Medical education in that era included formal lectures for a semester or two and several years of apprenticeship. There was no formal tuition, no prerequisite academic preparation, and written exams were not mandatory. With the progress of science in the nineteenth century started the new era of medical education calling for full time investigators and teachers in biochemistry, bacteriology, pharmacology, etc. In the 1870s, the first teaching hospital, the Hospital of the University of Pennsylvania, was built.

Medical school in the 20th Century

The birth of modern medical education in The United States and Canada is often attributed to Abraham Flexner, a professional educator, who in 1910 published the Flexner Report for the Carnegie Foundation. The report was a commentary of the state of medical education at the time. It criticized the fact that there were too many medical schools, many of which were substandard. At the time the report was published there were 155 medical schools in the United States and Canada and only 16 of these required 2 or more years of college work as an admission requirement. Flexner proposed a 4-year medical school curriculum -- two years of basic science education followed by two years of clinical training. He also proposed the requirements for admission to include the high school diploma and a minimum of 2 years of college science. The report resulted in the closure of many medical schools that were not incorporated within a university. In 1935 there were 66 M.D. granting institutions that survived the reform, 57 of which were part of a university.

These improvements in medical education were followed by the birth of standardized testing for medical school admissions. The Medical College Admission Test (MCAT) was developed in 1928. It was implemented to improve attrition rates that at the time ranged from 5-50%. By 1946 attrition rates at medical schools in the U.S. decreased to 7%.

The student body

As for the student body in these early medical schools, it will come as no surprise that the students were white and male. Medical schools were closed to African-Americans, except for a few older medical schools in the north. The first African-American to graduate from a northern medical school was Dr. David J. Peck who graduated from Rush Medical School in 1847. Between 1868 and 1904 seven medical schools for African-Americans were established. Unfortunately, by 1923 only Howard University Medical School and Meharry Medical School remained open. Things were not much better for women. The first medical school for women, The Women's Medical College of Pennsylvania, was founded in 1850, and is now known as the Medical College of Pennsylvania. The first woman to graduate from a medical school in the U.S. was Dr. Elizabeth Blackwell. She graduated first in class from Geneva Medical College in New York in 1849. The first African-American woman to graduate from a medical school in the U.S. was Dr. Rebecca Lee Crumpler who graduated from the New England Female Medical College in Boston in 1846.

Med school today

Today there are 125 M.D. granting institutions, most of which still follow the curriculum that was proposed by Flexner and all of which require the MCAT. Thing have changed however, most notably the student and medical school faculty body. Each year, a little over 17,000 students start their first year of medical schools, close to 30 % of whom are minorities. In 2004 50% of the entering class of medical students and 45% of the graduating class were women.
--Ivana Nikolic

In 2005, 37,364 people applied to medical schools in the United States, and 17,004 of these people were accepted and enrolled later that year. Of the 46 percent of applicants accepted to medical school, there is no GPA or MCAT score that guarantees acceptance. Here are some of the basic statistics on medical schools and the average MCAT scores and GPA for applicants and matriculates.

Medical schools

There are a total of 125 allopathic American medical schools, with locations in 44 states, the District of Columbia, and Puerto Rico. New York State has the most medical schools, with 12, followed by California with eight and Illinois and Texas each with seven. On the other end of the spectrum, six states -- Alaska, Delaware, Idaho, Maine, Montana, and Wyoming -- do not have any medical schools, and nineteen states have only one medical school. Of the 125 medical schools, 75 are public institutions, whereas 50 are private institutions. The difference between the two is that public schools get funding from state governments, whereas private schools rely on tuition, fees, and gifts for financial support. Because public schools are state funded, they take mostly students from within their state (which usually comprises 80-90% of students). Some of these medical schools are quite large and have multiple campuses and over 300 entering students a year, such as the University of Illinois College of Medicine. However, others are quite small and admit roughly 40 students a year, such as Mayo in Minnesota. Many schools provide students with the opportunity to complete other degrees in combination with their medical education, such as a PhD, law degree, Master of Public Health, or Master of Business Administration. If you are interested in a particular dual-degree program, it is best to contact schools directly to determine if they offer the programs that interest you.

The cost

The cost of attending medical school varies greatly, with private schools generally being more expensive than public schools. The average yearly cost for an in-state resident to attend a public medical school, which includes tuition and fees, was $19,961 in 2005-2006, whereas the average yearly cost for an out-of-state resident to attend a public school was $38,865. The average cost for a state resident or non-resident to attend a private medical school was $38,190 and $39,024, respectively (please note that most private schools have the same tuition for both in-state and out-of-state students. However, a small number charge less tuition for in-state residents). Although it can be informative to look at the average costs of medical schools, it is important to remember that the tuition and fees vary greatly even amongst private or public schools. For instance, the most expensive medical school in the country for non-residents is not a private school, but a public state school, the University of Colorado, which cost non-residents a whopping $75,739 in 2005-2006. The most expensive public medical school for state residents has an annual price tag of less than half of this, which is the University of Minnesota-Twin Cities with a 2005-2006 tuition and fees of $30,998. In contrast, the least expensive public school for state residents was East Carolina-Brody in North Carolina with an annual cost of $9,068, whereas the least expensive public school for non-residents was the University of Puerto Rico at $17,248, with the University of Mississippi a close second at $18,309. Among private schools, Tufts University in Boston was the most expensive for both residents and non-residents, with a cost of $46,063, whereas Baylor was the least expensive, costing Texas state residents $12,607 per year and non-residents $25,707 per year. Given such striking differences, if the cost of attending medical school is an important factor for you, it is essential to determine the actual cost associated with attending each of the medical schools that you apply to. It may be helpful to even do a little investigative work to determine the amount of financial aid, in the forms or grants, scholarships, and loans that students are awarded at particular schools. While data on the indebtedness of the most recent medical school graduates is not yet available, in 2003, roughly 85 percent of graduates had medical school loan debts. The average debt for public school graduates was $100,000, whereas that for private school graduates was $135,000. It is estimated that these values will continue to rise, and by 2007, the average public medical school graduate will owe roughly $117,000, and the average private medical school graduate will owe roughly $150,000.

The student

There is not a particular set of guidelines that gets a person into medical school, or makes a person a successful physician. However, it may be helpful to know some basic statistics about the most recent applicants and matriculates. In 2005, there were 37,364 applicants, which was up 4.6 percent from 2004, though not nearly as high as the peak number of applicants of nearly 47,000 in 1996. Of the 37,364 applicants, 49.8 percent were women, and 75.7 percent were first-time applicants. California residents accounted for the highest number of applicants, at 4,288, while Rhode Island had the least at 71. Forty-six percent of the 37,364 applicants matriculated to a medical school in 2005. Forty-nine percent of those were women with an average age of 23, whereas the average age of male matriculates was 24. Twenty-nine percent of applicants attended school in their state of residency, whereas 17 percent went out-of-state. The mean MCAT verbal, physical science, biological science, and writing scores for 2005 applicants were 8.9, 9.1, 9.5, and P, respectively. As may be expected, the average MCAT verbal, physical science, biological science, and writing scores for accepted students were slightly higher at 9.7, 10.1, 10.4, and P, respectively. The average total GPA of applicants was 3.48, with a breakdown of an average science GPA of 3.37 and a non-science GPA of 3.60. For medical school matriculates, the average total GPA was 3.63, with a science GPA of 3.56 and a non-science GPA of 3.70.

Although all of these can numbers can seem daunting, we hope that you can use this basic information as a starting point as you consider how you can best market yourself to be accepted into the medical school that is the best fit for you. All data is from the American Association of Medical Colleges website: www.aamc.org
--Sarah Evans