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Healthcare utilization, preventive care, and structural barriers among medical students at a three-campus U.S.
Hyo Bin You1,2, Natasha Lee3, Krishna Sinha4
1Mayo Clinic Alix School of Medicine, Rochester, MN, USA. you.hyobin@mayo.edu.
Background:
Medical students may delay or forgo care because of time constraints, cost, confidentiality concerns, and fragmented access. Data describing healthcare utilization and preventive care among geographically distributed medical student populations remain limited. This study aimed to characterize healthcare utilization, preventive care uptake, and barriers to care among medical students and to examine associations with selected demographic and structural factors.
Methods:
Medical students across Mayo Clinic Alix School of Medicine campuses in Arizona, Minnesota, and Florida were invited to complete an anonymous survey between August 2025 and February 2026. Primary outcomes were healthcare utilization, delayed care due to academic pressure, and preventive care uptake. Secondary measures included reported barriers, insurance understanding, and suggested institutional interventions. Descriptive statistics were used to summarize the sample. Fisher's exact tests and t-tests were used for selected bivariate comparisons.
Results:
Of 480 invited students, 89 responded (response rate 18.5%). Campus data were available for 85 respondents: 53/85 (62.4%) from Minnesota, 26/85 (30.6%) from Arizona, and 6/85 (7.1%) from Florida. Among respondents with available data, 72/80 (90.0%) reported using healthcare services during medical school and 40/66 (60.6%) reported delaying care because of academic pressure. Among M3 and M4 respondents, 13/26 (50.0%) reported less frequent care during clerkships. Regarding preventive care, 49/71 (69.0%) reported being up to date on annual checkups, 42/65 (64.6%) on dental care, and 43/69 (62.3%) on sexually transmitted infection screening. The most commonly endorsed barriers were time (69/75, 92.0%), cost (36/75, 48.0%), access (15/75, 20.0%), and confidentiality (12/75, 16.0%). Students from low-income backgrounds were less likely to report any healthcare use (13/18 [72.2%] vs. 57/60 [95.0%], p=.014) and less likely to be up to date on dental care (6/16 [37.5%] vs. 36/49 [73.5%], p=.015). Women were more likely than men to report any healthcare use (49/51 [96.1%] vs. 23/29 [79.3%], p=.024), reproductive health service use (16/45 [35.6%] vs. 0/21 [0%], p=.001), and being up to date on dental care (30/38 [78.9%] vs. 12/27 [44.4%], p=.008).
Conclusions:
Healthcare use among medical students was common, but delayed care and gaps in preventive care were frequent. Time and cost dominated perceived barriers, and disparities by socioeconomic background were evident. Protected time for appointments, insurance support, and student-centered access pathways may improve trainee health.
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