Medical Students' Academic Standing Rising Despite Enrollment Boost

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Tex Med. 2010;106(12):49-52.

By Ken Ortolon
Senior Editor

With substantial class size increases at Texas medical schools over the past several years and the opening of the Texas Tech University Paul L. Foster School of Medicine in El Paso, there was uncertainty among many medical educators about whether the overall qualifications of some medical school applicants might drop.

But, in fact, it appears the exact opposite is happening.

According to data released by the Texas Medical and Dental Schools Application Service (TMDSAS), grade point averages (GPAs) and scores on the Medical College Admission Test (MCAT) for medical school applicants and first-year enrollees have been trending upward since 2000.

Medical educators say that is good news as Texas looks to expand opportunities for medical education through more new medical schools and increased enrollment.

"The bottom line is there definitely is an adequate pool of good premed students, so that if we had the capacity we could increase the number of physicians in Texas," said Steven Berk, MD, dean of the Texas Tech Health Sciences Center School of Medicine in Lubbock.


MCATs on the Rise

According to the TMDSAS data, average GPAs for first-year enrollees at Texas medical schools, excluding Baylor College of Medicine, rose from a low of 3.62 in 2001 and 2002 to 3.68 in 2009. Meanwhile, average MCAT scores increased from a low of 28.3 to 30.0 during the same period.

Baylor does not participate in the TMDSAS. A Baylor spokesperson says its average GPAs and MCAT scores remained fairly consistent over the past several years. In 2009, Baylor's entering class had an average GPA of 3.82 and an average MCAT score of 33.42.

While the numbers for first-year enrollees improved, so did those for applicants. GPAs for applicants increased from 3.46 in 2000 to 3.52 in 2009. MCAT scores for applicants also climbed from 26.3 in 2002 to 27.5 in 2009.

The increases occurred even though the number of applicants and enrollees rose significantly during those years. In 2000, Texas medical schools had 3,146 applicants and admitted 984 first-year students. In 2009, there were 4,128 applicants and 1,424 enrollees.

Cynthia Jumper, MD, chair of Texas Medical Association's Council on Medical Education, is not surprised that scores remained high.

"We were always turning down good applicants," said Dr. Jumper, chair of internal medicine at the Texas Tech School of Medicine. "For every one we would accept, there were several we turned down or several who chose other professions. So I was never personally concerned about that."

But Henry Sondheimer, MD, director of student affairs and programs at the Association of American Medical Colleges, says increasing test scores are "somewhat counterintuitive."

Dr. Sondheimer says that test scores nationally also are improving.

"The academic profile of the matriculants has, if anything, continued to improve," even though the number of first-year enrollees in U.S. medical schools increased from 16,400 in 2002 to more than 18,600 this year, he said.

"So my impression is we are still attracting or, if anything, attracting even more very, very strong applicants to medical school even though we've had a 13-percent increase in the total size of the matriculant pool with both new schools and increases in class sizes from 2002 to 2010," he said.


Where'd They Come From?

But where are all these bright young medical students coming from? Dr. Berk says there was a backlog of good students who couldn't get into medical school in the past.

"I think everyone was pretty confident there were enough good students who hadn't gotten into medical school that the pool would actually still be very strong," he said. "And the Texas schools all have very good reputations; the tuition is very low compared with out-of-state schools. So the Texas students all want to come back here."

Dr. Jumper says it may also be that medical schools are attracting a new group of students.

"I am personally seeing a slight change in applicants who want to do maybe a little bit more public health, maybe a little bit more worldwide health," she said. "A lot of our students are much more involved in charitable work and mission work and going overseas to help a more vulnerable group.

"So, I think it's opening up to a different group of students with a different interest," she continued, "and I think it's just bringing a large candidate pool, which is refreshing."

Dr. Sondheimer says it also could be attributed to the economy and cyclical swings in the popularity of medical school and business school among bright, young students.

"Applicants to medical school and applicants to business school are inversely related," he said. "The peak of applicants to medical school was 47,000 in 1996. The trough was in 2002, when it was 33,000. That corresponded with what was perceived as everybody wanting to go to Wall Street, with a big increase in business school applications."

This year, medical school applications rose to 43,000 while business schools saw a decline, he adds. "Presumably, the smart young people once again think maybe going to medical school is a better long-term plan than going to business school."


Attracting Even More 

While medical educators are pleased with the high quality of applicants they see each year, they also say America needs even more good applicants in the coming years as physicians from the baby boom generation begin to retire.

Dr. Sondheimer says 13,000 U.S. physicians turned 65 in 2010. That will increase to 23,000 in 2015, he says.

"We really are concerned that the number of physicians reaching retirement age changes suddenly when you get out of the war baby years and into the post-World War II years," he said. "That's one of the reasons why the association in 2002 advocated for a 30-percent increase in total enrollment over the next 10 to 15 years."

Ken Ortolon can be reached by telephone at (800) 880-1300, ext. 1392, or (512) 370-1392; by fax at (512) 370-1629; or by e-mail at ken.ortolon@texmed.org.       


RELATED STORY 

Minority Enrollment Up in U.S. Medical Schools

The number of minority students enrolled in U.S. medical schools rose in 2010, according to data released in October by the Association of American Medical Colleges (AAMC)

The AAMC data show that enrollment among African-Americans, American Indians, and Hispanics was up significantly over 2009 figures. The number of freshman male medical students still outnumbered the number of female freshmen in 2010, however.

Black student enrollment grew 2.9 percent, American-Indian student enrollment increased nearly 25 percent, and Hispanic student enrollment was up 9 percent. Women made up 47 percent and men, 53 percent, of the incoming 2010 medical class. Altogether, U.S. medical schools received 42,742 applications for the 2010 freshman class compared with 42,269 in 2009.

The total number of first-time applicants in 2010 increased 2.5 percent – up to 31,834 applications – over 2009. "The growth in first-time applicants demonstrates that medicine is still a compelling career choice for many individuals," said AAMC President and Chief Executive Officer Darrell Kirch, MD.

The most significant growth in minority students was in the percentage of Hispanic males who entered medical school this fall. Hispanic male enrollees increased by 17.1 percent, while Hispanic female enrollees increased by 1.6 percent from last year.          

AAMC officials say these diversity gains were spread across all regions of the country. The largest increase was in the West, which saw underrepresented minority enrollment grow from 14.4 percent in 2009 to 16.1 percent this year.

"Improving the diversity of U.S. medical students will be a driver of excellence in our health care system," said Dr. Kirch. "We are very encouraged that more minority students are pursuing a career in medicine, and we hope that these strong gains continue in the years ahead."

An AAMC spokesperson said state-by-state data on minority enrollment is not yet available. The number of Hispanic and African-American entrants in Texas medical schools, however, has remained relatively flat since 2004, while the number of Asian and Pacific Islanders has grown slightly.

According to data from the Texas Medical and Dental Schools Application Service (TMDSAS), of 1,424 students admitted to Texas medical schools in 2009, 5 percent were African-American, 13 percent were Hispanic, 25 percent were Asian/Pacific Islander, 52 percent were Caucasian, less than 1 percent were American Indian, and 4 percent were other or unreported.

Those totals do not include Baylor College of Medicine, which does not participate in the TMDSAS.


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