Abstract
BackgroundThe socioeconomic status of applicants to Canadian medical schools has been understudied in the past two decades. Institutional efforts have been made to address the lack of socioeconomic diversity across Canada during this time. We investigated the income characteristics of medical school applicants, as well as the relationship between applicant income and offer of admission, to characterize the current state of socioeconomic diversity in medical admissions.MethodsWe conducted a retrospective cohort study on 26,120 applicants at one Ontario medical school from 2013 to 2018. Characteristics of applicants who were offered admission were compared to the general population and applicants not offered admission. Regression analyses were used to investigate the association between median total neighborhood income and successful admission.ResultsThe median total neighborhood income for medical school applicants was $98,816, which was approximately $28,480 higher than the Canadian general population. Those not admitted to the medical school had a median total neighborhood income of $98,304 compared to $105,984 for those offered admission (p < 0.001). This trend was seen in every province and territory in Canada. Median total neighborhood income was a predictor of an offer of admission; applicants in the >75th percentile income group had 54% increased odds of being offered admission when compared to applicants in the <25th percentile in our unadjusted model. Income was not significant in our adjusted models but showed that the income medians drastically shifted between pre-interview and post-interview periods, from $98,816 to $104,960 (p < 0.001).ConclusionMedical school applicants are from higher economic strata compared to the general population. Despite already representing a high economic stratum, a higher median total neighborhood income relative to other applicants was associated with an offer of admission.
Highlights
The socioeconomic status of applicants to Canadian medical schools has been understudied in the past two decades
One hundred and ninety-six applicants were dropped during the merge because there were no matches between data sets, and an additional 3193 applications were dropped because a postal code was not recorded for these applications or repeat applications were identified, and could not be included in the analysis
It has been previously established that medical school applicants tend to be from higher income households [2, 11], our study is significant because, despite institutional calls to action and knowledge of these facts for decades, we show that there is still significant disparity in the socioeconomic diversity of medical school admissions
Summary
The socioeconomic status of applicants to Canadian medical schools has been understudied in the past two decades. Since most medical students graduate to practice in Canada, Faculties of Medicine must address the ability of future physicians to serve the diverse needs of individuals and communities first through their admissions process. Concerns have been raised about the dearth of economic diversity among Canadian medical school students and the systemic barriers faced by potential applicants of lower socioeconomic status, such as the high application costs and lack of access to mentors [1]. In 2010, the Association of Faculties of Medicine of Canada (AFMC) had encouraged Canadian medical schools to support and select a representative mix of medical student candidates, in order to uphold their social mandate and to graduate a physician workforce better able to care and advocate for a diverse population [4]. We used median neighborhood income as a measure of applicant income, which does not capture individual income but is meant to be a surrogate measure of socioeconomic status
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