University of Wisconsin–Madison Medical College of Wisconsin

Leveraging Virtual Platforms to Overcome the Minority Tax Among International Medical Students and Professionals

Dear Editor:

International students represent less than 1% of medical students in the United States and face unique obstacles when pursing medical training. During premedical years, visa regulations limit the clinical, research, and gap-year opportunities for which they are eligible. During medical school, they qualify for few loan options, most of which do not cover full tuition. When applying for residency, visa requirements and cost negatively impact their candidacy.1 Most importantly, reliable information about these nuances and programs that accept international students is lacking.

We serve as co-executive directors of F1Doctors (, a national, student volunteer-led mentorship platform for international prehealth and medical students. It was designed to help overcome these challenges by connecting international premedical students with medical student mentors. Additionally, medical students gain access to other peer and resident/attending mentors to help navigate postgraduate training. The mentors volunteer to be listed on our platform and often hear about F1Doctors through social media, ads on partner websites, or current members. Mentees are able to filter for mentors based on location, stage in training, institution, and expertise and can send them a message directly through our website. These mentor-mentee relationships can range from addressing 1 question (eg, student experience at a specific institution) or can be more longitudinal, where the mentor guides students through medical school/residency applications. The overall objective of these relationships is to fill gaps in the current guidance available for international students and provide access to mentors who have taken a similar path.

Through our social media and email listservs, we recently asked mentees which areas of F1Doctors need improvement. This led to numerous respondents reporting problems with timely response from mentors. Given that only 15% of international applicants matriculate into medical school,1 the prehealth students greatly outnumber the medical students. As such, the 100 medical student mentors on the platform received nearly 500 requests from mentees this past year. The bottleneck narrows with postgraduate training, as F1Doctors has only 20 resident/attending mentors. This phenomenon is seen among other underrepresented minority (URM) groups, whereby a few URM faculty are tasked with mentoring many students. This requires mentors to invest a significant amount of their personal time, referred to as the “minority tax.” This model of mentorship is unsustainable.

One solution is to leverage virtual platforms to create opportunities where the few mentors can disseminate information to a large group of mentees. As such, our team spearheaded a podcast featuring a variety of medical students and doctors. In the last 10 months, the 9 released episodes were downloaded by 1068 listeners. Our social media team hosted Instagram takeovers by medical students around the country; for those 24 hours, the students shared a typical workday and answered real-time questions from mentees. These are saved on our platform. The team also posts tips-of-the-week addressing common questions and features reliable resources on the website. Finally, we coordinate various Zoom events, the most popular of which involves medical students breaking down their American Medical College Application Service applications and Q and A sessions with residents; 15 to 40 students attend each event.

While these initiatives cannot replace the connectedness of one-on-one mentoring relationships, they provide more sustainable avenues for addressing common challenges and questions. This reserves one-on-one meetings for more personalized, targeted guidance. As an added benefit, the members utilizing our platform have an avenue to interact with each other and find camaraderie. Our work provides a framework for implementing a low-cost, virtual, and completely student-volunteer run initiative that provides mentorship for URM students throughout the country, while also limiting the minority tax placed on mentors.

—Gopika SenthilKumar, Matheus Moreira S. Peraci

  1. Jaber Chehayeb R, SenthilKumar G, Saade, Z, Gallo Marin B, Aghagoli, G, Virji AZ. 2022. Examining the first peer-to-peer mentorship program (F1Doctors) for international medical students. J Interdiscip Stud Educ. 2022;11(1):102–125.

Author Affiliations: Medical College of Wisconsin, Milwaukee, Wisconsin (SenthilKumar); Touro College of Osteopathic Medicine, Middletown, New York (Peraci).
Corresponding Author: Gopika SenthilKumar, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226; phone 302.559.5155; email; ORCID ID 0000-0001-5781-1056
Funding/Support: None declared.
Financial Disclosures: None declared.
Acknowledgements: The authors wish to acknowledge the leadership team of F1 Doctors:- Shada Sinclair, Zenzhou (Zach) Zhao, Kalina Tenorio L. Machado, Nicole Martuscelli, Kamelia Drenkova, Zhengyang (Kevin) Su, Deepali Balla, Navaz Shroff, Abubakr El Sobky, Raissa Zuim Dantas de Souza, Scarlett Cheon, Sean Backer, Wendy Lee, and Venkat Suru.
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