Beyond Access: Social Inequities and Discriminatory Experiences Among Brazilian Medical Students

BACKGROUND: Universities are expected to promote diversity and inclusion; however, medical schools may continue to reproduce discriminatory practices. In Brazil, Law No. 12,711/2012 expanded access to higher education through affirmative action, yet evidence on how discrimination is experienced during medical training remains limited. METHODS: We conducted a cross-sectional study of 143 medical students (years 1-6) at a Brazilian federal university in 2025. Discriminatory experiences were assessed using the Explicit Discrimination Scale (EDS). Group differences were analyzed using Mann-Whitney U and Kruskal-Wallis tests. RESULTS: Participants were predominantly White (66.7%), female (77.5%), and from higher-income backgrounds (60.1%), although half entered through affirmative action (50.4%). Higher discrimination scores were significantly associated with lower socioeconomic status, racial/ethnic minority identity, disability status, public secondary school attendance, use of affirmative action policies, and first-year academic standing (p < 0.05). CONCLUSIONS: Despite expanded access to medical education in Brazil, disparities in student experiences persist. These findings underscore the need for targeted institutional strategies to foster inclusive learning environments and support student well-being and progression.