Equity for Medical Students in Puerto Rico

Highlighted Institutions:

Below are the institutions/programs that have requested and received a formal institutional presentation regarding the unique forms of discrimination faced by medical students at the four medical schools in Puerto Rico. We acknowledge and applaud them for their support of an equitable residency selection process. Please explore their residency programs and/or website by clicking on the corresponding links/logo below.

Office for Diversity, Equity and Inclusion

KP Northern California,
KP Southern California,
KP Colorado,
KP Georgia,
KP Mid-Atlantic States,
KP Oregon/SW Washington,
KP Washington,
KP Hawaii

Georgetown Family Medicine

Center for Diversity Equity and Inclusion

Dean’s Forum
Dean’s Retreat

ACGME DEI Officers Forum

Discrimination Needs Assessment Press Release

PRESS RELEASE – August 30, 2022

Latina/o/x/e, Hispanic or of Spanish Origin+ (LHS+)-Identified Medical Students Continue to Face Unique Experiences of Discrimination During the Residency Selection Process

Between July 19, 2022 – August 22, 2022, the Latino Medical Student Association (LMSA), the largest and oldest national organization for the advancement of LHS+ identified students in medicine, launched a national needs assessment to better document experiences of discrimination faced by LHS+ identified medical students when applying to residency programs, especially students matriculated at the four LCME-accredited medical schools in Puerto Rico.  This first-ever needs assessment was in response to personal accounts and an email from the Association of American Medical Colleges (AAMC) reminding academic medicine community members that “the four medical schools in Puerto Rico are fully accredited by the Liaison Committee on Medical Education (LCME). Residents of Puerto Rico are U.S. citizens who carry U.S. passports, and graduates from these medical schools are graduates of a U.S. medical school, not international graduates.” (AAMC Announcements and Information – May 9, 2022)  LMSA leaders, in collaboration with the four medical schools in Puerto Rico, and Dowin Boatright, MD, MBA, MHS have been concerned that considering LHS+ identified matriculants of AOA- and LCME-accredited medical schools on the U.S. mainland and in Puerto Rico as “international”, “non-U.S. citizens” or “non-English speakers” is discriminatory and places an inequitable burden on these trainees as they apply for residency positions and strive to become physicians for our U.S. population, which is nearly 18.9% LHS+ identified (U.S. Census Bureau, QuickFacts, https://www.census.gov/quickfacts/fact/table/US/PST045221, accessed on August 29, 2022)   


When asked – “Did you hear from upper-class persons or medical school graduates that during the residency application process they…”

Type of discriminationPuerto Rico Medical Students (%) n-113Mainland Medical Students (%) n- 37p-value^
Received offensive questions or comments regarding their own English proficiency? (Yes)48.7%48.6%NS
Received notification of application denial because they were considered an international medical student? (Yes)51.4%35.3%NS
Received offensive questions or comments because they were considered an international medical student? (Yes)56.3%29.4%<0.01
Received offensive questions or comments based on the medical school they attended? (Yes)61.3%54.3%NS
Were asked if they were a U.S. Citizen? (Yes)64.6%48.6%NS
Were asked to show documentation or proof of U.S. Citizenship? (Yes)43.1%19.4%<0.05
^Chi-square analyses were conducted to compare dependent variables across independent variables, p<0.05.  NS represents ‘not significant’.  

A high proportion of LHS+ identified medical students, irrespective of medical school location, have heard from upper-class persons that they experienced offensive questions/comments regarding their English proficiency, the medical school they attended, and citizenship status.  The aforementioned forms of discrimination may contribute to increased stress, anxiety, or imposter syndrome among LHS+-identified medical student applicants to residency programs and cause discriminatory rejections when applying to residency programs.  


Disseminated findings via AMA, AOA and ACGME listservs

Published findings on the AAMC Program Director Workstation

Broadcasted findings via ACGME Bulletins/E-Communications

Gave presentations to ACGME and AACOM: Dean’s Forum and Dean’s Retreat

4 Informational webinars held

One-Page Summary Sheets Created and Disseminated to Institutions

Toolkits Created and Disseminated to Institutions

Presentations to GME Offices across the Nation

Working with IT personnel to reconfigure VSLO/ERAS Applications

Re-launch IRB-Approved survey in February 2023

In addition, all learners, faculty, and staff can report episodes of discrimination, at any time, to the AAMC ERAS Investigations via erasinvestigations@aamc.org , your medical school leadership (e.g. Dean of Students Affairs, Dean for GME/DIO, Dean of Diversity) or to your University Office for Equal Opportunity. Residents or fellows can make formal complaints about their treatment in their program via complaints@acgme.org  Feel free to also contact LMSA leadership for further information – Director Deion Ellis MD, MMS at center@lmsa.net LMSA National Executive Director J.P. Sanchez MD, MPH at exec.director@lmsa.net , or LMSA National President Gualberto Muñoz MS IV at president@lmsa.net 

Link to Full Press Release


Use the Links Below for Two Brief Videos on Actionable Steps to Reduce Discrimination Faced by Medical Students in Puerto Rico.

CLICK HERE for Video Resource 1 (13-minute video by LMSA National Executive Director)

Information on the Four Medical Schools in Puerto Rico

Ponce Health Sciences University School of Medicine (PHSU)

San Juan Bautista School of Medicine (SJB)

Universidad Central Del Caribe School of Medicine (UCC)

University of Puerto Rico School of Medicine (UPR)