Mind the Gap - How First-Generation and International Students Navigate Prehealth Pathways - Insights from the HPSA/SDN Fall 2024 Applicant Experience Survey

Oct 3, 2026

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Health Professional Student Association survey insights examine how immigrant/F1-visa-holding and first-generation prehealth students prepared for the 2024-2025 application cycle. The report analyzes self-disclosed performance on MCAT, Casper, and PREview and compares these outcomes with other-generational US respondents, alongside patterns in how applicants seek advising and information. Findings indicate immigrants and first-gen students show lower exam performance, potentially tied to English comprehension and differing awareness of academic and social norms, and may need more holistic support.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages17

Reading Time43 min

AccessFree to download

Survey Methodology

Key Findings on Test Performance (MCAT, Casper, and PREview)

Support for International and First-Generation Students

Insights on Advising Resources and Satisfaction

Action Steps

Mind the Gap: How First-Generation and International Students Navigate Prehealth Pathways Insights from the HPSA/SDN Fall 2024 Applicant Experience Survey Emil Chuck, Ph. D. Director of Advising Services, Health Professional Student Association Copyright © 2025 Health Professional Student Association Article The path to health professions is challenging for all students, but for immigrants and first-generation (first-gen) prehealth students, it can feel like navigating uncharted territory without a map. These students often enter higher education with limited exposure to academic culture and professional networks, creating invisible barriers to success that persist throughout their educational journey ( Posid 2021 , Ruiz 2021) . While universities have begun implementing targeted support systems, research shows that these challenges multiply exponentially when these students pursue competitive health professional programs (Joy 2018 , Havemann 2023) . The HPSA/SDN Fall 2024 Applicant Experience Survey offers compelling new evidence that highlights these systemic disparities and suggests pathways toward more equitable outcomes. The Health Professional Student Association’s Fall 2024 Applicant Experience Survey examined how immigrant/F1-visa-holding (immigrant/F1) , first-generation (first-gen) US, and other-generation (other-gen) US prehealth students prepared for the 2024-2025 application cycle. For premed applicants, we compared each cohort’s standardized exams ( MCAT) and situational judgment tests (Casper and PREview) . We also examined how each group sought advice about the application process from prehealth advisors versus internet sources. Survey Methodology The data in this report were analyzed from the HPSA Fall 2024 Applicant Experience Survey. The survey was declared IRB-exempt ( IRB00012821 , IORG00100811; IRB Protocol 12424601) . Anonymous, volunteered responses were captured from an open call to 2024-2025 prehealth applicants between October and December 2024 using RedCap. Key Findings on Test Performance ( MCAT, Casper, and PREview) 112 respondents self-disclosed their performance on the MCAT, Casper, and PREview exams as part of their application profile. Figure 1 compares immigrant/F1 , first-gen, and other-generational respondents. 18 immigrant/F1 respondents reported lower overall performance on the MCAT as shown by the interquartile range (506 to 515.5) and median (507) . First-gen respondents’ performance was better ( IQR 507 to 518.5 , median 512) , but was lower than other-gen respondents ( IQR 509 to 519 , median 514) . Smaller performance differences were observed with the CARS section scores ( Figure 2) . Immigrant/F1 respondents had lower performance ( IQR 124 to 129 , median 126) compared to first-gen ( IQR 127 to 129.75 , median 128.5) or other-gen ( IQR 126 to 130 , median 128) . Smaller numbers of respondents took situational judgment tests. Among those taking the AAMC PREview exam, immigrant/F1 respondents reported lower scores ( IQR 4 to 6.5 , median 5.5) compared to first-gen ( IQR 4.75 to 7 , median 6.5) or other-gen respondents ( IQR 6 to 7.25 , median 7) . Copyright © 2025 Health Professional Student Association In contrast, other-gen respondents reported better performances on the Casper assessment ; 38 of 56 had third-or fourth-quartile (highest) results. 4 of 10 first-gen and 4 of 10 immigrant/F1 respondents reported third-or fourth-quartile results. 5 of 10 immigrant/F1 respondents had first-quartile (lowest) performances. While our results must be cautiously viewed through the lens of our small sample, they affirm that immigrant/F1 and first-gen applicants tend to have lower exam performance. Immigrant/F1 Casper and PREview performance may be due to English comprehension challenges (CARS scores) or less awareness of expected social norms about academic culture (tested with AAMC PREview) or American society (tested with Casper) . If these results repr

FAQs

What cohorts does the HPSA/SDN Fall 2024 applicant experience survey compare?

It compares immigrant/F1-visa-holding students, first-generation US students, and other-generational US prehealth students preparing for the 2024-2025 cycle.

Which exams were analyzed in relation to test performance?

The report examines self-disclosed performance on MCAT, Casper, and PREview, including section-level outcomes such as CARS.

How do immigrant/F1 and first-gen applicants differ in where they seek application information?

About half used undergraduate prehealth advising offices, but they also relied heavily on internet resources. The survey notes lower use of independent, for-profit consultants and limited access to postbac advisors.

Oct 3, 2026

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