I was recently watching a webinar that brought up the obstacles that FGLI (First-Generation and Low-Income) students face in the application and admissions process to medical schools. I think, by this point, it’s a pretty well known fact that medical schools (and law schools as well) have way more students from the top income brackets than from the bottom 15-25%. In the webinar they outlined how cost, social capital and bandwidth are some of the contributing factors to this. In terms of cost, the application to graduate schools is notoriously costly and tuition is often not covered once accepted. Furthermore, there are additional costs such as investments, both in time and money, towards crafting a competitive application riddled with internships, extracurriculars and hundreds of hours of service.

Barriers to Entry

Standardized tests for graduate schools (i.e. LSAT and MCAT) may not be costly to register for (thanks to fee waivers), however, to adequately prepare for these exams students that invest time and resources are likely to score better. Higher scores on these exams are often a deciding factor in admittance, but also for merit scholarships. Furthermore, the cost of attending college is already at an all time high and many students will be burdened with undergraduate debts before even matriculating to graduate school.

The financial costs of several components of the process are very prohibitive for many students. The idea of taking on even more debt can dissuade many students from applying and matriculating. Increasingly, there are becoming more avenues for students that do not complete post-secondary degrees to have high-earning jobs. A college education is by no means a prerequisite to success, but for certain careers it is a necessary part of the process.


Financial barriers don’t exist in a vacuum. They often appear in the context of other challenges such as systemic racism, lack of opportunity and role models. In recent news, we’ve heard about how black patients often receive unequal or inferior treatments – please see the earlier article on this for more statistics on the health disparities attributed to it. These negative experiences in an academic or healthcare setting can dissuade many students from these backgrounds in pursuing a degree in these settings.

Furthermore, a lack of opportunity is a big issue as well. The components of a strong application often include some sort of relevant work experience, volunteering, and perhaps 1-2 long-term projects. However, more and more companies are not paying their interns and unpaid internships are another barrier for students that are from FGLI backgrounds. In theory, there are laws against exploitation of labor in this way, but many companies get away with it through various loopholes. Students from FGLI backgrounds often provide for themselves and their families so an unpaid internship is financially unsustainable and thus often not a pursuable goal. Outside of relevant work experience, the time to dedicate to a good application should not be underscored. Students spend years cultivating their narratives, extracurriculars and the like.


Meanwhile, students from low-income backgrounds may have to choose between a board position at a club or working a job that pays for the bills at home. In an ideal world, these would be looked upon equally, but based on the numbers it would seem that disproportionately the better “applicant package” is favored in admissions. Students from FGLI/FLI backgrounds often also attended underfunded schools for their K-12 education which puts them at a disadvantage to their peers in several ways. A lack of credits means later registration times (possibility of not getting a needed course), more classes to take and pay for, and having to deal with the so-called “weeder” courses. A lack of prior exposure to the material is often debilitating as many professors assume a base background knowledge in their students that might not be there. Anecdotally, I knew fellow students that had taken rigorous physics, organic chemistry and upper-level biology material in high school whereas many other peers had had maybe one course with a notoriously inadequate instructor. There is a difference.

What Should Be Done

Some have suggested that financial literacy courses, introduced early-on, may help students when they are pursuing a post-secondary education. While I agree, we have a financial literacy component to our own non-profit organization, I think that this poses a few difficulties. The infrastructure at schools with students that would need it the most is not there. First, we must establish both a technology and an adequate staffing infrastructure to promote these courses in underfunded schools. Furthermore, these courses should be tailored to these students without senseless advice like “don’t shop too much” that already doesn’t apply. These courses should be mandatory, perhaps even a graduation requirement, to ensure that these students have equal access and will be attending the courses and taking the content seriously. These courses should have a nominal cost to the underfunded school districts if at all and no cost to the students at these schools.

Mentorship should be established early-on for these students. Participants in mentorship are 40% more likely to achieve their goals if they write them down. This increases to 70% if the goals are shared with someone to keep them accountable, such as a mentor. Having a mentor in their intended field of study can be especially encouraging. These mentors can help them avoid mistakes an answer any questions about the path to their career. At many underfunded schools counselors are overwhelmed, so many students can easily fall through the gaps. FLI students likely have nobody in their family or often even in their social circle that is a physician or lawyer that they can ask for advice. This social capital is a crucial aspect of landing competitive internships, getting a headstart on preparations and more.


Ideally, there would be more initiatives to combat these pervasive barriers to entry. This could be in the form of legislation or simply on the part of new initiatives such as which provides free resources for MCAT preparation. MCAT preparation is a costly endeavor with tutors often costing upwards of 50-60 dollars an hour and courses costing thousands of dollars. There are similiar initiatives out there for other forms of graduate school and I would encourage more people to look into establishing and supporting these initiatives.