番茄社区

This story was originally published on August 18, 2020. As part of 番茄社区's review of the past year's top stories, we are republishing it along with an update reviewing subsequent developments in medical school applications this year.

Applications to medical schools are up sharply over this time last year, according to the Association of American Medical Colleges (AAMC) and American Association of Colleges of Osteopathic Medicine (AACOM).

applications to AAMC schools received by early August were up 14%, and AACOM reported a 17.7% surge as of August 11.

While applications have been steadily increasing over the last few years, the increases haven't often reached double digits.

The pandemic is a major reason for the spike, sources told 番茄社区, with some applicants finding a calling in medicine, while others are looking for something to fill idle time or combat uncertainty.

Preliminary statistics do not mean the application process will definitely be more competitive this year. "It is just a snapshot in time during a very unconventional time," said Geoffrey Young, AAMC's senior director of student affairs and programs.

But, to take two examples: Nearly 9,000 had applied to Michigan State University's College of Human Medicine as of mid-June, the , for a student class of 190. And applications to Rowan University School of Osteopathic Medicine in suburban Philadelphia are up 17% over last year.

This year's surge exceeds recent trends. Applications for 2019-2020 to AACOM schools, for example, increased by 6.1% over the 2018-2019 cycle.

At AAMC schools, the number of applicants increased slightly each of the last two cycles. It had dipped in 2017-2018, after increasing every cycle since 2010-2011. The last cycle's total was 53,371 -- 24.9% ahead of 2010-2011.

Many Factors at Work

Applicants this year are motivated in large part by an interest in medicine. That counters a 21st-century trend seeing many more science brains pursue careers in computer science over medicine, said Sahil Mehta, MD, who runs the consultancy . They want to join a profession that is being celebrated and earning more publicity than ever in recent memory, he added.

"There's a trend towards students and people thinking about this earlier, a trend towards more students looking to a career in medicine," Mehta said, noting his clients have especially expressed interest in epidemiology, public health, and infectious disease.

Prospective students who would normally take jobs in medical research or fellowships for a year have lost opportunities to COVID-19, Mehta said. They are applying to medical school a year earlier than expected instead. "The pandemic has hit applicants in a way that has caused a lot of unpredictability," he noted.

Additionally, many schools have relaxed their admissions processes, sometimes encouraging students to apply without all of their prerequisites lined up, said Jayme Bograd, AACOM's director of application services, recruitment, and student affairs.

Students have also had more downtime to work on applications, Bograd said, because they have largely been cut off from social time.

Some schools' decisions to waive or minimize the importance of the MCAT is also a factor, said Kristen Moon, who runs the consultancy . It has induced applicants to apply to more reach schools. "I think it gave some students hope," Moon said. "They are saying, 'let's just try, let's just apply.'"

At the same time, Mehta said, the MCAT's frequent cancellations have led some prospective students to throw their hands up and put off applying until next year, when they hope they can count on taking the MCAT as scheduled.

Bograd said another factor driving the AACOM applications is the addition of three new programs over the last two cycles -- including Texas's Sam Houston State and California Health and Science University, which both debut classes this fall.

Paula Watkins, assistant dean for admissions at Rowan University School of Osteopathic Medicine, does not know if the flood will last throughout the entire cycle. "It's just so early to tell whether it will continue," she said.

But with COVID-19 not going anywhere, Moon is confident it will last for the duration of this cycle at least. "I don't see much changing this year for sure," she said.

Looking Ahead

As for next year and beyond, some prospective students are expediting their applications because they fear next year will be even more competitive, Mehta said. He also expects to see a consistent increase in applications beginning in 3 to 5 years.

If applications do increase, that could squeeze out more qualified applicants. While applications have been increasing over the last few years, insiders confirmed, the number of corresponding slots at schools has not increased at the same rate.

For example, the number of applicants to AACOM schools increased by 78.7% over the decade spanning the 2008-2009 to 2018-2019 cycles (which was the last cycle with all figures available), while total enrollment increased by 79.8% and first-year enrollment by 70.5%.

The number of AAMC matriculants increased by 17.2% and total enrollment by 17.8% from 2010-2011 to 2019-2020, while the number of applicants was up 24.9% (though the number of applicants for a full cycle has scarcely increased since 2015-2016).

"I don't think the number accepted is going to change significantly," Young said. "It's always going to be competitive."

But the sudden influx this year, if sustained, would make the process even more so.

Over the last few years, AAMC schools have expanded their capacity, Young said, and a few new schools have launched. But, he added, "The data show at least more recently we can expect an increase in applicants -- a slight increase -- but we only have so many positions."

Central Michigan University College of Medicine "could consider" adding 20 more slots to its 2021 incoming class, the State Journal reported. Meanwhile the MSU school says it is at capacity. Other AAMC schools may increase class sizes by one or two, Young said, but they cannot further grow without approval from accreditors.

The overall relative dearth of medical school slots is in part due to a corresponding paucity of residency spots, Joseph Kerschner, MD, dean of the Medical College of Wisconsin, . Young agreed with that assertion, while cautioning that the situation is nuanced. The AAMC "would love to see positions added to residency," he said, echoing an for Congress to increase the number of federally funded slots.

The total class size approved by the increased by 6.6% for 2020-2021, after increasing 5.6% the previous school year -- in part due to the new schools launching. Neither the COCA nor the AACOM could say how many more total slots will be available for the 2021-2022 school year.

Rowan plans to keep its class size about the same as this year's 216 students, Watkins said. The school could consider increasing its class sizes in the future if the demand is consistently higher, she said, noting the physician workforce needs to be strengthened. "But we want to make sure there are adequate physicians to care for an increasingly diverse patient population," she said.

For now, it is unclear if many schools have enough resources to handle the flood of applications.

Watkins said Rowan "absolutely" has enough to give each application the same scrutiny as applications of past years.

"They're working very diligently," Young said of AAMC member schools. "They're getting it done."

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