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After the game: Medical school applications hit record high… : Emergency medicine news


medical school, COVID-19, workforce


One of the most interesting changes in healthcare during the COVID-19 pandemic has been the effect on the number of applicants to medical school. These are on the rise.

These applications have increased by the highest percentage since 1980, and we have seen a significant increase in applications from the two largest groups of underrepresented minorities (URMs) in medicine, black and Hispanic students.

You have to go back some 30 years to find the latest double-digit increases in medical school applications: 12% in 1991, 11% in 1992, and 13% in 1993. The largest increases since the turn of the millennium were 8% in 2007. and six percent in 2013 and 2015. All other years since 2000 were below five percent with an average increase of around two percent.

Applications in 2021, however, from first-time applicants and repeat applicants increased by 15%, and applications from first-time applicants alone increased by 18%. More than 62,400 students applied to medical school in 2021, compared to about 53,000 in 2020. What prompted these 8,500 people to apply to medical school this year? (AAMC. Fall 2021 Applicant, Enrollment and Enrollment Data Tables;

Many theories have been floated, without much evidence. Some suggest those considering attending medical school had little to do during the pandemic lockdown. It is conceivable that many were planning to take a year off to gain some clinical experience through activities such as writing, but the pandemic has canceled the vast majority of these plans, and many potential candidates may have sought ways to keep busy by improving their resumes and filling out applications. (AAMC. Dec. 8, 2021;

Another plausible cause is that potential candidates were motivated by the work of healthcare personnel during the pandemic. The 24-hour news feed of the sacrifices endured by doctors and nurses was inspirational. This phenomenon has been dubbed the Fauci effect. The pandemic represented a call to action for candidates who were reluctant to become doctors. (Forbes. June 17, 2021;

A perfect storm

The heightened attention to economic inequalities created by the pandemic may also have contributed. Low-income people and certain ethnic groups have suffered disproportionately from poor COVID outcomes. This phenomenon, combined with recent social justice movements, could inspire some people to pursue a career in health care. Interestingly, minority applicants applied in greater numbers.

All medical schools are motivated to increase diversity within their student body, and many openly court applicants from underrepresented minorities, especially black and Hispanic students.

Application fee assistance is also offered by the Association of American Medical Colleges to provide economically disadvantaged applicants the opportunity to mitigate the cost of applying to enough medical schools to have a reasonable chance of being accepted. These elements combined likely contributed to the impressive 25% increase in black applicants and 8% increase in Hispanic applicants. (AAMC. Dec. 8, 2021;

All of this information begs the question: Is the dramatic increase in the number of medical school applicants this year an outlier or the start of a trend? Anecdotally, leaders in academic medicine tend to think this is a one-time event and that interest in medical school among current undergraduates is lower.

Perhaps what we are seeing this year is a perfect storm created by too many qualified people with little to do who have been inspired by medical personnel on the front lines of a global crisis. Only time will tell, but what are the implications if this wave of people interested in healthcare careers continues?

Supply and demand

As in all markets, demand decreases when supply increases. As a result, medical schools will be more selective about which candidates they choose for each class. A sustained increase in the number of applicants could stimulate the development of new medical schools or allow existing schools to open branch campuses; 52 of the 155 U.S. medical schools currently operate at least one. (AAMC. 2022;

Even as opportunities to attend medical school increase, more applicants may flock to physician assistant and nurse practitioner schools; the country has about 280 PA schools and about 400 PI programs. Non-physician providers potentially compete for jobs with all physicians, including emergency physicians. (Accreditation Review Commission on Physician Assistant Education, Inc.; American Association Of Nurse Practitioners,

And what about nurses? Everyone in health recognizes that we need a lot more. The good news is that applications to nursing schools are also on the rise, but nursing schools turned down over 80,000 applicants in 2020. Unfortunately, the bad news is that undergraduate nursing degree enrollments fell by more than 2.5% in 2020 due to the decline. class sizes. Enrollment in medical schools increased, but the reverse happened for nursing schools. (American Association of Colleges of Nursing. April 1, 2021;

The increase in medical school applications from RMUs is encouraging. Overall diversity in emergency medicine and most other specialties cannot be improved until we have more medical graduates from RMU, as I noted in my March column. (REM. 2022;43[3]:8; A deeper dive into the factors that created the surge in applications from URM’s two largest groups, Black and Hispanic students, can provide important insights into how to sustain this important trend.

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Dr Cookis the director of the emergency medicine residency program at Prisma Health in Columbia, SC. He is also the founder of 3rd Rock Ultrasound ( Friend with him, follow him on Twitter@3rdRockUS, and read his past columns on