They talk about how last year was likely an anomaly due to Covid. Time will tell. One big figure that jumped out to me was the change in number of applicants since 2002-03, an increase of 85.7%. Matriculants have only increased 37.5% for the same time period.
When I did the calcs to see acceptance rate it came back at 37.97% (23,711/62,443).
To anyone with offspring wanting to head toward med school as often comes up in various threads, take heed of current recommendations to have solid applications. It’s not as “easy” as it used to be to get in.
I know someone applying to Med school this year. I feel really bad for them. They are not guaranteed admission anywhere. They have a solid resume, but average MCATs . Not applying to top schools , but rather trying to get into any Med school. They are trying to focus on interviews, for the few that they might get. I hate to see what happens if they dont get in anywhere. They have been wanting to go since they were young and so this is not a “covid decision”
I feel for anyone applying in years where it’s more difficult than normal, esp for those who’ve had the dream for eons. Getting in is tough enough as it is.
Unfortunately, there can also be problems getting jobs post residency in some specialties. @WayOutWestMom probably knows more about the specifics with that. From what I’ve heard it has to do with hospitals having cash flow problems due to Covid. There are the uninsured (all the time) and with no or fewer elective procedures coupled with all the extras needed from Covid, it’s not going well financially for many places.
While last year’s application cycle saw a record increase in the number of applicants, early data for this year shows that increase has not been sustained. (No increase in the number of applicant this year, in fact, a small decrease over last year.)
And historically the number of med school applications have gone up and down, partly following the economy. The number of applications goes up when economic times are hard and down when other high paying jobs are plentiful (like during the tech boom of the mid-late 1990s)
And looking over the past 50 years, from 1971-1978, admission rates were even lower than they were last cycle. Admission rates ranged from 33% to 38% in those years. (Source: Medical education in the United States, 1980–1981 and 1981–82. Journal of the American Medical Association 246:2893–3044, 1981 and 248:3223–3328, 1982)
It should also be noted that the number of available of med school seats has seen HUGE increase in the past 20 years, increasing by 30% for MD programs and over 40% for DO programs. This means in absolutely numbers more students are getting admitted to med school now than were admitted in the mid-2000s when the admissions rates were much higher, close to 50% of applicants.
There are some employment issues in the post-residency job market in many specialties, particularly in pathology, radiation oncology and emergency medicine. (Oversupply of new residency graduates vs number of available jobs ) Additionally the ongoing Covid pandemic has depressed revenues for all hospitals and is making hospitals hesitant to hire new staff. The job market for physicians in popular areas (urban & suburban areas of the East and West Coasts) is tight.
Many of D2’s med school classmates are doing fellowships (and in at least one case adding a PhD to her fellowship) in order to delay their entry into an unfavorable job market.
If it doesn’t work out, another path to consider:
My nephew didn’t wasn’t accepted to med school in his first round of applications. He then enrolled on a masters program at Tufts that was a conduit into Tufts medical school provided a certain GPA was achieved. He’s now doing his first year of residency.
Those “conduit” programs are called Special Master’s Programs (SMPs)
SMPs are high risk-high reward propositions. Do well at a SMP and you have a decent chance at getting a med school admission. Do poorly at a SMP (finish outside the top 15-25% of the class or earn less than 3.75 GPA in the program) and you can kiss any chance of EVER attending any med school good-bye.
In recent years, universities have realized that SMPs can be huge moneymakers for their bio depts and the number of SMPs has proliferated. Caveat Emptor!
The answer is complex. Educating a medical student requires more than just classroom and labs. It requires access to clinical training facilities and clinical preceptors (physicians who do small group, hands-on instruction as part of their daily patient rounds). Med student training is time-intensive and clinical preceptors see significantly fewer patients per day than a regular physician. (And this is one reason why academic physician make less money than private practice physicians. They see far fewer patients.) This also means that training hospitals generate less revenue. Also a training hospitals need to meet certain minimum standards (LCME, the accrediting body for MD programs, and COCA, the accrediting body for DO programs, set these standards) in order to be an acceptable host for med students. Patients at these training hospitals also must be willing to allow med students to see them–and patients in private hospitals are significantly less willing to be “guinea pigs” for students than patients at public hospitals.
The scarcity of clinical training sites is major bottleneck for med schools. Some med schools in New England ship their 3rd & 4th year med students all the way out to California to do their clinical rotations.
This is a huge over-simplification, of course, but it gives some basic insight into why it’s hard to increase class sizes.
Then there is the whole issue of post med school training (residency). Residency is where students learn how to be doctors. Without completing a residency, med school grads cannot get a medical license to practice. Almost all residency training is underwritten by Medicare. The amount of funding for residency has been fixed since the early 1990s and Congress is loathe is increase it. Do you really want med schools to produce more medical grads than the residency system can train? Nothing like having a half million $$ in loans and being unable to get a residency spot.
Some of the more radical proposals to reform medical education are to eliminate the MCAT and eliminate most in-person didactic (classroom) instruction and let student do individual computer based competency training (under restrictive time limits). Then using a student’s USMLE Step 1 score to decide who get to advance to clinical training. It wouldn’t increase the number of clinical training slots, but it would make the first 2 years of med school more accessible.
How does this work in med schools where students are actively engaged in working with patients from the first year? I’ll admit to liking the plan where students are doing the book learning while also doing some apprentice-like training. It’s not anywhere near the same as residency, of course, or even as involved as third/fourth years, but it’s still hands/eyes on vs pure books.
So far this hasn’t got past the theoretical discussion stage so I have no idea what the final proposal might actually look like, but my understanding is that there would be no clinical involvement whatsoever. Once a student passed Step 1, only then would they be considered for continuing on to the clinical portion of medical education. My guess is progressing to the next stage would be via an interview process much like med schools currently use to admit students and require a summer intensive program to get students up to speed in the needed hands-on physical exam skills prior to beginning clinical rotations.
It appears to me that this would lower the cost of medical school but only by pushing the costs onto the individual student who would need to purchase access to online coursework and buy the necessary study aids to pass Step 1 (Anki, Pathoma, First Aid, etc) It could also further make med school accessible only the wealthy students because a student would need cost of living support while studying essentially full time to pass the requisite coursework and Step 1 in the 2-3 years that would be allowed.
They raised enough money to make medical school tuition-free for all students.
Not loans. Not grants. FREE.
These students can graduate without the crushing debt that pushes them to become orthopedic surgeons or similar high paid specialists. Peds, family medicine, etc are a lot more realistic without hundreds of thousands in debt informing your decision.
For the various things that medical education does wrong, there are many things that are done right. Much has changed since I graduated 25 years ago, a lot for the better.
Not to take anything away from NYU because I think it’s a remarkable achievement, the scholarship covers tuition only. According to the NYU website students still have to cover other expenses including housing which they estimate to be $128,210 over the 4 years. Definitely better than the $360,000+ if tuition is included but still a significant amount of money.
It would be quite something if they offered to feed and house the students in New York City for 4 years as well, I don’t disagree.
My hope is that the best and brightest students will choose NYU - already a top tier school even before this tuition waiver - prompting other schools to follow suit with fundraising or leveraging their enormous endowments to similarly lift the burden from young physicians, freeing them to follow their heart and not just their fiscal viability. A healthier balance of primary care docs to specialists would help us keep overall healthcare costs better contained. And I am speaking as a specialist myself - 25 years ago I did the math just like many others do.
The public medical school in my former state has one of the lowest tuitions in the country and requires all med students to do a intensive 6 week shadowing experience with a primary care physician in an underserved area (rural or urban) in the summer after MS1. (The school sets it up.) Students are also required to do one rural primary care medicine rotation during MS4. My younger D did her rotation with IHS (Indian Health Service) on the Navajo Reservation in AZ.
Additionally, there is a state service scholarship program that pays 100% of tuition & fees plus a modest living expenses stipend for any medical student who commits to enter primary care and work in a an underserved area of the state post-residency. The payback for the scholarship is 1-for-1. (One year of service for every year of scholarship received.)
I’d like to see more med schools do something like this rather than just offer free tuition to everyone.
Unfortunately the early data from NYU shows its grads going into non-primary care fields at the same high rates they did before the free tuition program was introduced. (Probably because they have very high standardized test scores feel they deserve better than “just” primary care.)
Seems like there should be more incentive for the best physicians to go into primary care, since a patient can show up in front of a primary care physician with anything, and the physician needs to figure out what it can be and what (if anything) can or needs to be done about it. Yes, the primary care physician may refer to a specialist in some situations, but needs to know enough to know which specialist to refer the patient to.
Seeing as the first class to receive the tuition waiver for their entire medical school time has yet to graduate, I think it’s a little early to judge NYU’s program. Changing attitudes takes time, and expecting someone who only had to pay 3 years of tuition instead of 4 to leap into primary care is unrealistic.
Certainly, many of the applicants who matriculate at top ranked medical schools may have a research focus or be attracted to the cutting edge of medical practice, which is often in specialty care. What we really need is a cultural change in which it becomes desirable and exciting for our top tier grads to go into primary care.
My own personal internist is an MD/PhD from a top 5 school. He is an amazing doc with a prodigious and very up to date knowledge base not just in his own field but even in many of the specialty fields he interacts with.
What I like about the NYU program is that it is an attempt to get highly competitive docs to have the option of primary care. The situation of primary care slots filling from less competitive schools and scrambling 4th years students who didn’t match in derm has been going on for decades. Things to shake up the status quo are good. Young docs finishing their residency in their young 30s don’t need a mountain of debt dictating their choices.
I agree. But then again one of my daughters is a emergency medicine physician so I may be biased. D treats anything and anyone who comes thru the ER doors. Her breadth of knowledge is remarkable.