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The Impact of Wealth on Medical Education

Updated: Mar 28, 2019


This week, the Justice Department released details on the College Admissions Bribery Scandal, where 50 of this country’s wealthy elite paid to have their children fraudulently admitted to top universities in the U.S. The fraud is far reaching – from actresses to business professionals and college officials – and underscores the inherent inequities in the structure of higher education in America.



It would be difficult to think that the inequity stops once these individuals gain admission into undergraduate colleges and universities. Privilege begets privilege, and the rich are able to stay on top by gaming the system (often legally) to work in their favor. At times, it can manifest in the egregious displays of wealth and power – donating a university building or leveraging powerful business connections. Other times, it can be as simple as recognizing that some students must maintain a full course load while working a part- or full-time job to provide for themselves and their families. Many affluent students are able to focus wholly on studying for classes and standardized tests and taking part in non-paid extracurricular activities. These benefits accumulate over time and, in sum, heavily stack the deck against low income students (and particularly those of color) when working to be competitive undergraduate, graduate, and medical school applicants.



In medicine, we still see a wealth imbalance. According to a SortSmart Inc. study, a majority of medical school trainees are motivated by the field in part due to financial gain, status, or family pressures. However, of those driven by an intrinsic motivation to serve others, the majority are from low income backgrounds. 30% of medical students come from families making more that $120,000 a year, which is the largest proportion of any income group. Furthermore, over 60% of students of color in medical training come from households with yearly incomes below $80,000, highlighting that the income inequality works in favor of white people and likely points to the impact of generational wealth. Standardized test scores, including the MCAT, are associated with wealth where more affluent students are more likely to perform better on these exams. This difference is not due to inherent intellectual differences but is rooted in the way standardized testing works in favor of those who have access to more resources and more time to prepare.



On many levels, the U.S. education system is broken. We know that representation matters, and having a system that unfairly benefits the rich only multiplies the harm levied against communities of color, low-income communities, and rural communities. In medicine, it might make physicians less likely to pursue careers in primary care, which impacts the health of everyone in the country. From a sociological lens, large wealth disparity and wealth stratification drives up health care costs and worsens health outcomes at all levels of the wealth hierarchy. Furthermore, data suggest that health outcomes improve when patients are treated by physicians who look like them and are able to empathize with their lived experience. In totality, this highlights the fact that diversity in medicine is a critical facet of improving the practice and delivery of medicine as a whole.



It is incumbent on us as future health professionals to actively work to combat the implicit bias present in the medical admissions process and make medical education a more attainable goal for everyone on the socioeconomic ladder, not just for the well-to-do. In truth, this will require coordinated and collaborative effort on many levels – from national policy intervention to grassroots community support. We at CMS are attempting to cover one small aspect of the broader issue; access to information about different medical schools. We are working to level the playing field by aggregating relevant information and increasing access such that applicants can better find schools that match their goals and ambitions, be more competitive in the application process as a result, and ultimately enhance the field of medicine. To better achieve this goal, we are excited to announce our CMS Fee-Assistance Program. Those who qualify for the AAMC Fee Assistance Program will also be eligible for a year subscription to the Premium Tool for our database. Through small steps, we hope to make our objective of more equitable medical education a reality.



Love,

Derrick O.

Compare Medical Schools | Co-Founder





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References:


Adler, Nancy E., and Katherine Newman. “Socioeconomic Disparities In Health: Pathways And Policies.” Health Affairs, 2002, www.healthaffairs.org/doi/full/10.1377/hlthaff.21.2.60.


Aron, Laudan. “Why Is the Rich US in Such Poor Health?” New Scientist, 10 July 2013, www.newscientist.com/article/mg21929250-200-why-is-the-rich-us-in-such-poor-health/.


SortSmart Candidate Selection Inc. “Medical School Admissions Practices in the U.S. More Likely to Select Applicants Motivated by Status, Financial Gains, and Familial Pressure to Pursue Medicine and May Result in Bias against Applicants from Lower Income Levels, New SortSmart Study Suggests.” PR Newswire: Press Release Distribution, Targeting, Monitoring and Marketing, 16 Jan. 2018, www.prnewswire.com/news-releases/medical-school-admissions-practices-in-the-us-more-likely-to-select-applicants-motivated-by-status-financial-gains-and-familial-pressure-to-pursue-medicine-and-may-result-in-bias-against-applicants-from-lower-income-levels-n-669556583.html.




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