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Original Investigation
May 2017

Racial Disparities in Medical Student Membership in the Alpha Omega Alpha Honor Society

Author Affiliations
  • 1Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut
  • 2Fellow, Robert Wood Johnson Clincal Scholars Program, Veterans Affairs Scholar
  • 3Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
  • 4Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut
  • 5Department of Engineering, Central Connecticut State University, New Britain
  • 6Equity Research and Innovation Center, Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut
JAMA Intern Med. 2017;177(5):659-665. doi:10.1001/jamainternmed.2016.9623
Key Points

Question  Are minority medical students less likely than white medical students to be members of the Alpha Omega Alpha honor society?

Findings  In this cohort study of 4655 US medical students, Alpha Omega Alpha membership for white students was nearly 6 times greater than that for black students and nearly 2 times greater than for Asian students, both significant differences.

Meaning  The selection process for Alpha Omega Alpha membership may be vulnerable to bias, which may affect future opportunities for minority medical students.


Importance  Previous studies have found racial and ethnic inequities in the receipt of academic awards, such as promotions and National Institutes of Health research funding, among academic medical center faculty. Few data exist about similar racial/ethnic disparities at the level of undergraduate medical education.

Objective  To examine the association between medical student race/ethnicity and induction into the Alpha Omega Alpha (AΩA) honor society.

Design, Setting, and Participants  This study analyzed data from the Electronic Residency Application Service, the official service used by US medical students to apply to residency programs. A total of 4655 US medical students from 123 allopathic US medical schools who applied to 12 distinct residency programs associated with one academic health center in the 2014 to 2015 academic year were studied.

Main Outcomes and Measures  Membership in the AΩA society among black, white, Hispanic, and Asian medical students.

Results  A total of 4655 unique applications were analyzed in the study (median age, 26 years; 2133 women [45.8%]). Overall, self-reported race/ethnicity in our sample was 2605 (56.0%) white (691 [71.5%] of AΩA applicants were white), 276 (5.9%) black (7 [0.7%] AΩA), 186 (4.0%) Hispanic (27 [2.8%] AΩA), and 1170 (25.1%) Asian (168 [17.4%] AΩA). After controlling for US Medical Licensing Examination Step 1 scores, research productivity, community service, leadership activity, and Gold Humanism membership, the study found that black (adjusted odds ratio [aOR], 0.16; 95% CI, 0.07-0.37) and Asian (aOR, 0.52; 95% CI, 0.42-0.65) medical students remained less likely to be AΩA members than white medical students. No statistically significant difference was found in AΩA membership between white and Hispanic medical students (aOR, 0.79; 99% CI, 0.45-1.37) in the adjusted model.

Conclusions and Relevance  Black and Asian medical students were less likely than their white counterparts to be members of AΩA, which may reflect bias in selection. In turn, AΩA membership selection may affect future opportunities for minority medical students.