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The Hechinger Report
The ‘Fauci effect’: Inspired by front-line health care workers, record numbers apply to medical schools
The number of medical school applicants is up an ‘unprecedented’ 18 percent this year
By Jon Marcus
December 1, 2020
SOMERVILLE, Mass. — When Covid-19 restrictions reduced his work
schedule, Sam Smith turned to another time-consuming job: applying to
medical schools.
He’d always wanted to go into medicine, Smith said. But what was
happening in the world had a big impact on the kind of medicine he
hopes to practice. Now, Smith said, he wants to specialize in
infectious diseases.
The experience of the last year “makes me think, there’s probably going
to be another pandemic” in the future, said Smith, 25, who has an
undergraduate degree in chemical engineering from the University of
Colorado Boulder and moved here when his girlfriend started Harvard Law
School. “So I want to be on the front lines of the next one.”
Even as college and university enrollment overall has dropped this
fall, Smith is part of a wave of what officials say is an all-time
record number of applicants to medical school.
The number of medical school applicants is up 18 percent this year over
last year, according to the Association of American Medical Colleges,
or AAMC, driven by the example of front-line medical workers and
high-profile public health figures such as National Institute of
Allergy and Infectious Diseases Director Anthony Fauci and by renewed
attention to inequities in the delivery of health care.
“It’s unprecedented,” said Geoffrey Young, the AAMC’s senior
director for student affairs and programs, who compares it to another
response to a traumatic moment in American history: the terrorist
attacks of September 11, 2001.
“After 9/11, there was a huge increase in the number of men and women
that were entering into the military,” Young said. “So far in my
lifetime, at least, and for as long as I’ve been in medical education,
that’s the only comparison that I could make.”
The Stanford University School of Medicine reports a 50 percent jump in
the number of applications it received this year over last year, or
11,000 applications for 90 seats. New York University’s Grossman School
of Medicine says it’s seen a 4 percent increase, but that comes on top
of a 47 percent rise last year after the medical school made tuition
free; this year, it has more than 9,600 applications for 102 spots. The
Boston University School of Medicine says applications are up 27
percent, to 12,024 for about 110 seats.
“What’s been happening this year is that more of the people who
had at some point thought about medical school decided to stick with
it,” said Kristen Goodell, associate dean of admissions at the school
of medicine at BU. “And that, I think, may have a lot to do with the
fact that people look at Anthony Fauci, look at the doctors in their
community and say, ‘You know, that is amazing. This is a way for me to
make a difference.’ ”
Medical school admissions officers have come up with a name for this. They call it the Fauci Effect.
Ryan Chahal, who is also applying to medical school, is among those inspired by Fauci, he said.
“There definitely was a Fauci Effect for me,” said Chahal, 25, who
lives in Tampa. “People who are interested in medicine are interested
in evidence and evidence-based approaches to things, and he has been
very evidence-based.”
Fauci said he’s gotten hundreds of letters from people telling him they want to practice medicine.
The United States will be short 54,100 to 139,000 physicians by 2033,
while the proportion of people who are over 65 will grow by an expected
45 percent.
It’s “very flattering,” he said in an interview. “I think probably a
more realistic assessment is that, rather than the Fauci Effect, it’s
the effect of a physician who is trying to and hopefully succeeding in
having an important impact on an individual’s health, as well as on
global health. So if it works to get more young individuals into
medical school, go ahead and use my name. Be my guest.”
Among other reasons admissions officials cite for the increase in
prospective medical school students is that the pandemic has given many
people more free time to complete the arduous application process.
Normally, before applying to medical school, nearly half of all
applicants first spend a year or two after college working, traveling,
doing research, pursuing master’s degrees or volunteering, the AAMC’s
Young said.
But this year, “a lot of the plans they made postgrad honestly fell
through,” said Sahil Mehta, founder of MedSchoolCoach, which prepares
students for the Medical College Admission Test, or MCAT.
“We saw a lot of students who said, ‘You know what? I’m going to
apply this year,’ ” Mehta said. “Maybe they were on the fence and they
saw what was happening. They saw that health care workers were really
at the forefront of trying to solve this. It really lit a fire under
people.”
When the dermatology practice where she was working as a medical
assistant shut down temporarily because of Covid-19, Mary Grace Kelley
had the chance to retake the MCAT and significantly improved her score.
“This is a perfect time of no distractions,” said Kelley, 23, who lives
in the Boston suburbs and is applying to medical schools this year from
her childhood bedroom in her parents’ house, which is hung with team
photos and varsity letters from her time as an undergraduate Division I
hockey forward. “I’m not very good at sitting still.”
Some institutions also waived the requirement that applicants submit
results from the MCAT, which canceled several test dates in the spring;
Stanford, which is among the schools that made the MCAT optional,
reports that 5 percent of applicants did not submit a score.
So many applications have they now received that medical school
admissions officers — many of them working remotely — are staggering
under the volume. “My mailbox is almost full with emails apologizing
for the delays,” Chahal said. “They’ve just had a huge number of
applications.”
This deluge comes as the nation faces a projected shortage of
physicians, and when its aging population is requiring more specialty
care.
The United States will be short 54,100 to 139,000 physicians by 2033,
the AAMC estimates, while the proportion of people who are over 65 will
grow by an expected 45 percent. More than two out of every five doctors
now practicing will reach retirement age over the next 10 years.
Already, there are fewer primary care providers than are needed —
internal medicine doctors, family physicians and pediatricians — in
nearly 7,200 areas of the United States with a combined population of
roughly 82 million people, according to the Kaiser Family Foundation.
Thirty-five percent of registered voters in a survey last year said
they’d had trouble finding a doctor, up from 25 percent in 2015.
The bad news for the surge of medical applicants is that medical
schools aren’t likely to expand to accommodate them next fall, meaning
that the odds of getting in this year will be much lower. “It’s
discouraging a little bit, to be honest,” Smith said.
And while 30 new medical schools have been accredited since 2002 —
bringing the total to 155 and increasing enrollment by 33 percent, to
the current 93,000 — there’s been almost no increase since 1997 in
Medicare payments for residency training, which costs an average of
$171,855 per year, leaving hospitals to either limit the number of
residents or cover the cost themselves.
Medical school graduates finish with a staggering $241,560 of student
loan debt, on average, according to the National Center for Education
Statistics, discouraging many would-be doctors, including those from
low-income and ethnic and racial minority groups; the figure is from
2015-16, the last year for which it’s available.
Eight percent of medical students are Black and 7 percent Hispanic,
both proportions smaller than their share of the population. (Ten
percent identify themselves as multiracial.)
“I do think that the debt probably scares off some people,” said
Goodell, who is also a former chair of the Council on Graduate Medical
Education.
Managed health care and more red tape and bureaucracy have increasingly
also soured some people on careers in medicine, said Mehta, a
practicing radiologist. “That really started to disenfranchise
the ways physicians practiced medicine. They were getting burned out,”
he said.
This year’s many medical school applicants appear undeterred, however.
“Everyone feels some sort of responsibility,” Kelley said. “We are
basically the next generation. We’re going to be taking care of our
parents, grandparents. So there’s definitely a call to arms thinking
that, if there’s another pandemic, it’ll be up to us.”
Mehta expects the trend to continue.
“Given that about 60 percent of people [applying this year] won’t get
in, you’re probably only going to see an increase in competitiveness
next year,” he said. “The bigger thing is you now have people who are
freshmen in college, sophomores in college, juniors in college, or even
in high school, who for the last few months have been watching Dr.
Fauci on TV and thinking, ‘Maybe this is for me.’ ”
Fauci said he sees the flood of medical school applicants as a sign
that people are thinking about social justice — “that you have
responsibility not only to yourself, but as an integral part of
society.”
He said he hopes the trend will counterbalance and “maybe would even
overcome the other side of the coin, which is the really somewhat
stunning and disturbing fact that people have no regard at all for
society, only just focusing very selfishly on themselves.”
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