Investigating the Impact of Educational Backgrounds on Medical Students’ Perceptions of Admissions Pathways at the Michael G. DeGroote School of Medicine at McMaster University

Background: Many Canadian medical schools have introduced equity-focused admissions pathways for Black and Indigenous applicants, yet little is known about how current medical students perceive these policies. Understanding these perceptions is critical to ensuring equity initiatives are effective and well-supported. Methods: We conducted a cross-sectional survey of 95 undergraduate medical students at McMaster University. The survey included Likert-scale, multiple-choice, and open-ended questions assessing attitudes toward Black and Indigenous facilitated admissions pathways. Educational background was categorized by the number of humanities/social science courses taken prior to medical school. Quantitative data were summarized descriptively; qualitative responses were thematically analyzed. Results: Most students supported diversity in medicine and agreed that equity pathways address barriers faced by Black and Indigenous applicants. However, fewer than half felt informed about the purpose of these pathways. Responses highlighted concerns about transparency, fairness, and the possibility that pathways may disproportionately benefit higher-socioeconomic-status applicants. Subgroup trends did not show consistent support among students with greater exposure to humanities/social sciences; some expressed stronger skepticism regarding fairness. Qualitative themes emphasized the need for clearer communication, recognition of socioeconomic barriers, and expansion of equity initiatives. Interpretation: Students broadly valued equity-focused admissions but questioned their implementation and transparency. Concerns about socioeconomic privilege and unclear standards indicate a need for better institutional communication and more inclusive eligibility criteria. Equity pathways should be paired with structured education and clear messaging to foster trust, improve understanding, and align admissions policies with the social accountability mandate of medical education.