For some, the timeline for getting into medical school is fairly straightforward: finish high school, go to college for four years and then enter medical school.
For others, that timeline will be different. Many students are choosing a path that includes a gap in between undergrad and med school matriculation. The current average age of a medical school matriculant is 24.
According to the Association of American Medical Colleges, there were more than 10,000 more applicants to U.S. medical schools during the 2018-2019 school year than during the 2008-2009 school year, a roughly 25% increase. The acceptance rate at U.S. medical schools ranges from 2% to 21%, according to U.S. News and World Report, which adds up to the competition being fierce.
Many students are deciding to take a few years off to strengthen their application before applying. During this time they might take more classes, get a master’s degree, retake the MCAT, or get health care experience by working as a certified nursing assistant (CNA) or an EMT.
This trend is detrimental to the health care field. There are both financial and career consequences to delaying medical school, and students should know about them before they decide to take time off before med school.
Starting at 22 vs. 26
Take two med students: one who enters medical school directly at 22 and the other who enters at 26 after working for four years as a CNA. Let’s assume they both graduate medical school in four years, complete a three-year emergency medicine residency and then practice until they are 65, then retire.
The 22-year-old student will be an experienced practicing physician for four more years than the 26-year-old student. And those four years are added on at the end of their career, which is when they are the most experienced and, one could say, the most valuable to the health care system because of the knowledge accumulated throughout their career.
If the age of new doctors keeps rising and the retirement age stays the same, the health care system will be losing years and years of high-value physician labor.
What should change
One way to address this issue would be to encourage premeds to apply straight from undergrad and help them make their applications strong by the end of their junior year.
I’d also love to see medical schools start looking at applicants in a different way and place less focus on a student’s MCAT and GPA. Can we instead examine each applicant like an osteopathic physician would examine a patient, assessing their mind, body, and spirit and looking at them as unique individuals rather than a set of symptoms or test scores? Doing so could lead to fewer students taking years off to work on their MCAT score or otherwise become more competitive applicants.
Many osteopathic medical schools are already doing this to some degree, as are some MD schools. Also, in 2015 the AAMC released a revamped MCAT that was designed to better assess applicants’ well-roundedness. Let’s build on this trend and take it further.
The financial cost of years off
Going back to our 22-year-old and 26-year-old students: the 26-year-old who worked as a CNA for four years likely earned around $30,000 during each of those years, giving him or her a gross income of about $120,000 during the break in education.
The 22-year-old who went straight into medical school had four additional years of working as a physician at the end of their career, when an emergency physician can earn $350,000 annually, for a total of $1.4 million in additional earnings, or $1.3 million more earned across their career than the 26-year-old matriculant.
For most doctors, money isn’t the reason they go into the field of medicine. Nevertheless, their lifetime earnings should be a consideration.
Benefits of years off
Despite these consequences, there are some potential benefits to taking years off. Some people say that the extra time will make individuals more confident in their choice to become a physician, which could decrease their likelihood of dropping out.
Another potential benefit is that older individuals could have more life experience which could lead to them being more well-rounded physicians.
However, I did a brief search for data to support these statements and did not find solid evidence suggesting that these benefits are widespread among those who take time off before med school.
In the end, the decision to take years off before medical school is complex and will depend highly on an individual’s unique circumstances. Students should, however, be aware of the potential consequences of delaying matriculation. What are your thoughts on delaying medical school? Please let me know in the comments below.