Medical students spend time learning about the nonmedical aspects of their patients’ lives that affect their health—factors such as housing access and economic stability. But what happens when future physicians are struggling to meet their own basic needs?
As new research shows medical students have rates of food insecurity that surpass the general U.S. population, undergraduate medical education institutions are taking on student well-being at its most basic level: nutrition.
“Throughout your four years of medical school, you talk about resilience, and we really know that some of the things that get emphasis in helping with resilience are having survival needs being met,” said Anitza Quintero, a fourth-year medical student at Geisinger College of Health Sciences who is spearheading an effort to fight food insecurity among her fellow students. “Flourishing doesn't mean you give them everything, but you have that meaning, that connection.”
Danville, Pennsylvania-based Geisinger is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Food insecurity appears pervasive
Quintero and Geisinger are taking on a problem documented in a JAMA Network Open™ study published last year.
Researchers surveyed 1,834 medical students at eight U.S. medical schools, finding that 21.2% reported being food insecure. They found that being of certain races or ethnicities, having dependents and having financial need were linked to even higher rates of food insecurity.
By comparison, the U.S. Department of Agriculture found that in 2023, 13.5% of all U.S. households were categorized as having either “low” or “very low” food security.
Quintero was part of a group of medical students who who conducted three studies about food insecurity among medical students. In the second wave, which surveyed 1,659 students in 15 medical schools, one in four students nationally reported food insecurity, and there were even higher rates among Geisinger’s student population.
“It was very eye-opening because it's a population you don't really think will suffer some of these situations,” she said, adding that the school’s survey results caused them “to really dive in deeper and see what some of the causes were of this food insecurity.”
They learned that those with food insecurity were, in many cases, first-generation immigrants or were low-income students receiving federal needs-based Pell Grants.
“I would have never thought—two, three, four or five years ago—that food insecurity would be as prevalent among this population as it is,” said Joel Rosencrance, MSEd, director of student well-being at Geisinger College of Health Sciences. “I stock our food pantry here [in the medical sciences building] and see the utilization that it gets.”
Taking on the problem from all angles
Food insecurity can set back medical schools’ basic mission of creating future physicians, researchers warned.
“Those with unmet basic needs may struggle to navigate their education and training,” says the JAMA Network Open study, co-written by 25 authors from the eight medical schools from around the country.
The authors recommended that medical schools offer financial aid counseling or help medical students develop money-management skills. Other opportunities for helping students meet their basic needs, which would help them be able to better afford proper nutrition, included:
- Providing a meal card program for students to use at hospital cafeterias.
- Creating a transit-pass program that allows free or reduced-price public transportation.
- Partnering with farmers markets or community organizations to offer produce boxes.
The study’s authors also mentioned the creation of food pantries, a tactic that Geisinger has pursued. Through the work of Quintero and other medical students, Geisinger recently received a grant to expand the medical school’s food pantry and work has started on the project.
“I’m hopeful it will help students throughout their next four years in medical school,” Quintero said. “We know that this food pantry is not just a food pantry—it’s a learning health system for basic needs. And you want to make sure that students feel supported, not only academically.”
Rosencrance said that it’s important for medical schools to explore various ways they can help meet medical students’ basic needs.
“There are other factors that play into this that we have to address alongside of this issue,” he said. “We do have to take this holistic approach.”
Learn more concrete actions that help medical students navigate the challenges of their educational experiences in the AMA STEPS Forward® toolkit, “Medical Student Well-Being: Minimize Burnout and Improve Mental Health Among Medical Students.”
Taking stigma out of nutritional support
Quintero said the open-access nature of Geisinger’s efforts makes it easier for medical students to feel comfortable getting whatever help they need.
“The culture within our institution has made it very open,” she said. “If anything, it’s almost cool that you get to use the food pantry because we do try to provide great snacks and great opportunities. And when you're having a tough academic day, there's nothing better than going to the food pantry on the fourth floor—located right by the ping-pong tables—and you have this bonding and community. So, we really made it safe in our school.”
Rosencrance said it’s remarkable the “stress that it can alleviate for our students to not have to worry about where their next meal is coming from, but to rather be able to focus on quality education and learning how to provide for the area that they grew up in or the community that they're a part of.”
Ultimately, medical schools should consider the long view when it comes to supporting medical students in their well-being, Quintero and Rosencrance said.
“Supporting trainees’ basic needs is not just about wellness. ... It's about workforce sustainability and equity,” Quintero said. As physicians in training, medical students “want to prepare to lead in these situations in the real world, as well, because they don't exist just in the medical field or in low-income families. It happens everywhere.”
