Efficacy of Early Exposure Medical Programs for Underrepresented Students: A Systematic Review

Background: Despite decades of initiatives, the physician workforce does not reflect the United States demographic diversity. Underrepresented students are lost at multiple stages of the path to medicine due to academic, financial, and psychosocial barriers, including limited access to ethnoracially concordant role models. Although “pipeline” and “outreach” programs have been implemented, evidence-based evaluation of their effectiveness remains limited. Objective: To identify components of early medical exposure programs associated with increased interest in medicine, self-efficacy, and diversity in the medical field. Methods: We conducted a systematic review of published studies evaluating early medical exposure programs measuring quantitative outcomes. Searches of PubMed, Cochrane, and ScienceDirect were performed for publications from April 1999 to October 2025. Two reviewers independently screened studies, with discrepancies resolved by consensus. Results: Of 464 studies identified, 24 met inclusion criteria. Mentorship (n=18) and research (n=13) were the common program components, followed by application preparation, observership experience, and subspecialty exposure. High school students were the primary participants (n=14), followed by undergraduates (n=8). Program duration varied from one day to three years, with longer programs associated with improved academic performance and increased higher education. Frequently reported outcomes included further education (n=10), increased biomedical and STEM degrees (n=8), increased interest in medicine (n=7), improved academic performance (n=4), and greater self-efficacy (n=4). Risk of bias was rated as “Low” or “Moderate.” Conclusion: Early exposure programs for underrepresented students are associated with increased interest in medicine, improved self-efficacy, reduced perceived barriers, and academic benefits. Mentorship and research emerged as the most prominent components, associated with increased likelihood of further education and the pursuit of biomedical/STEM degrees.