February 17, 2022, 9:09 a.m. Michael Devitt — The class of students who entered medical school in the United States in the fall of 2021 is larger and more diverse than practically any class that has preceded it, with the rise led by a significant increase in the number of applicants and students who identify as Black or African American.
That’s one of several notable findings in a recently released analysis of applicant and matriculant data from the Association of American Medical Colleges. Highlights from the analysis are available in summary data tables; the full data tables also are available.
The analysis showed that the total number of applicants to U.S. medical schools for the 2021-2022 school year reached more than 62,000 for the first time, while the number of matriculating students surpassed 22,000 for the second consecutive year, with both increases due largely to interest from students in racial and ethnic groups that have been traditionally underrepresented in medicine.
“It is gratifying to see this growth in the diversity and number of students interested in a career in medicine, particularly during such a unique time in history as a result of the global pandemic and the effects of health disparities in our country,” AAMC President and CEO David Skorton, M.D., said in a press release. “For nearly two years, Americans have watched the heroism and dedication of physicians on the front lines. As the nation faces a real and significant projected shortage of physicians, I am inspired by how many individuals want to follow in the footsteps of those before them to serve their communities.”
The analysis tracked application, acceptance and matriculation data from 2002, the baseline year used to calculate medical school enrollment increases that the AAMC called for in 2006.
For the 2021-2022 school year, there were a total of 22,666 matriculants to U.S. medical schools — an increase of 1.9% over the previous year and a 37.5% increase from 2002.
The analysis also showed a substantial increase in the number of people applying to U.S. medical schools. Each year between 2002 and 2020, the total number of applicants increased an average of about 2.3% over the prior year. Previously, the highest year-to-year increase occurred in 2007 (8.2%); in 2021, the total number of applicants increased 17.8%, reaching a total of 62,443.
Overall, the class that entered medical school in 2021 was more diverse than in previous years, as 51.5% of students entering medical school identified as white, followed by 26.5% who identified as Asian. There were considerable gains among those who identified as Hispanic, Latino or of Spanish origin (12.7%, up from 12% in 2020) and Black or African American (11.3%, up from 9.5%).
In terms of year-to-year changes, the number of Black or African American first-year medical students increased by 21% between 2020 and 2021. Asian first-year medical students increased by 8.3%, and those who identified as Hispanic, Latino or of Spanish origin increased by 7.1%.
For the first time since AAMC began tracking racial and ethnic data, the majority of applicants in 2021 did not identify as white. Just under 50% of those who applied to medical school identified as white, while 25% of applicants identified as Asian, and 11.7% each identified as Black or African American or as Hispanic, Latino or of Spanish origin.
“We are especially encouraged by the growth in applications and new enrollments by students in racial and ethnic groups that are underrepresented in medicine,” said Geoffrey Young, Ph.D., the AAMC’s senior director for transforming health workforce.
Women also continued to increase their presence in medical school. According to the analysis, women accounted for 56.8% of all applicants in 2021, 55.5% of matriculants and 52.7% all individuals enrolled in U.S. medical schools.
Medical College Admissions Test scores and GPAs, meanwhile, remained consistent for applicants and matriculants year-to-year. Although GPAs and MCAT scores among 2021 applicants declined slightly compared with those for 2020 applicants, those scores increased slightly among 2021 matriculants. In addition, the age range of enrollees spanned from 16 years to 55 years, and 163 enrollees indicated that they were military veterans.
It should be noted that the AAMC’s race/ethnicity data includes individuals who identified in one or more racial or ethnic categories. For example, the Black or African American category includes individuals who identified as Black or African American, as well as individuals who identified as Black or African American plus at least one other racial/ethnic category.
Renée Crichlow, M.D., of Brookline, Mass., has practiced full-spectrum family medicine for more than two decades. She serves in a variety of roles at the AAFP, including as a member of the Commission on Federal and State Policy and the medical editor for diversity, equity and inclusion for American Family Physician. Outside the Academy, she serves as the chief medical officer at Codman Square Health Center in Dorchester, Mass., and is a vice chair of health equity in the Department of Family Medicine at Boston University Medical Center, among numerous other responsibilities. Several years ago, Crichlow developed The Ladder, a mentorship program that encourages youth from low-income communities to pursue careers in medicine.
Crichlow told AAFP News that generally speaking, data has shown that individuals who are historically underrepresented in medicine are more likely to enter primary care, with a significant number entering family medicine. Although it has been suggested that the COVID-19 pandemic caused many people to consider a career in medicine, Crichlow did not think the pandemic was solely responsible for the recent rise in applicants.
“Some may think that the increased number of applicants enrolled in medical school may have been attributable to the inspirational influence of the pandemic. I don’t attribute the increase to that,” said Crichlow.
She noted that while the pandemic has had a disproportionate impact on racial and ethnic minorities, increases in medical school applications occurred among individuals of all races and ethnicities. Instead, she suggested that streamlined applications processes and reduced financial burdens contributed to a larger applicant pool.
“I believe that the systemic mitigation of the effects of the pandemic on the normal process of applying to medical school had a greater impact on people’s ability to apply to medical school,” she explained. “It was cheaper and overall (there were) fewer hoops to jump through because of lockdowns, etc.”
“I believe that the biggest impact on applications was the fact that many places made the MCAT — which is a very expensive test to take and to prepare for — optional, that many of the past barriers such as unpaid internships and research work were not possible during the pandemic,” Crichlow added. “There were virtual interviews that saved money on travel. Students who had generally lower wealth were able to have more competitive applications. (There were) all of these changes, and the AAMC was still able to say that this year’s medical school enrollees had ‘strong academic credentials, with a median undergraduate GPA of 3.81, an increase from previous years.’”
While the rise in applicants has been encouraging, Crichlow cautioned that the enrollment increases that occurred last year could be an outlier unless some of the changes that allowed for more individuals to apply to medical school remain in place.
“I don’t believe that we will see large gains in the enrollment of URM students in future years unless we continue to maintain the systemic changes that occurred for the application pool in 2021,” Crichlow said. “The economic burdens of applying for medical school were drastically different; as a result, we have a more representative pool of medical students. We can either continue that trend by making real changes in our application and acceptance systems, or we can go back to a less representative means of filling our medical schools.”
Finally, Crichlow suggested that the Academy should view the increase as an opportunity to find ways to get more people in the medical school pipeline and help grow the specialty.
“I believe we should learn from this,” Crichlow continued. “I believe we should take the time to study the application process and see what changes occurred that encouraged more students to apply and encouraged more students of color to apply.”
The AAMC data pertains only to medical schools in the United States that grant M.D. degrees. The American Osteopathic Association collects data on medical schools that grant D.O. degrees.
The AAMC provides analyses on workforce, equity and other issues, and additional information on U.S. medical school applicants, matriculants, enrollments and graduates, as well as data on M.D./Ph.D. students and residency applicants, is also available.