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In this episode of Making the Rounds, fourth-year medical student at the University of Minnesota medical school and AMA Research Challenge finalist Arman Shahriar, dives into his research on socio-economic diversity among medical students in the U.S. and his vision for the future of health care.

Learn more about the AMA Research Challenge.

Speakers

  • Arman Shahriar, fourth-year medical student, University of Minnesota Medical School
  • Brendan Murphy, senior news writer, American Medical Association

Host

  • Shamsh Shaikh, 2020 co-winner of the AMA Research Challenge

Listen to the episode on the go on Apple Podcasts, Spotify or anywhere podcasts are available.

Shaikh: The AMA Research Challenge is the largest national, multi-specialty research event for medical students and residents. Hello, I’m Shamsh Shaikh, co-winner of the 2020 AMA Research Challenge with Victoria Danan. Today’s interview features one of this year’s five finalists for the 2021 AMA Research Challenge, interviewed by AMA Senior News Writer Brendan Murphy.

Murphy: Hello, my name is Brendan Murphy. I am a news writer for the AMA covering issues related to medical students and I am pleased to be joined today by Arman Shahriar, a fourth-year medical student at the University of Minnesota, who is also a finalist for the 2021 AMA research challenge. How are you Arman?

Arman Shahriar
Arman Shahriar, one of five AMA Research Challenge finalists.

Shahriar: Hey, Brendan. I'm doing well. Thanks for having me on.

Murphy: Would you mind introducing yourself up to our audience?

Shahriar: Sure, my name is Arman Shahriar, I'm a fourth-year medical student at the University of Minnesota Medical School. I was born and raised in Minnesota and I'm currently applying to internal medicine residencies. So, I'm kind of in interviewing while I also finish up some clinical rotations at the moment.

Murphy: And you've taken time out of your busy schedule to join us today and we are very grateful for that Arman.

Shahriar: Oh, thank you. It's not as busy as I made it sound.

Murphy: So as a finalist for the research challenge, you're one of five that event takes place on December 8 and in advance of that we'd love to talk to you about your project. Will you tell us a little bit about your project on socioeconomic diversity and med students, how you got interested in it and why it's important for the health of the nation?

Shahriar: Sure yeah, so we got interested, when I say we this is a team, several classmates of mine and myself have paired up with some faculty at our university to look into this topic because it's just not really talked about. And socioeconomic diversity is probably the form of diversity that's been least explored of all the forms of diversity in the medical student body. To answer the question of why it's important to the health of the nation, there's pretty compelling evidence that patients do better when their doctors share lived experiences with them. Lived experiences can be a result of race and ethnicity but can also be a result of socioeconomic status, religion and a host of other things. And as I mentioned, socioeconomics have been far less explored than demographic factors like race and ethnicity and gender, et cetera.

Murphy: It is an interesting area of study and there has been so much attention paid to racial and ethnic diversity. I'd be curious about maybe drawing from your own experiences as a medical student and how you may witness this topic around to you, and how it affected medical students around you.

Shahriar: Yeah, I would say in one line, money is a topic people don't generally talk about in our society. So socioeconomic diversity I think is more of a hidden form of diversity and among our classmates and colleagues … I think there's a just ... there's a reluctance to talk about it and it makes it a really important issue when you're considering the dollar figures that go into paying for medical school and paying for what it takes to actually become a doctor in this country.

Murphy: Can you tell us about your research methodology and your results?

Shahriar: Yeah, so this was at heart it was a pretty simple study. We used the best available data on matriculating U.S. medical student income and also the best available data on U.S. household income. And we basically just compared the two and we stratified respondents by race and ethnicity. And so our data source for medical students was the AAMC's matriculating student questionnaire, it goes out every year to all allopathic matriculating medical students and they have a pretty robust response rate yearly. And the comparison group or the income in the country at large data, we were gathering that from the U.S. Census. And really what we found is that, so there is a pretty significant socioeconomic diversity gap which persists across races and ethnicities. So it's been well known for some time that overall medical students come from high income households but this has never looked at stratified by race and ethnicity.

And kind of the significance of this is there has been a lot of attention over the past two decades paid towards racial and ethnic diversity in the medical student body, which is appropriate for all the reasons I previously mentioned. But there hasn't been much progress and a lot of the literature kind of, there are a lot of question marks as to why and this is a novel explanation as to why, and actually if you look at some of the big papers on the topic of racial and ethnic diversity and you just do a simple control F, there's very little actual mention of the phrase socioeconomic status or even income. So this kind of adds to the body of literature examining diversity in medical schools as kind of a different explanation, another possible explanation as to why there's been so much trouble diversifying with respect to race and ethnicity.

Murphy: There are detailed action plans for increasing the student body's representation from students from underrepresented backgrounds racially and ethnically. Does that exist for students from lower socioeconomic brackets? And if it doesn't what would it look like in your view?

Shahriar: Yeah, so I think there are far fewer action plans when it comes to socioeconomic diversity. I think part of the reason for that is that the solutions are likely much more complex. And in my opinion, solutions to this problem are going to come from partnerships with low-income schools, low-income communities and really intentional efforts on the parts of medical schools and also health systems who partner with medical schools very commonly such as my university works with several health systems.

Murphy: Certainly, tackling income inequality is a part of health equity and I think that that's been pretty evident in the AMAs action plan. Looking at this particular topic area and your work in it, do you plan to expand the research beyond its current scope at all?

Shahriar: Yeah, so pending this current project which has been submitted for publication and also, going to be presented at this conference and in this challenge, we plan on probably starting a bigger project that looks at temporal trends in socioeconomic diversity. So looking back over the course of the past three, four decades and stratifying that data by race and ethnicity to really see if anything changed over time and if anything has changed for any particular groups over time. But I think the bigger goal, end goal of this work will be to spur conversation and work towards action plans to start addressing the issue because it's one of those issues as kind of staring us in the face.

Murphy: Organized medicine is working toward the goal of creating a more accessible health care system, including the AMA. Are you involved in any of that work as an advocate?

Shahriar: Yeah, I've been involved with Students for National Health Program, the Minnesota chapter, which is the student organization under the parent Physicians for a National Health Program, who have been standing behind various proposals for a national health program.

Murphy: My last question for you and this is always a fun one, the AMA Research Challenge comes with a $10,000 grand prize for the winner. Do you have any plans of how you would spend that prize money?

Shahriar: Yeah, I think we'd likely donate a large amount of it to a local organization. There's a few we've been talking about as a group and the rest would likely be used to fund our teams ongoing work as we're all kind of doing this voluntarily. So the data requests and open access fees and things like that that come with doing research. It would probably help us move our projects along and be able to take on more work.

Murphy: Well best of luck in the upcoming competition Arman. That competition is taking place, the AMA Research Challenge, on December 8. And good luck Arman, we look forward to seeing how you present before the judges.

Shahriar: Awesome, thank you so much.

Shaikh: Join us on December 8 at 7 P.M. Central time to see all five finalists present their research to an elite panel of judges. The overall winner will receive a $10,000 grand prize sponsored by Laurel Road. For full details, visit ama-assn.org/research2021.


Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.

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