Diversity in medicine: how do underrepresented minority medical students select their specialty? A cross-sectional...

As the diversity of the U.S. population increases, it is important to reflect this racial/ethnic diversity across all specialties in medicine. The primary objective of this study was to identify factors influencing specialty decision-making amongst underrepresented in medicine (URM) medical students. The secondary objectives were to identify biases and stressors experienced by URM medical students and to understand perceived support in specialty decision-making.

In this cross-sectional survey study, a 55-item questionnaire was distributed electronically to the national and local email lists for the Student National Medical Association (SNMA) and Latino Medical Student Association (LMSA). Eligibility criteria included U.S. medical students self-identifying as URM.

Among the 257 respondents, the top five desired specialties were obstetrics and gynecology (11.7%), emergency medicine (10.1%), pediatrics (9.3%), internal medicine (8.2%), and orthopedics (6.6%). When stratified by gender and race/ethnicity, differences were observed in desired specialties among Hispanic and Black males and females. The top three characteristics with a major or significant influence on specialty choice included the nature of patient care (94.1%), patient population (78.6%), and working hours/lifestyle (70.4%). Over half of respondents (55.9%) reported that mentorship within their chosen specialty had a significant or major influence on their specialty choice. Additionally, the majority (69.9%) agreed or strongly agreed that racial/ethnic concordant mentorship was likely to influence their specialty decision.

Larger and specialty-focused studies, particularly for the least diverse specialties in medicine, are needed to characterize the facilitators and barriers that influence URM students in their specialty choice. Ultimately, these efforts may help reduce barriers to matriculation of URMs in their desired specialty and also foster a more representative physician workforce, and in the long-term, advance health outcomes for diverse patient populations.