”

    From Efficacy of Early Exposure Medical Programs for Underrepresented Students: A Systematic Review (2026) · cites this paper as [1]

    The Introduction (page not provided) says URiM representation in medical school classes has not kept pace with changes in population distribution and that growth in Black applicants has lagged behind other groups. It does not directly compare the diversity of the applicant pool with population diversity; its population comparison concerns enrolled classes. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Underrepresented students are lost at various stages on the path to a medical career, described as a "leaky pipeline."

    “This phenomenon has been described as a “leaky pipeline,” in which underrepresented students are lost at various stages on the path to a medical career [1].”

    From Efficacy of Early Exposure Medical Programs for Underrepresented Students: A Systematic Review (2026) · cites this paper as [1]

  • Persistent academic gaps, often stemming from under-resourced K-12 education, and reliance on standardized metrics such as the MCAT and GPA contribute to leaks in the pipeline for URiM students.

    “These leaks have been linked to intersectional barriers, including persistent academic gaps (often stemming from under-resourced K-12 education) and reliance on standardized metrics such as the Medical College Admissions Test (MCAT) and grade point average (GPA), where score gaps persist due to a lack of academic resources.”

    From Efficacy of Early Exposure Medical Programs for Underrepresented Students: A Systematic Review (2026) · cites this paper as [1]

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Cited by

Sorted by citations

Authors
Tello, C., & Goode, C. A.
Affiliations
  • American University of the Caribbean School of Medicine (SX)
  • Western University of Health Sciences (US)
Corresponding author
Goode, Christine A.
Venue
Frontiers in Psychology
Publisher
Frontiers Media SA
Published
2023-05-25
Volume
14
Pages
1141045-1141045
ISSN
1664-1078 (ISSN-L)
DOI
10.3389/fpsyg.2023.1141045
PMC
PMC10247986
OpenAlex
W4378232562
Cited by
31
References
10
Citations by year
2026: 9 · 2025: 12 · 2024: 9 · 2023: 1
FWCI
1.41
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Medical Education and Admissions
  • Social Sciences › Gender Studies › Diversity and Career in Medicine
  • Social Sciences › Safety Research › Career Development and Diversity
Keywords
underrepresented students, medical school matriculation, medical school applicants, barriers to medical education, protective factors, academic metrics, test scores, physician workforce diversity, adversity

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