Discrimination Experiences Among Medical Students

Importance: 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. Objective: To examine the association of general, gender-based, and race-based discrimination with disability status, sex, race, and ethnicity during medical school. Design, Settings, and Participants: 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. Main Outcomes and Measures: 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. Results: 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). Conclusions: 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.