Admissions Ratios and US Medical Students

The competition for US medical school positions is global, limited only by English language proficiency and the ability to finance a prestigious US college and do well in college and MCAT testing.

Robert C. Bowman, M.D. rcbowman@atsu.edu  www.ruralmedicaleducation.org

Allopathic Admissions in the United States, Gender, Ethnicity, Distribution

1994 - 2000 Allopathic Graduates Male Ratio, one out of ___ are allopathic medical students Female Ratio, one out of ___ are allopathic medical students Medical Students 1994-2000 % of Medical Students Ratio Population 18 - 24 to Allopathic Medical Students Ratio High and Low Alternates Range or Alternative Measurement Changes Anticipated Pop in 2000 % of Population By Group % 18-24 by census in MIM 2001 number 18 - 24 by add m n f Male 18-24 by adding 18 - 24 cats in 2000 Female 18-24 by adding 18 - 24 cats in 2000 Male med stud avg 1994-2000 Female med stud avg 1994-2000 Medical Students 1994-2000 (AAMC) Male Med Students Female Med Students % of Allopathic Medical Students, Male Segment % of Allopathic Medical Students, Female Segment
Asian Indian 17 24 8,136 6.50% 22.6 24.8 Add 10% pop Fastest Increasing 1700000 0.60% 10.80% 183600 161933 81219 80714 0.58 0.42 8136 4719 3417 3.80% 2.70%
Chinese 46 63 4,882 3.90% 59.7 65.7 Add 10% pop Increasing 2700000 1.00% 10.80% 291600 257175 128989 128186 0.58 0.42 4882 2832 2050 2.30% 1.60%
All Foreign Born 267 298 7,533 6.00% 279.8 100 Add 10% pop Increasing past 16% 17562914 6.20% 12.00% 2107550 2107550 1165087 942463 0.58 0.42 7533 4369 3164 3.50% 2.50%
All Asian Students 48 66 20,340 16.20% 63.2 70.1 Add 10% pop Increasing past 22% 11898828 4.20% 10.80% 1285073 1133431 568485 564946 0.58 0.42 20340 11797 8543 9.40% 6.80%
Vietnamese 61 98 1,424 1.10% 83.6 91.7 Add 10% pop Increasing 1122528 0.40% 10.60% 118988 106928 53631 53297 0.62 0.38 1424 883 541 0.70% 0.40%
All Urban Born 166 194 109,228 87.00% 138.6 144 80% Urban not 77% Increasing 162824682 57.90% 9.30% 15142695 19502538 9946294 9556244 0.55 0.45 109228 60075 49153 47.90% 39.20%
US All Student Total 187 220 125,549 100.00% 201.7 180 With Expansion Increasing 281421906 100.00% 9.00% 25327972 25327972 12917265 12410706 0.55 0.45 125549 69052 56497 55.00% 45.00%
White 192 290 81,973 65.30% 214.1 190 - 230 Declining Yearly Decreasing 211460626 75.10% 8.30% 17551232 18850900 9590900 9260000 0.61 0.39 81973 50004 31969 39.80% 25.50%
Any Native American  473 534 871 0.70% 501.3 501.3 Any vs All Stable 4119301 1.50% 10.60% 436646 436646 222689 213956 0.54 0.46 871 470 401 0.40% 0.30%
Only Native American 316 348 871 0.70% 314.7 314.7 Any vs All Stable 2586000 0.90% 10.60% 274116 287785 148427 139358 0.54 0.46 871 470 401 0.40% 0.30%
All Rural Born 433 302 16,321 13.00% 356.9 310.4 20% Rural not 23% Decreasing 64727038 23.00% 9.00% 5825433 5825433 2970971 2854462 0.42 0.58 16321 6855 9466 5.50% 7.50%
Black 534 364 8,880 7.10% 422.4 468.8 Add 10% pop Stable 36419434 12.90% 10.30% 3751202 3834463 1897485 1936978 0.4 0.6 8880 3552 5328 2.80% 4.20%
Mexican American 892 1060 2,887 2.30% 915.1 1006.5 Add 10% pop Stable 20640711 7.30% 12.80% 2642011 2773415 1519075 1254340 0.59 0.41 2887 1703 1184 1.40% 0.90%
All Hispanic 737 876 5,975 4.80% 756.3 831.3 Add 10% pop Stable 35305818 12.50% 12.80% 4519145 4743880 2598352 2145528 0.59 0.41 5975 3525 2450 2.80% 2.00%
Low Income Rural 823 572 3,690 2.90% 677.6 600 - 800 Range Decreasing 27781728 9.90% 9.00% 2500356 2500356 1275181 1225174 0.42 0.58 3690 1550 2140 1.20% 1.70%
Income Quintile and % of Medical Students Admitted By Income Group                                            
Top Quintile Income (60 - 65%) 66 56 75,329 60.00% 67.2 60 Increasing 2% per Year Increasing 56284381 20.00% 9.00% 5065594 5065594 2786077 2279517 0.56 0.54 75329 42184 40678 33.60% 32.40%
2nd Quintile Income (18 - 22%) 209 193 25,110 20.00% 201.7 164 - 200 Range Stable 56284381 20.00% 9.00% 5065594 5065594 2786077 2279517 0.53 0.47 25110 13308 11802 10.60% 9.40%
3rd Quintile Income (9 - 13%) 403 343 15,066 12.00% 373.6 310 - 450 Range Decreasing 56284381 20.00% 10.00% 5628438 5628438 3095641 2532797 0.51 0.49 15066 7684 7382 6.10% 5.90%
4th Quintile Income (6 - 8%) 706 533 10,044 8.00% 616.4 550 - 750 Range Decreasing 56284381 20.00% 11.00% 6191282 6191282 3405205 2786077 0.48 0.52 10044 4821 5223 3.80% 4.20%
Bottom Quintile Income (1 - 3%) 2751 2642 2,511 2.00% 2689.8 1600 - 4000 Range Decreasing 56284381 20.00% 12.00% 6754126 6754126 3039357 3714769 0.44 0.56 2511 1105 1406 0.90% 1.10%

Using Logarithms for both the broad spread of income and of admissions ratios, the relationship clearly is linear between income and admissions.

Admissions Income Quartiles for graph and more details

The same linear relationship is seen between income and physician distribution or admissions and physician distribution for family medicine, rural locations, and office-based primary care in poverty locations.

Income Quintile FP Choice by pop density quintile Rural Choice by pop density quintile Office IM by Pop Density quintile Office FP by County Income Quint Rural by County Income Quint Office IM by County Income Quint Cardiology by County Income Quint Orthoped by County Income Office Rural FP by county income Off Primary Care poverty by county income Off PC Poverty by pop density
Lowest 18.16 20.52 9.39 16.15 18.60 9.60 1.89 2.88 5.85 5.59 5.28
2nd 13.57 12.73 9.51 11.93 11.70 9.80 2.24 3.21 3.19 3.18 3.95
3rd 11.35 9.75 10.14 12.19 10.80 9.53 1.99 3.23 2.63 2.99 3.29
4th 10.47 9.59 9.47 11.35 8.60 10.22 2.08 3.16 2.19 3.16 2.95
Richest 7.34 6.47 10.59 9.28 7.80 10.36 2.37 3.02 1.72 2.87 2.44

 

Back to Admissions

For ethnicity, gender, and rurality, the range is 1 in 20 for Asian Indian to 1 in 1000 for female Mexican American students. When considering income alone, the range is 1 in 60 for the top income quartile to 1 in 2700 for those at the lowest 20% income levels and may be as low as 1 in 4000. Many US urban areas have this wide range of admissions probability within the same or adjacent zip code areas.

Admissions varies with income, population density, and parent education level. Population density, education, and income levels of the county of birth of medical students predict well over 50% of the variance in admissions. These socioeconomic measures also influence test scores such as SAT/ACT and MCAT. Higher socioeconomics means low choice of distributional careers and poor retention for practice in the state where students attended medical school. Family medicine is a more likely choice in lower socioeconomic students and in allopathic public schools, FPs are 44% more likely to be retained in their state for practice (1987 - 2000 medical school graduates compared to 2005 locations in the Masterfile)

The actual number of 18 - 24 year olds used in the table involves census values, however these are known to lag behind for groups with rapid increases. The groups with the most rapid increases are Indian-Pakistani, Vietnamese, and Mexican American.

States vary greatly in the growth of various populations, the students admitted, income levels, and education levels.  Medical school admissions would be expected to vary greatly as well.

There is also a variation to consider regarding east-west location or longitude. Family medicine is a much more common choice by all students in students who have more western locations. Students in the east tend toward general internal medicine, and general pediatrics. Mexican American and Vietnamese populations have choice of family medicine at nearly the same rates as rural populations. They also have a more western location. Black and Cuban and Puerto Rican populations have eastern locations and lower choice of family medicine. Whether this is medical education bias, lack of exposure to family medicine during upbringing, or the impact of poverty is unknown. Family medicine is a low choice for populations with skewed income and education distributions with more in poverty and more elite in income and education. Those higher income do not choose FP. Those lower income mostly cannot access college or medical school at all. Those that do have elite test taking skills in urban areas are shuttled to special schools and programs. This may socialize such students away from distributional choices and toward subspecialities and elite medical schools.

For a detailed description of the impact of birth origins on choice of specialty and location, see Birth Origins Articles

Distribution, Income, MCAT

1994 - 2000 Allopathic Graduates

FP Choice

Rural Choice in FP Graduates

Approximate Money Income Levels 2003

Parent Income Level of Accepted Parent Income Level of Applicant MCAT all applicants 1996 (AAMC) MCAT Accepted 1996 (AAMC)

Asian Indian

2%

15%

$55,000

100000   9.70  

Chinese

6%

6%

 

80000   10.30  

All Asian

7%

11%

 

90000 80000 9.70 10.6

Vietnamese

22%

5%

 

42500   9.10  

All Urban Born

13%

21%

 

higher      

US All Student

18%

24%

 

       

White

14%

26%

$48,000

90000 80000 9.50 10.3

Native Am

9%

47%

$33,000

60000 55000 8.10 8.9

All Rural Born

22%

30%

 

lower      

Black

13%

11%

$33,000

55385 50000 6.90 8.4

All Hispanic

12%

12%

$33,000

       

Mexican Am

19%

13%

$33,000

50000 48000 8.00 9.1

Other Hispanic

7%

11%

$33,000

70000 60000 8.60 9.7

Older students have 2 - 5 point higher FP and Rural choice (2 for rural born, 5 for urban born)
Male students have similar 2-  5 point increases over females in rural choice unless specific admissions or different training Accelerated
About half of US allopathic Asian students are foreign born, and half born in US (census, fp studies) Asian Students in Education and Medical Education

Birth Origins and Distribution Tables are an updated version of those below

Distribution of 110638 US Allopathic Med School Students by Urban Influence Code (1993) of County of Birth 1970 Population (approx birth) US Medical School Grads 1994-2000 Admissions Ratio Per Yr Per 100k By Birth Origin Board Certified FP 1969 Income in 1989 $
1 metro over 1 million pop 101367458 51895 0.94 13.1% $9653
2 metro less than 1 million 58220559 25595 0.81 17.8% $8439
3 adjacent metro over 10000 pop 2897447 745 0.47 19.6% $8088
4 adjacent less than 10000 pop 1962738 231 0.22 22.9% $7141
5 adjacent small metro > 10000 8371383 2455 0.54 18.3% $7829
6 adjacent small metro < 10000 10317604 1403 0.25 20.5% $6879
7 not adjacent > 10000 8330790 3417 0.75 18.0% $7825
8 not adjacent 2500 - 10000 8528640 1900 0.41 20.5% $7215
9 not adjacent less than 2500 3216612 429 0.24 24.9% $6826
Foreign Born (raised codes 1,2)   17854 Higher 10.6%  
Military Birth                    847   19.5%  
Missing Birth Data                1119   13.3%  
Total                           203213231 110638 1.00 15.8%  
Adjust Code 1 add .7 foreign born 101367458 64393 1.17 13.1%  
Adjust Code 2 add .3 foreign born 58220559 30951 0.98 17.8%  

The effect of Foreign born if included where they were raised in the United States, is to raise admissions ratios for those born and raised in metro counties. See adjusted code 1 and 2. Codes 1, 2, 3, 5, 7 have more education and health resources.

 

Ethnicity and the Steps Toward Family Medicine

 

18-24 yr Pop

College 1995

MedStud

Choose FP

 

White

68%

75%

68.1%

14%

urban born

 

 

 

 

20 - 30%

rural born

Asian

3.5%

5.8%

16.9%

3 - 24 %

Indian - Vietnamese

Black

14.1%

10.7%

7.4%

10 - 15%

 

Hisp

12.6%

7.9%

5.9%

4 - 18%

PR - Mex American

Native

0.9%

1.0%

0.7%

10%

 

 

Census

Dept Educ

AAMC

FPGrad

 

*Note: Most Asian ethnicity FP residency graduates were from international schools

Ranges used because of incomplete ethnicity data

Traditional underrepresented minorities have had declining FP choice in recent years even as number have increased

AAMC MIM is AAMC 2001 Minorities in Medicine report

Birth Origins Articles

Medicine, Education, and Social Status

Parent Income and Ethnicity and FP Choice

County Birth Origins, Incomes, Choice of FP

Probability of admission tables - the impact of expansion did not improve rural origin or minority admissions

Admissions Ratio By Birth Origin

Physician Workforce Studies

Side Effects of Selecting for Family Medicine

www.ruralmedicaleducation.org

 

wolf grey 3s sport blue 3s sport blue 6s cheap air jordans louis vuitton outlet jordan 3 wolf grey louis vuitton outlet sport blue 6s coach outlet kate spade outlet nike kd vii wolf grey 3s coach factory outlet online louis vuitton outlet sport blue 3s louis vuitton outlet louis vuitton outlet louis vuitton outlet louis vuitton outlet coach outlet online