Starting as an Undergrad
Choosing a career is a developmental process. The pre-med years are the time to think about goals, evaluate your strengths, and examine options. Research is important, as are one-on-one conversations with people in the field and first-hand experience in medical environments.
One former director of medical education (also known as the "DME" or "clerkship director") urges that students considering medical school give serious thought to their motivation. "When I interviewed college students, the ones I worried about were those who had chosen medicine because they thought it was a good profession to 'make money,' she says. "I think if you choose a career in medicine, you have to have a passion for the care of people. There has to be a passion there to drive you, because medical school is not all that fun. It's a lot of hours and you're working hard. Sometimes people get all the way to medical school and then find out that they don't really want to be there."
Researching Medical Schools: Where to Start
The Association of American Medical Colleges (AAMC) represents 168 allopathic medical schools in the United States and Canada. The American Association of Colleges of Osteopathic Medicine (AACOM) represents 34 colleges of osteopathic medicine in the United States. Both the AAMC and the AACOM offer links and information of interest to those considering a career in medicine.
The Foundation for Advancement of International Medical Education and Research and the Educational Commission for Foreign Medical Graduates are excellent resources about the more than 2000 medical schools across the globe that are outside the United States and Canada. These organiztions also offer information about requirements to transition from an international medical school to a US residency program.
Advice to Pre-meds: Focus Does Matter, But All Things in Moderation!
The best medical school applicants are excellent students who are also well rounded. It is important to think about more than the curricular requirements when building a solid transcript for medical school applications. "We look for good grades in organic chemistry and other science courses," one educator says, "but varied experience in volunteerism and validating their interest in medicine by medical shadowing or participating in biomedical research can also be very helpful."
Because pediatricians strive to provide culturally sensitive care for a diverse patient population, future medical school applicants are well advised to seek out experiences that expand their understanding of other cultures. Volunteer work in underserved communities can provide valuable insights, as can a semester's study abroad. It is extremely useful to be fluent in a second language.
Roads Less Traveled: BS/MD and MD/PhD Program
A few universities offer combined BS/MD degree programs that enable students to bypass the Medical College Admission Test (MCAT) and proceed directly from college to medical school. According to the AAMC, 44 medical schools in the United States offer a BS/MD degree.
More than 90 medical schools offer formal MD/PhD combined degree programs. The AAMC reports that MD/PhDs represent about 3% of the typical graduating medical school class in the United States. Most MD/PhDs spend between 70% and 80% of their time in lab-based, clinical, or translational research and the balance in clinical service, teaching, and administrative activities, according to the AAMC, and most MD/PhD students complete their dual degree in 7 to 8 years.
Getting into Medical School
Data from the Association of American Medical Colleges (AAMC) indicates that 41% of 2017 medical school applicants matriculated. This is an average; some programs are substantially more competitive than others. Specific data on acceptance rates over time are provided on the site, along with a matrix that presents acceptance rates in terms of grade point average and Medical School Admission Test (MCAT) scores.
Most applicants take the MCAT about 18 months before they plan to enter medical school. The MCAT is administered by the AAMC, which develops test content in cooperation with US medical schools.
Applications for most medical schools are coordinated by the American Medical College Application Service (AMCAS). Most schools accept applications in the summer or early fall, but admission deadlines vary by school. It is important to check the Web sites of each medical school that interests you long before application season begins.
Medical schools interview promising candidates between October and February of the students' senior year. For those interested in a specific school, the Early Decision Program (EDP) may be worth exploring. Many medical schools offer this program, which requires an earlier application deadline and limits application to that single school until a decision has been made. If not accepted in EDP, there is still time to apply to the same school as a regular candidate, as well as to any other school.
Financing Your Medical Education
A tally of responses to the annual Association of American Medical Colleges (AAMC) graduation questionnaire showed that the median debt of medical students graduating in 2017 was $192,000. More than 48% of students finished medical school owing $200,000 or more.
According to the AAMC annual tuition and student fees survey, the median first-year tuition and fees for in-state residents attending public medical schools in 2017-2018 was $36,937.
Median first-year tuition and fees for in-state students attending private schools over the same time was $59,605. The AAMC estimates that costs in addition to tuition and fees associated with medical school attendance in 2017-2018 averaged $23,340.
Dealing with Debt
The AAP Annual Survey of Graduating Residents assesses trends in education debt among pediatric residents and starting post-residency salaries. According to the March 2018 AAP News Research Update article, after rising over many years, the growth in pediatric residents' educational debt has leveled off, and the starting salaries of those going into general pediatric practice have increased modestly.
In 2017, 75% of graduating residents reported student loan debt at the end of training.
Average debt among residents who reported any debt that year (debt from medical school and college, and if married, the spouse's educational debt), was $239,500.
On average, residents graduating in 2017 reported the following salaries (not including benefits or bonuses) by position:
Pediatric Hospitalist: $158,000
General pediatric practice: $151,000
Chief resident: $75,000
Pediatric subspecialty fellow: $63,000
Government Programs that Support Medical Education
There are various programs and service opportunities to reduce your medical school debt. According to the AAMC, these include:
Civil Service Programs
Loan Forgiveness Options
Seek Guidance Early
When scheduling an interview at a medical school, request a session with a financial aid officer. Find out how the process works at that school and learn what you can about options and procedures for paying for school.
It is critically important to obtain qualified advice before entering into any loan repayment employment agreement. Government programs are many and varied. A firm understanding of what commitments are made and what promises have been secured is essential. Look closely at the source of funding and the fine print. Consult mentors on your faculty and in your student affairs office before entering into any commitments.