Key Disparities between First-Generation and Continuing-Generation Medical Students: A Quantitative Analysis

Background: First-generation (FG) medical students face significant challenges that can hinder their academic success and well-being. Our study aimed to quantify the disparities between FG and continuing-generation (CG) across four domains including: resilience, social isolation, unmet basic needs, and perception of institutional support. Methods: An anonymous survey was administered to medical students at Geisinger Commonwealth School of Medicine. Students had four weeks to complete the voluntary, 30-question survey which included close-ended questions assessing challenges in each domain. Survey data were collected in Qualtrics and analyzed using R Epi for R 4.4.1 GUI 1.80 Big Sur Intel build (8416). Primary analysis was performed using Students T-test to evaluate difference in means between cohorts and one-way ANOVA was used in secondary analysis to correct for confounders between student attitudes across year in school. FG status was defined as having no parent with a 4-year college degree. Seventy-two students responded, and 62 completed surveys were included in the analysis. Results: Among the 62 respondents (15 FG, 47 CG), FG status predicted increased resilience (p=0.01), feelings of social isolation (p=0.005), and unmet basic needs (p<0.001). Key disparities included food/housing insecurity, affordability of educational resources, and access to visiting student learning opportunities. There were no significant differences in resilience (p=0.656), social isolation (p=0.656), basic needs (p=0.07), or perception of institutional support, (p=0.651) based on year of training. Qualitative themes highlighted FG students' financial strain, disconnection from peers, and desire for targeted support. Institutional scholarships received by 47% of FG and 53% of CG students (χ2=8.4e-31, p=1.0) mitigated but did not eliminate these disparities. Conclusion: Our data reveals substantial, ongoing challenges faced by FG medical students and support the previous findings identified by Havemann et al. We suggest that by enhancing healthcare access, grants for educational expenses, subsidized study materials, and fostering peer networks, AAMC stakeholders can proactively address these gaps in medical student success to build a physician workforce equipped to serve all patients and communities.