Abstract
Background Medical trainees often face high financial burden and limited financial literacy, which contributes to stress and burnout, especially among first-generation students and international medical graduates (IMGs). This study assessed baseline financial confidence, compared first- versus non-first-generation trainees, and evaluated a brief financial literacy intervention. Methods A mixed-methods study was conducted in May of 2025 at the Creighton University School of Medicine in Arizona, including medical students and internal medicine residents. Participants completed a pre-survey, attended a 30-minute physician-led lecture on debt management, credit, budgeting, and taxes, and then a post-survey. The primary outcomes included perceived financial literacy and credit-management confidence. The secondary outcomes included financial stress and satisfaction. Results Forty-five participants (27 students, 18 residents) completed pre-surveys, with 42 completing both pre- and post-surveys. Sixty-four percent identified as first-generation. At baseline, first-generation trainees reported significantly lower financial literacy (2.03 vs 2.84, p<0.001) and tax-filing competence (2.14 vs 2.62, p=0.026). In our post-intervention, 79% felt more equipped to manage finances, 86% more confident with credit, and 48% reported reduced stress. First-generation trainees showed greater improvement than peers (χ²=8.42, p=0.015). All participants recommended the session, with most requesting more practical content on taxes, debt repayment, and credit building. A financial literacy session was given, that showed improved knowledge, confidence, with decreased stress, with significant benefits for first-generation trainees. Conclusions These findings suggest a benefit to financial education integrated into medical curriculum as a wellness and equity strategy. Limitations include single-site design, modest sample size, and reliance on self-report. Future research should explore multi-institutional, longitudinal, and behavioral outcomes to assess sustained impact.