Socioeconomic inequity and the AI divide: implications for health equity and clinical proficiency in South African medical education
1
Medicine, University of Cape Town, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A1141
ABSTRACT
BACKGROUND:
The rapid ascent of Artificial Intelligence (AI) is fundamentally altering health professions education and, by extension, future public health systems. While global discourse emphasizes AI’s potential to augment learning, a critical empirical gap exists regarding its impact within the Global South. The disparity between free and premium AI tiers threatens to create a digital divide that mirrors historical socioeconomic stratifications. In South Africa, where many students face insurmountable financial barriers to basic subsistence, the additional cost of premium AI functionality may become a new marker of academic privilege, ultimately impacting the equity of the future healthcare workforce.
METHODS:
We conducted a comprehensive scoping review of emerging educational technologies and institutional digital readiness frameworks to map vulnerabilities in the South African medical curriculum. To address identified gaps, we designed a cross-sectional study (N≈1100) at the University of Cape Town. This study systematically evaluates the correlation between socioeconomic indicators—such as financial aid status and device ownership—and differential access to premium AI functionalities, utilizing qualitative metrics to assess perceived clinical reasoning proficiency.
RESULTS:
Preliminary scoping and literature review indicate that socioeconomic status is a primary predictor of access to high-functioning AI tools, establishing a tiered educational hierarchy within a single cohort. We anticipate that students limited to free-tier versions will report significant disadvantages in accuracy and feedback depth. Furthermore, groundwork reveals high student concern regarding the lack of formal curriculum integration and its impact on their competitive outcomes and clinical proficiency.
CONCLUSIONS:
Addressing the AI divide is a prerequisite for socially accountable medical education and sustainable health equity in post-apartheid South Africa. This research argues that proactive, university-funded integration is required to ensure that technological shifts do not exacerbate existing structural exclusions, thereby safeguarding the development of foundational clinical reasoning across all socioeconomic strata.
The rapid ascent of Artificial Intelligence (AI) is fundamentally altering health professions education and, by extension, future public health systems. While global discourse emphasizes AI’s potential to augment learning, a critical empirical gap exists regarding its impact within the Global South. The disparity between free and premium AI tiers threatens to create a digital divide that mirrors historical socioeconomic stratifications. In South Africa, where many students face insurmountable financial barriers to basic subsistence, the additional cost of premium AI functionality may become a new marker of academic privilege, ultimately impacting the equity of the future healthcare workforce.
METHODS:
We conducted a comprehensive scoping review of emerging educational technologies and institutional digital readiness frameworks to map vulnerabilities in the South African medical curriculum. To address identified gaps, we designed a cross-sectional study (N≈1100) at the University of Cape Town. This study systematically evaluates the correlation between socioeconomic indicators—such as financial aid status and device ownership—and differential access to premium AI functionalities, utilizing qualitative metrics to assess perceived clinical reasoning proficiency.
RESULTS:
Preliminary scoping and literature review indicate that socioeconomic status is a primary predictor of access to high-functioning AI tools, establishing a tiered educational hierarchy within a single cohort. We anticipate that students limited to free-tier versions will report significant disadvantages in accuracy and feedback depth. Furthermore, groundwork reveals high student concern regarding the lack of formal curriculum integration and its impact on their competitive outcomes and clinical proficiency.
CONCLUSIONS:
Addressing the AI divide is a prerequisite for socially accountable medical education and sustainable health equity in post-apartheid South Africa. This research argues that proactive, university-funded integration is required to ensure that technological shifts do not exacerbate existing structural exclusions, thereby safeguarding the development of foundational clinical reasoning across all socioeconomic strata.
| eISSN: | 2654-1459 |
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