Medical School Cohorts and Preparedness to Work With Individuals From Different Backgrounds: A Cross-Sectional Study.

Background and Aims: Medical schools seek to prepare students to work effectively with individuals from a variety of backgrounds. This study examined whether selected attributes of matriculants were associated with how graduates self-assessed their skills to work with individuals from different backgrounds. Methods: This retrospective cross-sectional study used data from 139,681 matriculants in 973 cohorts (2013-2014 to 2019-2020) at 139 U.S. MD-degree medical schools, and who graduated through 2022-2023. From the AAMC Graduation Questionnaire, we used the survey item, "The diversity within my medical school class enhanced my training and skills to work with individuals from different backgrounds," to create the cohort-level outcome measure Self-Assessed Skills at Graduation (SASG). For our independent variable, we created a Gower distance-based composite measure of within-cohort variation based on selected socio-demographic attributes (gender, race/ethnicity, and parental education), called Student Attribute Variation (SAV). Higher SAV values indicated greater heterogeneity in selected attributes. Results: SAV was positively correlated with SASG (r = 0.50, Conclusion: Findings highlight that greater variation in student composition is related to higher perceived development of professional skills.