The Road to Medical School in America

I have been on a journey to become a physician since 2013 when I graduated from high school and decided to pursue pre-med in college. The road to medical school is much longer and harder than I could have ever anticipated.

Every year thousands of students apply to medical school and almost 60 percent of them are turned away. Although medical schools encourage reapplication, the process is tedious, expensive, and wears you down.

When I finished college and began researching schools that I wanted to apply to, I was surprised by several interesting factors that the average person probably does not know about the medical schools or their application process in the United States.

There are two kinds of medical schools, public and private. Public medical schools usually reserve anywhere from 75-95 percent of their seats for instate students only. Of the 5-25 percent of seats reserved for out of state students, the medical school usually prefers someone who has a personal connection to that state, for example, someone who grew up there, but moved away or someone who has a family member who attended or works for that medical school. This system discourages out of state applicants to apply to public medical schools in different states greatly.

In-state tuitions for medical schools are quite reasonable. Of course, reasonable is a relative term considering that the average cost of a public medical in the United States is about 50,000 dollars per year. Since, medical school takes four years to complete, this adds up to over 200,000 dollars especially when you factor in living expenses. Out of state and private medical school tuitions cost even more.

For someone like me who lives in a state with only one public medical school, this limits my chances of getting into any other state’s medical school. The medical school in my state is small to begin with and only has approximately 65 seats to offer its own in state applicants. This is why out of state applicants prefer to apply to private medical schools as it increases their chances of being accepted, but private medical schools come at a higher cost.

Medical schools also require letters of recommendation, a copy of your transcript, secondary applications, and in-person interviews. Every step including the primary applications costs hundreds of dollars and if your interview is in a different state, then you also have to pay for a flight, a hotel, transportation, and a suit to be able to make it to your interview.

The system between private and public medical schools is set up this way specifically to encourage students to gain admittance and practice in the state they live in so that no state experiences a shortage of physicians more than others. Although it makes sense, it also is incredibly inconvenient.

In the United States, a student must go to college first and obtain a degree before they can apply to medical school. This is yet another expensive and time-consuming process that leaves students in debt before they can even apply to professional school. This process is widely understood and expected in the US, however, many other countries have a completely different system for high school students who already know that they wish to pursue a certain field of higher education. In Türkiye, students can apply to medical school right out of high school. Medical school is six years instead of four, but saves a student time, money, and energy. Every student takes a standardized entrance exam, much like the MCAT, and the score you receive makes you eligible for medical schools based on how well you performed.

Costa Rica, a country I traveled to in college, also has a similar medical school system to Türkiye. However, while Costa Rican medical schools admitted that the process is much faster and cheaper than medical school in the United States, many students also voiced that they wished they had gone to college first in order to have more time to decide if medicine was truly for them. Not only does Costa Rica have a surplus of physicians who cannot find work, but many have switched careers and had to start over after six years of medical school because they realized they made the wrong decision at 18. But don’t feel too sorry for them because at the end of the day, they have the ability to start over and change careers for, once again, free.

If someone in the United States wanted to become a lawyer after already having gone to medical school, not only would they need to go back to university to complete a degree that fulfills the specific requirements of law school, they would also be in hundreds of thousands of dollars of debt. This is why it is difficult in the United States to move upward on the education ladder, but also difficult to move sideways into a different profession and ultimately the reason why so many Americans are unhappy with the professions they have chosen because they are stuck and they know it.

You can argue that the United States is unable to provide cheaper education because the country is so large and the population is too big. Many politicians have declared that free education and free healthcare are only realities in small Scandinavian countries like Norway. And yet, Germany, France, Türkiye, Canada and other big countries are all able to subsidize the cost of their educations if not provide them for free.

There are pros and cons to every system. In a perfect world, we would be able to go to school for free wherever and whenever we wanted. I know that for someone like me who is a very decision-oriented person, going to medical school at 18 would have been a wonderful option. However, I also know that many people need more time after high school to make such a life-altering choice and that they benefit from exposure to many different subjects and fields in college.

However, the issue of money still remains. The biggest advantage of countries like Türkiye, is that education is almost free. Aside from some book purchases and some fees, most students can go to public universities and public professional schools for free because their government values education as not only a right, but as an investment in their citizens. While private universities can have higher tuitions, the amount of money is still incomparable to what we pay in the United States. A private university tuition in Türkiye would be equivalent, if not still less, than a community college in the United States.

Even though I am an American and I do love living in the United States, the American dream is a distant reality for many of us. So, I leave it to you to decide if America is truly the land of opportunity.

Esma Arslan