Purpose
Despite significant growth in the PA profession, diversity remains limited due to insufficient representation in student enrollment. This study examines barriers within the increasingly competitive application and admission process while investigating the relationship between intersectional marginalization identity (IMI) scores and various outcomes affecting marginalized PA students' well-being.

Methods
A retrospective cohort study analyzed data from the 2019 PAEA Matriculating Student Survey. IMI scores were calculated using demographic variables including age, gender, sex, sexual orientation, race, ethnicity, and underrepresented in medicine status. Outcomes measured included acceptance rates, Perceived Stress Scale (PSS-4) scores, Quality of Life (QOL) measures, and financial concerns. Statistical analyses included cross-tabulations, Kruskal-Wallis H tests, and Spearman's correlations.

Results
Non-marginalized students showed earlier career decision-making (p <.001) and higher acceptance rates (p=0.001). Marginalized students demonstrated significantly higher financial concerns, including outstanding pre-PA education loans (p <.001) and greater reliance on scholarships (p <.001). They also reported increased fatigue, lower overall quality of life, decreased physical and emotional well-being, reduced social activity, and less satisfaction with social support (p <.001).

Conclusion
Significant disparities exist between marginalized and non-marginalized PA students in program access, financial resources, and well-being measures. These findings highlight the urgent need for targeted interventions to address educational access barriers, enhance financial support, and develop inclusive support systems to promote diversity within the PA profession.