Purpose
This study explores the impact of familial educational background on medical student performance, a largely unexplored concept. By addressing gaps in research, we aim to inform medical school admissions and promote equity for students from diverse backgrounds.

Methods
A de-identified database of 425 medical students from the University of Nevada, Las Vegas, was analyzed to assess academic performance metrics, including MCAT scores and USMLE Step 1 and Step 2 results. The cohort included 118 first-generation students, 80 children of physicians, and 227 continuing-generation students. Statistical analyses, including ANOVAs and post-hoc tests, were conducted to compare performance across these groups.

Results
Significant differences in MCAT scores were observed based on familial educational background (p < 0.001). First-generation students scored lower than both continuing-generation students (p < 0.001) and students with physician parents (p < 0.001). However, no significant differences were noted in Step 1 and Step 2 scores among the groups.

Conclusions
The findings indicate that while first-generation students initially perform lower on MCAT scores, the disparities in academic performance diminish over time, as evidenced by comparable Step 1 and Step 2 scores across groups. These results emphasize that early test score disparities may not predict long-term success, underscoring the importance of supporting students from diverse backgrounds to ensure equity in medical education.