Association of Sociodemographic Characteristics With US Medical Student Attrition

This is a rather stupid academic article -- stupid for political correctness purposes, most probably. It is from JAMA, a top medical journal.

Its most surprising finding is that the dropout rate from medical school is not surprisingly high among blacks. Given their dismal performance in the rest of the educational system, one would expect blacks to show a high dropout rate from medical school. About a third of them drop out from High School. So what is going on?

Perhaps unfortunately for the authors, I used to teach research methods and statistics at a major university so I can see where the bodies are buried in their highly technical article

At the outset of the analysis, the data were "adjusted" to remove the influence of the test used to admit students in the first place -- undoubtedly a type of specialized IQ test. So the findings do NOT reflect the raw dropout among blacks: Only the dropout rate that would have occured if the black and white students had been of equal IQ.

But because there is a great push to get blacks into high-quality positions, blacks would have been accepted into medical school on the basis of much lower qualifications. So the "adjustments" greatly distorted what actually happened. The findings reported were highly theoretical rather than real

The dishonesty about race is pervasive. Is dishonesty ever beneficial in the long run?

Mytien Nguyen et al.


Importance Diversity in the medical workforce is critical to improve health care access and achieve equity for resource-limited communities. Despite increased efforts to recruit diverse medical trainees, there remains a large chasm between the racial and ethnic and socioeconomic composition of the patient population and that of the physician workforce.

Objective To analyze student attrition from medical school by sociodemographic identities.

Design, Setting, and Participants This retrospective cohort study included allopathic doctor of medicine (MD)–only US medical school matriculants in academic years 2014-2015 and 2015-2016. The analysis was performed from July to September 2021.

Main Outcomes and Measures The main outcome was attrition, defined as withdrawal or dismissal from medical school for any reason. Attrition rate was explored across 3 self-reported marginalized identities: underrepresented in medicine (URiM) race and ethnicity, low income, and underresourced neighborhood status. Logistic regression was assessed for each marginalized identity and intersections across the 3 identities.

Results Among 33 389 allopathic MD–only medical school matriculants (51.8% male), 938 (2.8%) experienced attrition from medical school within 5 years. Compared with non-Hispanic White students (423 of 18 213 [2.3%]), those without low income (593 of 25 205 [2.3%]), and those who did not grow up in an underresourced neighborhood (661 of 27 487 [2.4%]), students who were URiM (Hispanic [110 of 2096 (5.2%); adjusted odds ratio (aOR), 1.41; 95% CI, 1.13-1.77], non-Hispanic American Indian/Alaska Native/Native Hawaiian/Pacific Islander [13 of 118 (11.0%); aOR, 3.20; 95% CI, 1.76-5.80], and non-Hispanic Black/African American [120 of 2104 (5.7%); aOR, 1.41; 95% CI, 1.13-1.77]), those who had low income (345 of 8184 [4.2%]; aOR, 1.33; 95% CI, 1.15-1.54), and those from an underresourced neighborhood (277 of 5902 [4.6%]; aOR, 1.35; 95% CI, 1.16-1.58) were more likely to experience attrition from medical school. The rate of attrition from medical school was greatest among students with all 3 marginalized identities (ie, URiM, low income, and from an underresourced neighborhood), with an attrition rate 3.7 times higher than that among students who were not URiM, did not have low income, and were not from an underresourced neighborhood (7.3% [79 of 1086] vs 1.9% [397 of 20 353]; P < .001).

Conclusions and Relevance This retrospective cohort study demonstrated a significant association of medical student attrition with individual (race and ethnicity and family income) and structural (growing up in an underresourced neighborhood) measures of marginalization. The findings highlight a need to retain students from marginalized groups in medical school.


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