The Student Voice

Applying to Medical School: A Financial Barrier

               Ian M. Fowler,   Bachelor's degree candidate at
                                          University of Southern California

For more than a year, a large part of my time has been spent 
applying to medical schools.  I have dedicated much energy to 
prepare for and take the Medical College Admissions Test 
(MCAT), obtain multiple letters of recommendation from my 
professors, interview for a health professions committee 
letter of recommendation from my university, complete and 
submit the applications, and interview at various medical 
schools.  Although this process proved to be a positive 
experience, the extraordinary cost of applying to medical 
schools poses a danger of limiting individuals with limited 
financial resources.  Moreover, the lack of scholarship or 
loan programs to assist students with the application process 
further contributes to this danger.

One of the first hurdles of applying to medical school is the 
MCAT.  Although many students prepare for this exam on their 
own, a large portion of students choose to take preparatory 
classes offered by various private test preparation companies.  
These courses, which often cost in excess of $1000, teach 
students not only the basic concepts covered on the MCAT, 
but also helpful test-taking techniques unique to the MCAT.  
Thus, these preparatory classes may provide students with 
helpful advice and knowledge unavailable to those who cannot 
afford the classes.  I attribute much of my success on the 
MCAT to these helpful hints; furthermore, many of my fellow 
pre-medical colleagues, who were unable to take the preparatory 
classes because of financial constraints, scored poorly on the 
exam.  Hence, I believe MCAT preparation courses significantly 
increase one's probability of performing well on the MCAT, and, 
since these courses are out of reach for many pre-medical 
students from lower to moderate income families, a financially 
limiting situation exists.

In addition to preparatory classes, the actual application costs 
to medical schools represent another financial hindrance.  Under 
current application procedures, a  student must initiate the 
process by submitting one application to a centralized application 
service known as the American Medical Colleges Application Service  
(AMCAS).  In the application, the student indicates the medical 
schools to which he or she wishes to apply, provides academic and 
personal information, writes a one-page statement of purpose, and 
submits a fee of $55.00 for the first medical school with a sliding 
fee scale for the remaining medical schools.  Since most pre-medical 
advisors recommend students apply to ten or more medical schools, 
the expense of this initial application usually costs in excess of 
$400.  Furthermore, most medical schools send out secondary 
applications, which require submission of an additional fee in the 
range of $25 to $100 directly to the medical school.  Thus, a student 
applying to ten medical schools may spend nearly $1000 in application 
fees.  Although a fee waiver or reduction is available to some 
students in dire financial circumstances, most applicants are expected 
to pay the full amount.  Therefore, these steep application costs may 
prevent dedicated and qualified students from applying to medical school.

Once an applicant successfully completes the MCAT and applications, 
medical schools many invite him or her for an on-site interview.  
Interviews, which nearly all medical schools claim are a vital part 
of the application process, require the student to travel to the 
particular school of medicine.  Although some students may solely 
interview at medical schools within their state of residence, most 
applicants interview at schools across the United States.  Thus, 
the applicant must pay for airfare, hotel, local transportation, 
and food costs out of his or her own pocket.  For example, on a 
recent interview trip from Los Angeles to the East Coast, I spent 
approximately $500.  A successful applicant may interview at two or 
more distant medical schools and, therefore, spends $1000 or more 
in travel costs.  Hence, although interviews provide applicants with 
the opportunity to articulate their interests and desires in medicine 
to the admission committees, they represent a severe financial barrier 
for many pre-medical students.

In contrast to my belief that medical school application fees are 
extraordinary, some of my fellow pre-medical colleagues believe that 
if one cannot afford to apply to medical school, then that person cannot 
afford to attend medical school; however, this belief is flawed.  
Once medical schools admit an applicant, they provide an enormous 
amount of financial aid counseling and extensive loan and scholarship 
information to the student.  Hence, the admitted pre-medical student 
has the opportunity and means to finance his or her education via loans 
and scholarships, while the current applicant lacks the availability of 
such financial resources for application fees and interview expenses.  
Therefore, an applicant who cannot afford to apply to medical school 
can afford to attend medical school.

Financial expenses should not impede a student's desire to apply to 
medical school and achieve his or her goal of becoming a physician.  
Although AMCAS and some medical schools have attempted to alleviate 
this problem by providing fee waivers or reductions, these efforts 
fall short of solving the problem of financial impedance to medical 
applicants.  Many students from moderate income families cannot receive 
these fee waivers; moreover, their families cannot provide the $2000 to 
$3000 necessary to apply to medical school.  Thus, I believe that the 
Department of Education, in conjunction with private loan companies, 
should provide low interest, medical school application loan programs.  
Through these loan programs, qualified students who lack necessary 
application funds, may rightfully apply to medical schools without 
facing the exuberant and potentially limiting application fees.