Introduction: Underrepresented physician faculty have historically shouldered disproportionate academic service related to diversity and inclusion (DI) initiatives. However, this is not well-reported among underrepresented students. We characterize the perceived impact of institutional service related to racial justice on Black medical students during recent periods of racial tension. Methods: Semi-structured interviews were conducted via Zoom from Feb. 1-present among members of the Student National Medical Association (n=16 interviews). Interview questions assessed students’ (n= 16) engagement/motivations for DI service, impacts/acknowledgment of their service, and the impact of racial equity movements of 2020. Two researchers conducted qualitative content analysis to identify relevant themes/sub-themes. Results: Global-Themes: Students reported that engagement with DI initiatives was motivated by (1) a sense of duty (e.g., ‘if I don’t do it, it won’t get done’), (2) ‘paying it forward’, (3) a strong sense of community among students pursuing these efforts. Students overwhelmingly reported that DI initiatives have been primarily started/championed by students, rather than faculty or other leadership. Sub-Themes: Students reported an appreciation for conversations and anti-racism efforts started in 2020. Students have received minimal acknowledgement for their service and felt other activities (e.g., academic research) were more respected. Students, particularly M3s and M4s, discontinued DI service in favor of (1) focusing on other academic pursuits, (2) burnout/exhaustion, (3) opening space for younger students to participate. Conclusions: In this qualitative study, underrepresented medical students were highly motivated champions of DI initiatives. This study illuminates student experiences spearheading DI initiatives and provides insights to the “minority tax” as early as the medical school level. SOURCE OF Funding: Coca-Cola Critical Difference Grant
