Medical school climate experienced by underrepresented minority students: A systematic review of the literature

Purpose: Increasing minority representation in medicine is a strategy for improving clinical care and reducing health disparities. However, enrollment of underrepresented minority (URM) students remains disproportionately low at most medical schools.

Method: To evaluate whether improvements to the medical school social and learning environments experienced by URM students are needed and are a possible strategy for improving enrollment and retention, we systematically reviewed studies conducted between 1980 and 2011 that surveyed or intervened to improve the medical school environments experienced by URMs.

Results: MEDLINE, PubMed, OvidHealthStar and Web of Science yielded 28 studies that addressed differences in perceptions of social environment and social support (n=4), racial discrimination (n=5), other racialized experiences (n=4), student satisfaction with learning environment (n=3), academic performance (n=10), academic progress (n=5), and interventions to improve academic performance (n=3). They revealed that URMs have experienced less supportive social, and less positive learning environments, have been subjected to discrimination and racial harassment, and were more likely to perceive that their race negatively affected their medical school experiences than non-URM students. Academic performance on standardized exams was lower, progress less timely, and attrition higher for URMs than non-URM medical students.

Conclusions: An adverse climate may reduce the attractiveness of careers in medicine, impair academic performance, increase attrition, and influence attitudes toward and intentions to pursue a career in academic medicine. Results indicate that improvements to the social and learning environments experienced by URM students are needed and should be considered as a strategy for improving URM representation in medicine