Discrimination Experiences Among Medical Students.

Abstract

Previous research has documented the prevalence of discrimination based on race, ethnicity, sex, and sexual orientation among medical students; however, discrimination experienced by medical students with disabilities, and the impact of intersecting identities on these experiences, remains underexplored. To examine the association of general, gender-based, and race-based discrimination with disability status, sex, race, and ethnicity during medical school. This cross-sectional study surveyed graduating medical students in US accredited MD-granting medical schools from 2020 to 2022. Analyses were conducted from October to November 2024. Modified Poisson regression was used to estimate the relative risk of disability status, sex, race, and ethnicity with self-reported experiences of general, gender-based, and race-based discrimination and the intersection of disability status, sex, race, and ethnicity. Among 45 705 graduating medical students, 3863 (8.5%) reported having a disability; 24 163 (52.9%) identified as female; and 10 100 (22.1%) identified as Asian, 2661 (5.8%) as Black, 4524 (9.9%) as Hispanic, 25 154 (55.0%) as White, and 3266 (7.1%) as other race or ethnicity. Medical students with disability (MSWD) were more likely than their peers without disability to report general discrimination (relative risk [RR], 1.57; 95% CI, 1.50-1.65), gender-based discrimination (RR, 1.64; 95% CI, 1.57-1.72), race-based discrimination (RR, 1.55; 95% CI, 1.44-1.67), and multiple types of discrimination (RR, 1.82; 95% CI, 1.71-1.91). Asian, Black, and Hispanic female MSWD were more likely to report general and race-based discrimination than their White male peers without disability, with the prevalence of general, gender-based, and race-based discrimination among female Asian, Black, and Hispanic MSWD being greater than 25%. Compared with White male students without disability, Asian and Black female MSWD reported the highest risk of general discrimination (Asian: RR, 2.40; 95% CI, 2.09-2.77; Black: RR, 2.58; 95% CI, 2.17-3.06). White and Asian female MSWD reported the highest risk of gender-based discrimination (White: RR, 4.65; 95% CI, 4.30-5.04; Asian: RR, 4.41; 95% CI, 3.85-5.05). Asian and Black female MSWD reported the highest risk of race-based discrimination (Asian: RR, 8.53; 95% CI, 7.26-10.01; Black: RR, 12.48; 95% CI, 10.76-14.47). Finally, Asian and Black female MSWD reported the highest risk of multiple types of discrimination (Asian: RR, 6.50; 95% CI, 5.63-7.52; Black: RR, 7.21; 95% CI, 6.10-8.52). In this cross-sectional study of US medical students, Asian, Black, and Hispanic female MSWD were more likely to report general and race-based discrimination, whereas White and Asian female MSWD were more likely to report gender-based discrimination during medical school. These findings highlight the need to address intersecting forms of discrimination for medical students with disabilities.