Adverse Childhood Experiences, Household Income, and Mentorship Among Interns Who Are Underrepresented in Medicine

Abstract

ABSTRACT Background Underrepresented in medicine (UIM) interns have unique lived experiences that affect their paths to medicine, and more information is needed for medical residency and fellowship programs to better support them. Objective We describe self-reported differences between UIM and White physician interns in key demographic areas, including household income growing up, physician mentorship, and adverse childhood experiences (ACEs). Methods Between 2019 and 2021, we administered a diversity survey to incoming medical interns at the University of Minnesota-Twin Cities. Response rates across the 3 years were 51.2% (167 of 326), 93.9% (310 of 330), and 98.9% (354 of 358), respectively. We conducted analyses to compare UIM and White groups across demographic variables of interest. Results A total of 831 of 1014 interns (81.9%) completed the survey. Relative to White interns, UIM interns had lower household incomes growing up, lower rates of mentorship, and higher rates of experiencing 4 or more ACEs. The odds of experiencing the cumulative burden of having a childhood household income of $29,999 or less, no physician mentor, and 4 or more ACEs was approximately 10 times higher among UIM (6.41%) than White (0.66%) interns (OR=10.38, 95% CI 1.97-54.55). Conclusions Childhood household income, prior mentorship experiences, and number of ACEs differed between UIM and White interns.