Mytien Nguyen, MS MD-PhD Program, Yale School of Medicine, New Haven, Connecticut

Medical School Drop-Out Rates Highest Among Low Income Students from Marginalized Neighborhoods Interview with:

Mytien Nguyen, MS MD-PhD Program, Yale School of Medicine, New Haven, Connecticut

Mytien Nguyen

Mytien Nguyen, MS
MD-PhD Program, Yale School of Medicine,
New Haven, Connecticut  What is the background for this study? 

Response: It is well-recognized that diversity in the medical workforce is critical to improve health care access and achieve equity for neglected communities. Despite increased efforts to recruit diverse medical trainees, there remains a large chasm between the racial/ethnic and socioeconomic composition of the patient population and that of the physician workforce.  What are the main findings? Is the attrition rate linked to academic performance and/or admission selection factors? 

Response: We examined attrition, which includes withdrawal and dismissal for any reason, among about large cohort of allopathic medical students We found that attrition rates were highest among students who belonged to a race and/or ethnicity underrepresented in medicine (URiM) group, were low income, or grew up in an underresourced neighborhood. Critically, exploration of intersectional identities showed that attrition rate increased with increasing number of marginalized identities, with low-income URiM students from underresourced neighborhoods having the highest attrition rate. What should readers take away from your report? 

Response: There is an accumulation of disadvantage in medical education. Previous reported experiences of social isolation, racism, and discrimination have been associated with burnout and depression for marginalized students. Medical schools need to adopt a more proactive antiracism strategy, such as financial and administrative support for diversity, equity and inclusion offices, and requiring the Liaison Committee on Medical Education to monitor and attrition or early signs of it, such as leaves of absence. What recommendations do you have for future research as a result of this work?

Response: It is important to emphasize that the challenges students are encountering are not individual challenges, but challenges imposed by the medical training environment, climate, and system that are not created for students from marginalized backgrounds. Much of previous research on students’ progress have focused on individual interventions. We believe that it critical that we examine the environment and what aspect of the environment and climate that are not fostering the development of marginalized students and allowing them to thrive. 


Nguyen M, Chaudhry SI, Desai MM, et al. Association of Sociodemographic Characteristics With US Medical Student Attrition. JAMA Intern Med. Published online July 11, 2022. doi:10.1001/jamainternmed.2022.2194

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Last Updated on July 15, 2022 by Marie Benz MD FAAD