{"title":"Parental medical background and pre-admission preparedness in China's medical student selection.","authors":"Jin Yang, Hongbin Wu","doi":"10.1080/10872981.2025.2534048","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>While children of medical professionals are globally overrepresented in medical schools, evidence from China remains limited. This study examines parental medical background prevalence among Chinese medical undergraduates, its association with admission outcomes, and disparities in pre-admission preparedness within China's meritocratic National College Entrance Examination (NCEE) system - a critical context given its role as the primary gateway to higher education.</p><p><strong>Methods: </strong>Using data from the 2021 China Medical Student Survey (CMSS), a nationally representative sample of 19,299 clinical medical students was analyzed. Linear and logistic regression models were employed to assess the relationship between parental medical background and admission outcomes/pre-admission preparedness, controlling for socio-demographic covariates (e.g. gender, urban/rural residency, family income) and institutional/provincial fixed effects.</p><p><strong>Results: </strong>Children of medical professionals were significantly overrepresented (11.60% vs. 0.34% national physician-population ratio). Parental medical background did not predict advantages in NCEE scores or admission to long-term programs. However, paternal medical background was associated with higher pre-admission preparedness in clinical practice (β = 0.199, <i>p</i> < 0.05), health and society (β = 0.205, <i>p</i> < 0.01), professionalism (β = 0.130, <i>p</i> < 0.05), and a greater likelihood of understanding the major (OR = 0.724, <i>p</i> < 0.01), while maternal background only correlated with understanding of the major (OR = 0.623, <i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>In the context of China's NCEE-based student selection system, parental medical background has no direct influence on admission results, yet intergenerational disparities in preparedness persist. To foster substantive equity, China's meritocratic system could integrate targeted interventions (e.g. pre-med mentorship for disadvantaged students). These findings underscore the global imperative to balance meritocracy with policies addressing structural inequities in medical student selection.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"30 1","pages":"2534048"},"PeriodicalIF":3.8000,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265103/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Education Online","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/10872981.2025.2534048","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/15 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"EDUCATION & EDUCATIONAL RESEARCH","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: While children of medical professionals are globally overrepresented in medical schools, evidence from China remains limited. This study examines parental medical background prevalence among Chinese medical undergraduates, its association with admission outcomes, and disparities in pre-admission preparedness within China's meritocratic National College Entrance Examination (NCEE) system - a critical context given its role as the primary gateway to higher education.
Methods: Using data from the 2021 China Medical Student Survey (CMSS), a nationally representative sample of 19,299 clinical medical students was analyzed. Linear and logistic regression models were employed to assess the relationship between parental medical background and admission outcomes/pre-admission preparedness, controlling for socio-demographic covariates (e.g. gender, urban/rural residency, family income) and institutional/provincial fixed effects.
Results: Children of medical professionals were significantly overrepresented (11.60% vs. 0.34% national physician-population ratio). Parental medical background did not predict advantages in NCEE scores or admission to long-term programs. However, paternal medical background was associated with higher pre-admission preparedness in clinical practice (β = 0.199, p < 0.05), health and society (β = 0.205, p < 0.01), professionalism (β = 0.130, p < 0.05), and a greater likelihood of understanding the major (OR = 0.724, p < 0.01), while maternal background only correlated with understanding of the major (OR = 0.623, p < 0.01).
Conclusions: In the context of China's NCEE-based student selection system, parental medical background has no direct influence on admission results, yet intergenerational disparities in preparedness persist. To foster substantive equity, China's meritocratic system could integrate targeted interventions (e.g. pre-med mentorship for disadvantaged students). These findings underscore the global imperative to balance meritocracy with policies addressing structural inequities in medical student selection.
导读:虽然医学专业人员的子女在全球医学院的比例过高,但来自中国的证据仍然有限。本研究考察了中国医学本科生中父母医学背景的流行程度、其与录取结果的关系,以及在中国精英化的高考(NCEE)体系中,入学前准备的差异。鉴于高考作为高等教育的主要门户,这一背景至关重要。方法:利用2021年中国医学生调查(CMSS)的数据,对全国具有代表性的19,299名临床医学生进行分析。采用线性和逻辑回归模型来评估父母医疗背景与入院结果/入院前准备之间的关系,控制社会人口统计协变量(如性别、城市/农村居住、家庭收入)和机构/省级固定效应。结果:医学专业人员的儿童比例明显过高(11.60%对0.34%的全国医师人口比例)。父母的医学背景不能预测在高考成绩或长期项目录取方面的优势。然而,父亲的医学背景与临床实践中较高的录取前准备相关(β = 0.199, p p p p p p)。结论:在中国基于高考的生源选拔制度下,父母的医学背景对录取结果没有直接影响,但在准备方面的代际差异仍然存在。为了促进实质性的公平,中国的精英体系可以整合有针对性的干预措施(例如,为弱势学生提供医学预科指导)。这些发现强调了平衡精英管理与解决医学生选择结构性不平等问题的政策的全球必要性。
期刊介绍:
Medical Education Online is an open access journal of health care education, publishing peer-reviewed research, perspectives, reviews, and early documentation of new ideas and trends.
Medical Education Online aims to disseminate information on the education and training of physicians and other health care professionals. Manuscripts may address any aspect of health care education and training, including, but not limited to:
-Basic science education
-Clinical science education
-Residency education
-Learning theory
-Problem-based learning (PBL)
-Curriculum development
-Research design and statistics
-Measurement and evaluation
-Faculty development
-Informatics/web