Prevalence and Predictors of Food Insecurity Among Medical Students During Clinical Training: A Cross-Sectional Study

Food insecurity is a growing concern in higher education and may adversely affect medical students' academic performance, well-being, and professional development. Although awareness of this issue is increasing in graduate populations, limited data exist regarding its prevalence and associated factors within medical education. This study aimed to assess the prevalence of food insecurity among medical students completing clinical rotations and to identify demographic and institutional factors associated with increased risk.

We conducted a cross-sectional study of third- and fourth-year medical students from two US medical schools who were completing clinical rotations at a large academic health system during the 2022-2023 academic year. All 75 eligible students were invited to participate, and all completed an anonymous online survey distributed through Qualtrics. Food insecurity was assessed using the 10-item United States Department of Agriculture Adult Food Security Survey Module, and scores were categorized according to standard food security levels. Demographic variables collected included age, race/ethnicity, academic year, medical school, financial aid status, primary residence, and use of food-related resources. Descriptive statistics characterized participants, and group differences were analyzed using t-tests, ANOVA, and univariate and multivariate linear regression to identify predictors of food insecurity.

All 75 students responded (100% response rate). The median age was 26 years, and most identified as White (47 or 62.7%) or Asian (17 or 22.7%). The overall mean food insecurity score was 2.11 - more than three times the US national average. Students from Institution A had significantly higher scores than those from Institution B (2.71 vs. 0.53; p < 0.0001). Students receiving financial aid also reported higher scores than those not receiving aid (2.33 vs. 0.80; p = 0.0137). In multivariate regression, only the medical school attended remained a significant predictor (p = 0.0125), with Institution A students scoring 1.87 points higher on average. No significant associations were observed for academic year, race/ethnicity, or resource use.

Food insecurity appears to be more prevalent among medical students than in the general population, underscoring an important yet underrecognized challenge during clinical training. Institutional differences in food insecurity suggest that campus-specific or environmental factors may contribute to disparities in access, while the lack of significance for financial aid in adjusted analyses indicates the influence of additional structural barriers. These findings highlight the need for targeted, institution-specific support strategies and further research to develop effective interventions that improve food access and promote medical student well-being.