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Getting Into Medical School Is Getting Harder–Despite Doctor Shortages

Medically Reviewed By William C. Lloyd III, MD, FACS

After an immediate post-COVID surge, medical school applications returned to pre-pandemic levels.

Man on laptop

Whether you’ve been a practicing physician for 20 years or two months, you likely remember the stressful anticipation of waiting for your medical school acceptance letter. But despite our country’s desperate need for more doctors, receiving that letter remains very difficult.

In 2022, more than 55,000 potential doctors each submitted a whopping 18 applications to medical schools around the United States. Notably, those 55,000 applicants represent an 11% decrease from the year prior, when more than 62,000 potential students applied to medical school in the immediate surge resulting from the pandemic. However, only 43% of those individuals received an acceptance letter.

Given that the U.S. is seriously lacking in physicians, why is it so hard to become one?

More candidates means more rejections

The Association of American Medical Colleges (AAMC) predicts a shortage of between 37,800 and 124,000 doctors by 2034, and the causes are multifactorial. Our numbers are growing; the U.S. Census Bureau estimates a 10% increase in our population by 2032. And we’re living longer, necessitating more care in later life. Today’s doctors are prioritizing work-life balance more than previous generations, choosing to work fewer hours than their overcommitted predecessors. And a third of all currently practicing physicians will reach retirement age in the next decade.

On the flip side, more young people than ever before are pursuing careers in medicine. The AAMC reports the number of medical school applicants increased by 15% over the last decade. Research shows millennials and Gen Z-ers in general exhibit a strong desire to positively impact society and give back. Plus, these generations tend to have a greater interest in STEM (science, technology, engineering, and mathematics) fields due to U.S. schools emphasizing these subjects in recent decades. And medical schools have begun avidly recruiting humanities students, encouraging more young people than ever before to consider pursuing medicine.

So more people want to become doctors, and the U.S. sorely needs more doctors. It would seem on paper that the supply meets the demand. But this isn’t the case, of course. Although more people are applying to medical school, there simply aren’t enough slots for every interested applicant.

Med schools: Selective by design, and by mistake

Medical schools are discriminating on purpose; not everyone is fit to thrive as a doctor, and training institutions need to be able to identify students who are willing and able to endure the challenges inherent in the field. But many well-qualified candidates are passed over because there just aren’t enough programs in the U.S.

Very few new medical schools opened between the late 1970s and early 2000s as a result of an inaccurate labor market forecast that predicted an excess of doctors. And while med school class sizes have increased by about 30% in the last two decades, it’s still not enough to match (or even get close to) the spots needed to accommodate the number of candidates.

Historically revered medical institutions aren’t the only programs with low acceptance rates. It won’t be a surprise that in the 2022-2023 cycle, Harvard Medical School, ranked first in the country, enrolled only 2.21% of applicants. However, Baylor College of Medicine, ranked 22nd, enrolled just 3.1% of applicants. And the University of South Carolina’s School of Medicine, coming in at 90th in the U.S., also enrolled just 3.1% of students who applied.

The role of residency slots

The issue of availability extends past medical school and into residency programs, as well. The volume of residencies today is still significantly lower than the needed amount of slots, creating a bottleneck preventing students from becoming practicing physicians. Many residency slots are funded by Medicare, and in order to increase the number of positions available, residency slots must continue to expand.

In December of 2020, Congress added 1000 new Medicare Graduate Medical Education (GME) positions, ending a nearly 25 year freeze on federal support for GME. Those positions are being phased in over a five year period. It’s a start, but more help is needed.

Making the cut

With so many applicants and such low acceptance rates, students can find it hard to stand out. Most applicants look the same: they’re in the top 10% of their college class with MCAT scores in the 90th percentile. Medical schools are now looking for well-rounded candidates who, in addition to their high GPAs and MCAT scores, can boast of passions, hobbies, unique backgrounds, volunteer experiences, and leadership positions. Data show more college graduates are taking gap years prior to applying to medical school, giving them time to improve test scores as well as gain valuable experiences, pursue leadership roles, spend time in medical research, or dive into volunteer opportunities that set them apart from the pack.

So what can you say to young family members and friends who want to improve their chances of enrolling in medical school? In a nutshell, do your best to distinguish yourself from your peers. Take a range of college courses to show you have diverse academic interests. Seek out a clinical research internship over the summer–bonus points if you co-author a research paper with your internship mentor.

Pursue other health-related jobs in your free time, like working as a medical scribe. And when it comes to your actual applications, customize each one to each school. It’s not enough to fill in the blanks of one essay. Research the school and share why you’d be an ideal fit–and don’t forget to illustrate why this specific program would be right for you, as well.

Tips for applying

Beyond your test scores, grades, experiences, and the content of your character, it’s important to consider timing, Most experts recommend sending in your application as soon as possible, typically in June, especially if the school has rolling admissions. Alternatively, consider applying for early decision if you instantly fall in love with a program. You can only apply early decision to one school, and if you’re admitted, you’re required to attend, but showing your commitment to one institution early on can greatly increase your chances of joining its newest class.

When it comes to our remarkably selective med school enrollment process, there is one silver lining: the students that are accepted are the cream of the crop, and are ostensibly more likely to thrive in the world of medicine. But so much competition is no doubt edging out equally suited candidates who could join their ranks and serve with the same amount of care and wisdom, if given the chance.

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  1. 2022 FACTS: Applicants and Matriculants Data. Association of
    American Medical Colleges.
  2. How Many Med Schools Should You Apply To? The Princeton
  3. New Findings Confirm Predictions on Physician Shortage.
    Association of American Medical Colleges.
  4. The Role of GME Funding in Addressing the Physician
    Shortage. Association of American Medical Colleges.
  5. Why Getting Into Medical
    School Is Harder Than Ever. Savvy Pre-Med.
Medical Reviewer: William C. Lloyd III, MD, FACS
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.