Privilege breeds privilege: a descriptive analysis of medical students’ ethno-racial identity and capital to inform diversity, equity and inclusion in Canadian medical education

There remains limited information on racial diversity amongst medical student bodies. Given the lack of demographic data collected for medical student admissions, we sought to understand the ethno-racial identity and capital of medical students across Canada. Our objectives were two-fold: (1) Collect demographic data about medical students across Canada and (2) Apply Bourdieu’s theoretical framework of capital to the data. Adopting a pragmatist research paradigm, we collected data on Canadian medical students using an online survey administered to all medical students across 17 Canadian medical schools between April 2021 to December 2022. N = 2805 medical students responded (25.0% response rate). 66.7% identified as women and 1.1% identified as non-binary. Most were single and never married (88%) and without children (93%). 60.6% of participants reported that they are perceived as White, whereas 3.1% reported they are perceived as Black. 8.2% of the respondents identified as having an Indigenous identity, whereas 0.5% reported being perceived as an Indigenous person. Together, 31.4% of the sample self-reported their perceived ethno-racial identity as Black, Indigenous, and Person of Colour (BIPOC). 74% of medical students came from households with incomes over $80,000. Compared to non-Indigenous students, Indigenous students were significantly more likely to report having a physician parent (OR 3.72; 95% CI: 2.78–4.98), sibling (OR 6.34; 95% CI: 4.70–8.55) or romantic partner (OR 2.87; 95% CI: 2.15–3.83). Black students were significantly more likely than White students to have one or both parents (OR 2.49; 95% CI 1.59–3.92), or a sibling (OR 2.48; 95% CI 1.52–4.04) being a physician. Our findings show how forms of capital may act as potential barriers and facilitators to accessing medical education. While there has been progress in increasing the representation of underrepresented medical students through diversity initiatives, ethno-racial disparities may persist.