At Tulane University School of Medicine in New Orleans, applications for admission to the class of 2025 are up more than 35% compared to the same time last year. At Boston University School of Medicine, theyve risen by 26%. And at Saint Louis University School of Medicine, admissions officers have seen applications increase by 27%.

In fact, nearly two dozen medical schools have seen applications jump by at least 25% this year, according to AAMC data.

Final tallies wont arrive for another month or so all schools application windows must close first but early numbers are striking. So far, there are more than 7,500 additional applicants nationwide, according to data from the American Medical College Application Service (AMCAS), which processes submissions for most U.S. medical schools. Thats an increase of nearly 17%.

Consider some edifying context: In the past decade, the year-over-year increase has averaged less than 3%.

Weve been experiencing a leveling off in recent years, so the large increase was quite surprising, says AAMC Chief Services Officer Gabrielle Campbell. Its also inspiring.

Experts don't know exactly what's behind the increase, but they point to several likely factors. Some are rather mundane, including students having more time to focus on applications as college classes moved online. But at least some of this year's applicants are driven by COVID-19 patients terrible suffering and front-line providers extraordinary heroism.

I make an analogy to the time after 9/11, when we saw an increase in those motivated to serve this country militarily, says Geoffrey Young, PhD, AAMC senior director for student affairs and programs. This certainly seems like a significant factor this year.

Even in a usual cycle, applying to medical school is no simple matter. Candidates spend many months preparing for the MCAT exam, writing essays, and collecting recommendations. Applying for entry in 2021 meant completing the AMCAS application in the spring or summer of 2020, followed by individual schools required secondary applications. Once applications are completed, applicants anxiously await interview invitations, which could extend into the spring of 2021.

I make an analogy to the time after 9/11, when we saw an increase in those motivated to serve this country militarily. This certainly seems like a significant factor this year.

Geoffrey Young, PhDAAMC senior director for student affairs and programs

Now, many candidates wonder if increased competition will make landing a seat tougher than ever. For their part, schools say theyre determined to review all candidates fairly, especially given the upheaval many applicants faced during COVID-19. That means admissions teams are working longer hours, extending timelines, adding interview slots, and offering some sage advice to worried candidates.

Schools want to make sure that when they accept someone, its a good fit for both the school and the applicant, Campbell says. They also want to be sensitive to the many applicants who have been hit particularly hard by the pandemic. Thats a lot of work, but theyre highly committed to it.

The larger application numbers to date likely stem from several factors, among them that some applicants are seeking a reliable profession in uncertain times. Some aspects of the application process also got easier as medical schools extended deadlines. And of course, theres the motivation to help patients and communities in a time of crisis.

During COVID-19, my hunger to help continues to grow, says Alan Mauricio De Leon of Houston, who teaches at a majority Hispanic charter school impacted by the pandemic. One student, he recalls, slept in his familys car to avoid infecting them. I want to be a change agent to bring equitable, effective care to my community, he says.

Creson Lee is among the applicants motivated at least in part by the dedication of front-line providers. Lee, 24, was deeply impressed by hospital staff when her research job took her to a Penn Medicine COVID-19 testing site to enroll study participants this summer.

Testers would be out there all day under the sun wearing full gear, drenched in sweat, recalls Lee. Theyd always try to keep positive, sometimes putting on a silly PPE fashion show in the driveway. Lee, who already knew she wanted to be a doctor, fleetingly considered waiting for a more typical year to apply. Ultimately, though, it was important to me to run with this inspiration to pursue medicine right now, she says.

During COVID-19, my hunger to help continues to grow. I want to be a change agent to bring equitable, effective care to my community.

Alan Mauricio De Leon Medical school applicant

Some candidates likely were influenced by more practical considerations.

For some people, the job market looked too uncertain, and a lot more people might not have taken a gap year because there were fewer opportunities, says Valerie Parkas, MD, senior associate dean of admissions for the Icahn School of Medicine at Mount Sinai in New York. And then there were helpful changes to the application process. For example, most schools decided early on to move this years interviews online. Its a lot easier and less expensive to put on a nice shirt and log into Zoom than to travel across the country, she says.

For her part, Joanna Wasvary appreciated the extended application deadlines. That, plus my classes going online, means I can give my applications a lot more attention, says the University of Michigan senior. Wasvary therefore decided to forgo her planned gap year and potential work as a medical scribe. Itll be great to be a doctor one year earlier, she adds.

At Boston University, admissions officers have received more than 11,000 applications for 125 spots. Still, Associate Dean of Admissions Kristen Goodell, MD, doesnt think shell need to enlist additional reviewers. One reason is a protocol released last year that guides reviewers to keep certain criteria in mind. The process was designed for fairness, to reduce unconscious bias, says Goodell. But it turns out that knowing what to focus on also helps move through applications faster.

Other schools are building in more time to process applications. Tulane University, which has 16,000 applicants vying for 190 seats, is taking longer to extend interview invites. It just made sense to ensure that were reviewing the majority of applications before we give away all our interview spots, Woodson explains.

Kristen Goodell, MDAssociate deanof admissions at Boston University School of Medicine

One step medical schools dont plan on taking, though, is greatly increasing class sizes. Thats because substantial expansion requires approval from the medical school accrediting body, the Liaison Committee on Medical Education no simple matter. Plus, there's the issue of resources.

Schools usually decide their class size well in advance because they want to be spot-on in matching spaces with resources like clinical training sites, says Young. They dont want to find that they cant adequately train any additional students.

As aspiring doctors face more intense competition this year, admissions officers also offer their advice on some of candidates key concerns:

The increased numbers really shouldnt impact someones decision to apply. If they feel ready, they should apply. If they think their application needs bolstering, theres always next year, says Parkas. Careers are marathons.

Like many other admissions directors, Ivy Nip Asano, MD, director of admissions at the University of Hawaii at Manoa John A. Burns School of Medicine, reminds applicants that she is sensitive to extenuating circumstances this year. We understand that we need to take into consideration the effects of the pandemic on students ability to secure opportunities and experiences, she says.

At Boston University, Goodell emphasizes that she is seeking the same traits and abilities shes always sought and never uses some rigid checklist.

Weve already embraced admissions based on competencies. That means applicants dont need specific courses in a certain area, for example. They just need to demonstrate their abilities in that area, she says. This approach offers flexibility, which comes in really handy at a time like this. In addition, Goodell notes that Boston University uses holistic review, which considers an applicants full range of attributes and experiences.

For his part, Tulane Universitys Woodson advises applicants to make clear why they selected his school. Of course, we want people who will be a good fit for us, but with so many applicants, we also want to focus on those who will actually come here if accepted, he says.

Asano sums up her advice simply: I hope that applicants will share their authentic selves.

If you are a super-strong candidate, youre always going to get interview invitations. If youre a bit weak, no matter what the year, you wont get many. Then there is the group in the middle. For them, applying to more schools might increase the chances of an interview invite, Goodell says. A prehealth advisor can help you figure out which group youre in.

Could all the setbacks this year mean that fewer applicants from underrepresented backgrounds wind up in medical school?

We were concerned that all the disruptions could discourage people from racial and ethnic minority groups or lower socioeconomic backgrounds from taking the MCAT, says Cynthia Searcy, PhD, AAMC senior director of MCAT research and development. But the percent of those examinees actually mirrored those from 2019.

So far, application numbers also look encouraging.

To date, racial and ethnic minorities are applying to medical school in higher numbers compared to the same time last year," says the AAMCs Campbell. "For example, weve seen double-digit increases in the number of Black and Latino applicants.

This could still change, but given the stresses of the pandemic and social unrest that weve seen across the country, this is a positive early sign," she adds.

Once those applications land, holistic review should help ensure that schools consider the full picture of a candidates attributes and experiences, Young notes. He encourages admissions teams to use the AAMCs equity-related resources, including a recent webinar on how to prevent implicit bias in virtual interviews.

Other steps have helped support lower-income applicants. This year, the AAMC dramatically broadened its Fee Assistance Program, which provided $9.1 million worth of support last year. Qualifying applicants can receive a waiver for all AMCAS fees for one application submission with up to 20 medical school designations as well as MCAT benefits.

This year we raised the poverty level cut-off [so more potential candidates could benefit from the program], says Campbell. So far, weve had a 54% increase in [Fee Assistance Program] applications and a 76% increase in approvals.

Meanwhile, Goodell sees a quest for racial and social justice as helping to spur some of the rising application numbers.

So many people have seen that different groups in our country are facing such different effects from COVID-19 based on their ZIP code or their race, she says. This year, applicants are motivated to get out there and fix societal problems. Theyre saying, I need to do something to make this country more equitable, and I think the best way for me to do that is through medicine.

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Applications to medical school are at an all-time high. What does this mean for applicants and schools? - AAMC