What First-Year Medical Students Really Want from Minority Mentorship Programs

When students from groups underrepresented in medicine arrive at medical school, many carry an ambition that the profession has historically made difficult to fulfill: becoming a surgeon. Surgery remains one of the least diverse specialties in the United States, and a new study offers a rare quantitative window into why students seek help early, what they expect from that help, and whether the programs built for them actually deliver. Researchers at Duke University examined the written motivations of first-year medical students who joined ASPIRES, a seven-month mentorship initiative that pairs students from underrepresented backgrounds with surgical faculty, and found a striking alignment between student desires and program design.

The ASPIRES Program, short for Advancing Student Preparedness and Involvement for Representation and Equity in Surgery, was established at Duke to address a persistent pipeline problem. Longitudinal studies have documented declining racial and ethnic representation across 16 US clinical academic specialties, and national analyses of general surgery residency programs show that underrepresented minorities remain a small fraction of trainees. Prior research has linked this shortfall to disparities in mentorship access, which several studies identify as a decisive factor in whether underrepresented students pursue surgical careers at all.

To understand what students actually want from such a program, the research team turned to a simple but powerful data source. At the start of the program, every participant answered the question: Why are you interested in participating in ASPIRES? The team collected 73 de-identified responses across four cohorts from 2021 to 2024, achieving a 100 percent response rate. The respondents were predominantly Black or African American at 65 percent, with 35 percent identifying as Latinx or Hispanic and 64 percent as women, providing a demographic portrait of the students these pipeline initiatives are designed to reach.

The analytical approach followed established qualitative methodology. Two independent reviewers coded the responses using NVivo 14 software and a 26-factor thematic codebook developed iteratively as patterns emerged from the text. When the reviewers disagreed on how a passage should be coded, they resolved the discrepancy by consensus. This kind of thematic analysis is a standard tool in medical education research, allowing investigators to move beyond surface statements and identify the underlying drivers of student behavior across a large body of free-text responses.

Five core motivators emerged from the analysis: mentorship, preparation, exposure, career facilitation, and environment. The most frequently cited theme was mentorship itself, appearing in 63 percent of responses, followed by career preparation at 44 percent and a desire for representation or community at 41 percent. Roughly one in three students said they wanted early exposure and opportunities to explore surgical careers. In other words, students were not primarily asking for handholding; they were seeking relationships, roadmap knowledge, and a sense that people like them belong in the operating room.

Equally instructive were the themes that barely registered. Only 6.7 percent of students cited experiential learning as a motivation, and just 13.3 percent mentioned wanting insight into navigating the so-called hidden curriculum, the unspoken norms, networks, and expectations that often determine success in academic medicine. For program designers, this suggests students may not yet recognize how much of the professional socialization process is invisible to them, or they may prioritize visible resources like faculty contact over subtler forms of guidance during the first year.

The study’s central conclusion is one of reassurance: what students sought aligned closely with what ASPIRES was built to provide. That alignment matters because mismatched expectations are a known failure mode in mentorship. When a program promises skill development but students arrive seeking belonging, or vice versa, both mentors and mentees can end up frustrated. Here, the emphasis on identity-conscious mentorship, meaning mentorship that explicitly centers shared identity and belonging rather than treating it as an afterthought, appears to meet students exactly where they are.

The findings sit within a broader and growing evidence base. A 2026 systematic review in the American Journal of Surgery examined the availability of mentorship for underrepresented minorities in surgery and surgical subspecialties, while other studies have shown that structured mentorship programs can improve surgical residency match rates for underrepresented learners. Related initiatives such as LEAGUES, which focuses on leadership exposure for gender and minority equity in surgery, and a four-year follow-up of a preclinical mentorship and early exposure program published in the same journal, reinforce the idea that sustained, structured pipelines can move the needle on representation.

Why does surgical diversity matter beyond the profession itself? Prior research indicates that minority physicians are more likely to care for underserved patients, suggesting that a diversified surgical workforce could play a direct role in addressing health disparities. Meanwhile, the literature on stereotype threat documents how women and minorities exit science and medicine pathways when environments fail to signal belonging. Pipeline programs that combine technical preparation with community-building attack the problem from both ends at once, which may explain why the students in this study overwhelmingly valued representation alongside mentorship.

The Duke team concludes that ASPIRES represents a promising and scalable model for advancing equity in surgical education, and the data support that optimism: a complete response rate across four cohorts, clear thematic demand, and demonstrated alignment with program goals. The challenge ahead is replication and scale. If other institutions can adopt similar identity-conscious mentorship structures and measure student expectations as rigorously, the long path from first-year lecture hall to operating suite may become measurably more navigable for the students surgery has historically left behind.

Subject of Research: Motivations of first-year underrepresented medical students joining a surgical mentorship pipeline program

Article Title: First-year medical students’ motivations for joining an underrepresented minority mentorship program: are we meeting expectations?

Article References: Yanez, G., Soto, A. L., Zasloff, R. A., Mensah-Mamfo, M., Odei, A. D., Gomes, P. V., Medina, C. K., Reeves, R., Eward, W. C., DiLalla, G. A., & Vatsaas, C. J. (2026). First-year medical students’ motivations for joining an underrepresented minority mentorship program: are we meeting expectations?. Global Surgical Education – Journal of the Association for Surgical Education, 5(1), Article 159. https://doi.org/10.1007/s44186-026-00560-0

Image Credits: AI Generated

DOI: 10.1007/s44186-026-00560-0

Keywords: mentorship, underrepresented in medicine, surgery, medical education, pipeline programs, ASPIRES, thematic analysis, health equity, Duke University, surgical careers, representation, hidden curriculum