Latino, Black and Native American students who take the Medical College Admission Test (MCAT) to apply to medical school encounter more financial and educational barriers and face more discouragement from academic advisers compared with white students, according to a new study from UCLA Health.

Published in JAMA Health Forum, the study also found that Latino and Black students who take the MCAT are far less likely to apply to and attend medical school.

Previous research has demonstrated how certain barriers and systemic discrimination contribute to a lack of diversity among medical students and the physician workforce. This study is among the first to focus on barriers that students from underrepresented racial and ethnic group face earlier in their career path, according to a UCLA news release.

“The research is unique because it goes one step back and looks at students who are interested enough in medical school to take the MCAT—an intense, rigorous and expensive test—but have not applied yet,” said the study’s first author, Jessica Faiz, MD, emergency medicine physician, in a news release.

Researchers analyzed survey data from nearly 82,000 people who took the MCAT from 2015 to 2018, focusing on Latino, Asian, Black, Native American and white populations. Researchers then analyzed parental educational background, financial status or hardships, discouragement from advisers and whether the surveyed individuals ultimately decided to apply to and attend medical school.

Results showed that Latino, Black and Native American students were more likely to experience difficulty affording MCAT prep materials, to have attended a college with minimal resources, to have parents without a college degree and to have more college debt. These barriers all rendered it less likely that these students would apply to or attend medical school.

Results also showed that these groups were more likely to have an adviser negatively impact their decision to pursue a career in medicine compared with white students, possibly as a result of discrimination.

“If we see that these barriers exist in those who are already taking the MCAT, we can only imagine how many students are really falling off before that, and we know that that’s due to systemic factors,” Faiz said.

Faiz recommends educating members of admissions committees on how structural racism results in lasting effects for underrepresented students considering careers in medicine. She also encourages highlighting the value that diverse applicants can bring to medical schools and the physician workforce.