Mind the Mission: Associations between Medical Schools’ Social Mission Scores and Medical Students’ Racial Biases

Physicians’ racial biases contribute to racial health disparities. Medical school is an intensive experience and a critical time to potentially intervene on physicians’ racial biases. Characteristics of medical schools may attract more or less biased medical students and shape the biases of students at those schools. Each medical school has a Social Mission Score, which indexes their commitment to social equity based on the proportion of graduates entering primary care, practicing in underserved areas, and belonging to racial groups underrepresented in medicine. We explored the relationship between medical schools’ Social Mission Scores and the anti?Black implicit and explicit bias and quality and quantity of contact with Black people, both before and during medical school, of non?Black first-year medical students (N?= 3,554) at 49 U.S. medical schools. Multilevel models showed that students matriculating at schools with higher Social Mission Scores reported more frequent and favorable pre-medical school contact with Black people and significantly lower bias upon entry. In a separate sample of non-Black students at the same medical schools (N?= 3554), students at medical schools with higher Social Mission Scores perceived more warmth from other students toward Black people. Further, there was a significant drop in explicit racial bias over the course of medical school, and this drop was larger at medical schools with lower Social Mission Scores. Overall, we demonstrate that schools with high Social Mission Scores had students that reported more pre-existing contact with Black people and that these schools matriculate less-biased future physicians, which a different set of students at the same schools can perceive. Policies that weaken medical schools’ social mission commitments may therefore undermine the racial climate of medical schools with implications for racial health inequities.