Meaningful Interactional Diversity, Professional Development, and Service Intent in White Medical Students

Importance At a time when diversity in higher education is increasingly perceived as beneficial only to minority students and disadvantaging to majority-group students, it is crucial to investigate its benefits broadly. Objective To assess whether meaningful interactional diversity (ie, cross-cultural engagement that influences knowledge or opinions) is associated with key educational outcomes among White medical students. Design, Setting, and Participants This cross-sectional study included self-identified White-only medical students who matriculated to a US allopathic medical school between 2013 and 2022, graduated between 2015 and 2024, and responded to the Association of American Medical Colleges Graduation Questionnaire (GQ). GQ responses were anonymous. Data were analyzed from September 2024 to April 2025. Exposure Meaningful interactional diversity, defined by agreement on a 5-point Likert scale with the GQ item, “My knowledge or opinion was influenced or changed by becoming more aware of the perspectives of individuals from different backgrounds.” Main Outcomes and Measures Six self-reported binary outcomes derived from the GQ were assessed: personal and professional development fostered by medical schools, ability to care for and work with people from different backgrounds, and intention to work in an underserved area and with an underserved population regardless of practice location. Results Among 80 542 students (38 589 [47.91%] female) from 155 medical schools, 495 (0.61%) strongly disagreed, 1416 (1.76%) disagreed, 7387 (9.17%) were neutral, 35 155 (43.65%) agreed, and 36 089 (44.81%) strongly agreed with meaningful interactional diversity. Across increasing agreement with meaningful interactional diversity, higher likelihoods of personal and professional development and care and teamwork competence were observed, whereas associations with service intentions were confined to strong agreement. Compared with strong disagreement, strong agreement was associated with greater personal (adjusted relative risk [aRR], 2.37; 95% CI, 2.05-2.74) and professional (aRR, 1.59; 95% CI, 1.42-1.69) development, competence to care for (aRR, 1.23; 95% CI, 1.17-1.29) and work with (aRR, 10.69; 95% CI, 7.84-14.57) people from different backgrounds, and plans to work in underserved areas (aRR, 1.31; 95% CI, 1.08-1.58) or with underserved populations regardless of practice location (aRR, 1.59; 95% CI, 1.30-1.93). Conclusions and Relevance In this cross-sectional study of White medical students, meaningful interactional diversity was associated with graded improvements in core developmental outcomes and threshold-level associations with service intentions.