Out-of-State Students at State Medical Schools and Increasing Medical Education Debt

Area of Science:

• Medical Education
• Public Health Policy
• Health Economics

Background:

• Medical school tuition has risen significantly faster than inflation over the last two decades.
• This trend raises concerns about the accessibility of medical education for in-state residents.

Purpose of the Study:

• To investigate the increase in out-of-state matriculants at U.S. state-funded medical schools.
• To determine if this trend contributes to displacing in-state students and exacerbating educational debt.

Main Methods:

• Analysis of publicly available data from the Association of American Medical Colleges (AAMC) from 2004-2019.
• Included U.S. state-funded medical schools reporting tuition charges.
• Summarized trends in applications, matriculants, tuition costs, and average indebtedness for in-state and out-of-state students.

Main Results:

• The number of out-of-state matriculants in state-funded medical schools increased by 7% (from 16% to 23%) between 2004 and 2019.
• The median percentage of out-of-state applications rose from 60% to 80%, and matriculants from 13% to 17% (P < .001).
• Mean medical school debt, adjusted for inflation, increased by 75% from $144,100 in 2004 to $251,600 by 2016.

Conclusions:

• State-funded medical schools have seen a substantial rise in out-of-state matriculants since 2004.
• This trend may force residents to attend more expensive out-of-state or private institutions.
• Increased matriculation of out-of-state students correlates with rising medical education costs and student debt.