Background First-generation low-income (FGLI) medical students face unique challenges that influence their career paths. These students often encounter significant socioeconomic barriers, including financial burdens, lack of mentorship, and limited diversity within medical fields. The journey through medical school is particularly arduous for FGLI students who often lack the financial resources and professional networks available to their peers from more affluent backgrounds. Additionally, the high cost of medical education and the substantial debt burden can discourage these students from pursuing lower-paying specialties, further limiting their career choices. Understanding these factors is crucial for developing strategies to support FGLI students and enhance diversity within the medical profession.

Methods A comprehensive literature search was conducted across PubMed, CINAHL via Ebsco, and Embase via Elsevier databases from January 1, 2018, to June 27, 2024. Included studies were randomized controlled trials, cohort studies, case-control studies, cross-sectional studies, surveys, or systematic reviews focusing on FGLI medical students in the United States. Interventions involving support from medical schools, such as financial aid, mentorship programs, and early exposure to various specialties, were also considered.

Results The review identified that financial burdens, particularly student debt, are significant barriers that often deter FGLI students from pursuing lower-paying specialties such as primary care. The lack of diversity and mentorship within certain medical fields further exacerbates these challenges, making it difficult for minority and low-income students to find role models and supportive networks. Studies highlighted the effectiveness of interventions such as pipeline programs, which provide early exposure to various specialties and financial support mechanisms, in addressing these barriers. These interventions provide FGLI students with the tools and confidence needed to pursue a broader range of specialties, including those traditionally less accessible to them.

Conclusion Addressing the financial, social, and educational barriers faced by FGLI medical students through comprehensive and targeted interventions is essential. By implementing strategies that include financial support, enhanced mentorship, and early exposure to various specialties, medical schools can foster a more inclusive and diverse medical workforce. This approach will not only improve the recruitment and retention of FGLI students in a broader range of specialties but also enhance patient care and health outcomes across communities. Future research should focus on examining the long-term effects of these interventions and uncovering additional barriers and solutions to support the career development of FGLI medical students.