It’s still an issue, but one medical schools, LCME and AAMC are mindful of. AMCAS now asks about family financial background (parental education & job title, household income, dependence on government programs before age 16, how a student paid for college, age a student first began paid employment, how much of a student’s earning went to family support, grew up in a medical underserved area, etc) on the primary application form. AMCAS uses this information to rate an applicant’s level of disadvantage on a scale of 0 to 5, with 0 being no impediments to 5 being the most disadvantaged. This information is displayed on the first page of an applicant’s primary for all admission offices to see. The student is also offered the opportunity to explain any circumstances they felt affected their educational potential (attending underperforming local schools, the need to work their way through college, etc).
This information is used by individual medical schools to identify students who come from disadvantaged backgrounds and their application is read in this light–that they have had a longer road to travel to become successful and they may be given some slack w/r/t to pre-med EC/MCAT/GPA expectations.
Medical schools view paid clinical employment and volunteer clinical experiences as equivalent–with neither one being preferable.
AMCAS also offers a Fee Assistance Program for applicants from low income backgrounds. (Family + student income information required for program consideration.) FAP gives a student reduced price MCAT sittings (up to 3 tests/year), up to 14 primary and secondary fee waivers, a free 1 year subscription to MSAR and free access to MCAT prep materials.
Many medical schools will pay for transportation (and provide free lodging with a current med student host) for low income applicants (ones who have applied with FAP).
LCME also mandates that medical schools, as part of the accreditation requirements, recruit and enroll students from diverse backgrounds (ethnic and SES) and to provide any necessary additional support for those students during medical school–including additional funding and individual tutoring. LCME audits med schools approx every 3 year to make sure they are complying with this requirement. The failure to do this is one of the main reasons why SLU was placed in probation last year.
Still the process is far from perfect and many lower SES students get shut out by the process.