Medical students are trained to chase excellence: high board scores, strong clinical evaluations, and prestigious honors. These metrics are presented as objective markers of merit and gateways to competitive residency programs and leadership pathways. However, for Asian American, Native American, Pacific Islander (AANHPI) medical students, they often reveal a notable disparity: a discordant system where excellence is recorded, but leadership is withheld.

Two of the most influential distinctions in residency applications, Gold Humanism Honor Society (GHHS) induction and Alpha Omega Alpha (AOA) membership, are strongly associated with career advancement. However, recognition through these honors is not distributed equitably. Although AANHPI students comprise approximately 22–24% of U.S. medical students, while representing only 7% of the U.S. population, prior research has shown that AANHPI students are less likely to be selected for honor societies.1 The label of being “overrepresented” obscures these disparities, narrowing a diverse group into a single narrative and masking inequities in recognition and advancement.

One recently published journal article found that, compared with White students, graduates self-identifying as AANHPI were less likely to be AOA members, and Chinese, Korean, and Taiwanese graduates were less likely to be GHHS members.1 Furthermore, there was relatively low representation of Cambodian, Indonesian, Laotian, Native Hawaiian or Pacific Islander, and American Indian or Alaskan Native students in the study, highlighting their significant underrepresentation in medicine.1 When the system denies us these honors, the subtext is loud: “We value your labor, but we do not see your leadership.”

This bias is reflected in the language of clinical evaluations. AANHPI students are less likely to be described with standout terms such as “brilliant” or “natural leader,” and more often characterized as “diligent” or “dependable.” These descriptors are not inherently neutral; they shape how residency programs interpret an applicant’s potential. These are the traits of a good employee, not a department chair. As a first-generation Taiwanese American and an eldest daughter, I have spent my life being “a pleasure to have in class.” As a first-generation Chinese American and only child, remarks along the lines of “he’s quiet but is a great student” are the apparent ideal. In medical school, I realized that this praise is a double-edged sword. It rewards the “quiet consistency” that brings prestige to medical schools and keeps hospitals running, but simultaneously builds a professional ceiling that rewards self-advocacy and visibility, emphasized in Western cultural norms.

The consequences extend far beyond medical school. Clerkship evaluations influence honor society selection, honor societies shape residency opportunities, and residency training sets the trajectory for leadership roles. In this way, the “bamboo ceiling” in healthcare is not simply a mid-career phenomenon; it is constructed early, reinforced through implicitly biased evaluations, and solidified through inequitable recognition. Although AANHPI students make up nearly a quarter of medical students, their representation diminishes sharply in positions of authority. Only 9% of female and 11% of male department chairs at U.S. medical schools are AANHPI. While AANHPI individuals are present in administrative roles in these departments, they remain underrepresented in dean’s office leadership.

True diversity is not just about a total percentage; it is about reflecting the full mosaic of the American population at every level of authority. We cannot achieve health equity for AANHPI patients until we recognize and support students of their respective communities and empower them to lead. Medical schools must move beyond coarse amalgamations of diversity metrics; instead, we must strive to disaggregate AANHPI data, audit honor society selection processes, and address the implicit bias that prevents a “diligent” student from being seen as a “brilliant” leader by reinvigorating medical educator training.

References

1. Yang DH, Nguyen M, Zhang L, et al. Disparities for Asian American Medical Students in Alpha Omega Alpha and Gold Humanism Honor Societies. JAMA Netw Open. 2026;9(4):e265168. doi:10.1001/jamanetworkopen.2026.5168
2. Asian Americans, Native Hawaiians, and Pacific Islander populations’ contributions to healthcare: Learn about the career journey of Stanford medicine AANHPI leaders. Asian Americans, Native Hawaiians, and Pacific Islander Populations’ Contributions to Healthcare: Learn about the Career Journey of Stanford Medicine AANHPI Leaders – Stanford Environmental Health & Safety. Accessed May 26, 2026. https://ehs.stanford.edu/event/asian-americans-native-hawaiians-and-pacific-islander-populations-contributions-to-healthcare-learn-about-the-career-journey-of-stanford-medicine-aanhpi-leaders.

Author Bios

Jessie Chen is a dual-degree MD/MPH student at the University of Miami Miller School of Medicine. She serves nationally as the National Director of Organized Medicine for the Asian Pacific American Medical Students Association (APAMSA) and locally as the Chapter Mentorship Chair. Passionate about healthcare policy and community empowerment, Jessie works to amplify AANHPI voices in organized medicine while fostering the next generation of culturally competent physicians.

Preston Dang is a third-year osteopathic medical student at Western University-College of Osteopathic Medicine of the Pacific in Pomona, California. He is originally from Orange County, California, completed his B.S. in Microbiology, Immunology, and Molecular Genetics at UCLA, and M.P.H. at Tufts University School of Medicine in Boston, Massachusetts. He is currently serving his second term on APAMSA National Advocacy Committee, and is an active member within the American Medical Association and California Medical Association.