In May 2018, it happened. The American Medical College Application Service (AMCAS) opened its floodgates. As we wrapped up our last years in undergrad, we felt a twinge of excitement as we finally began applying to medical school.
But we quickly found one thing that wasn’t all-too-exciting: the bill. In 2018, the AMCAS charged $170 for the first school applied to and $39 per additional school. Like most medical school applicants, we applied broadly, to about 30 schools each (the average applicant applies to 20 to 30 medical schools). By the time we submitted our primary applications, we had each spent over ~$1,000. After secondary applications, which average around ~$75 to 100 each and are required from most schools, we had spent well over $4,000 on application fees alone.
And then came interviews. As California residents, we found ourselves flying out to the East Coast multiple times a month. We each attended about 10 interviews, which could cost upwards to $400 to 500 to account for flights (due to a master’s program and working full-time, our schedules were inflexible), transportation to the school, food, and sometimes hotels, if medical students were unable to host us. As recent college graduates who never owned two-piece suits, we also had to buy interview-appropriate outfits (and get them tailored and dry cleaned throughout the interview season).
We became increasingly hesitant to attend interviews, because it meant shelling out hundreds of dollars and taking time off work. In such a tumultuous and competitive process, not being able to attend an interview due to financial barriers adds undue stress on the applicant. When we were at interviews, we spent a lot of time thinking if people around us felt the same way.
The admissions faculty at every school we interviewed at boasted diversity in their student bodies. But how can a system that is inherently biased towards those that can foot the price of applying truly be recruiting a well-rounded set of students? In a 2018 report, the AAMC reported nearly one-quarter of matriculating students come from households in the top 5 percent of household income. Over 50 percent of matriculating students come from the top 85th. Although there are additional factors that contribute to these statistics, it is not hard to imagine that the application cost can play a hindering role.
Socioeconomic gaps in medicine continue to grow. If medical schools truly want to boost diversity in their classes, they must start by decreasing application costs for students across the socioeconomic spectrum. The Fee Assistance Program (FAP) is a great option for some students, but there are many who do not qualify that have to shoulder a heavy financial burden. Additionally, the incidental costs of preparing for and traveling to an interview amount to thousands more dollars spent, even with FAP qualification. Far too few medical schools offer any financial support to cover travel and incidental expenses, overshadowing what should be an incredibly exciting time with financial pressure.
Just like medical school itself, applying to medical school is a great financial investment. We were lucky that our investments worked out, as we are both preparing to begin medical school this summer. But now, it is time to think about loans.
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