Is Medical School Harder Today Than It Was Back Then?

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We often hear older generations talk about how much more difficult they had it when they were young—and doctors are no exception. It’s not uncommon to hear older physicians and younger physicians argue about whose training was more difficult. But how does medical school today actually compare to medical school in the past? Let’s explore both sides of the argument to determine who had it tougher.

 

1 | Getting into Medical School

Let’s start with how hard getting into medical school is today compared to previous decades.

According to data, the average matriculation rate between 1961 and 1981 was approximately 45% with some years having rates as high as 60% and others having rates as low as 35%. If we compare these numbers to the most recent data from the AAMC and the AACOM, the matriculation rate in recent years is approximately 36% for MD applicants and 31% for DO applicants.

Based on the numbers, we can see that a smaller percentage of premeds that apply to medical school today get in each year compared to previous decades.

These numbers don’t tell the whole story though. There are many other factors that determine acceptance into medical school including your GPA, MCAT score, and extracurriculars. Although data from previous decades is difficult to find, the trend in recent years has been that GPA and MCAT scores for matriculants have been steadily increasing.

In 2001, the average GPA for matriculants was 3.60 and the average MCAT was 29.6. This equates to roughly a 508 on the MCAT today. If we compare this to the most recent 2021-2022 application cycle, the average GPA for matriculants was 3.74 and the average MCAT was 512.

In addition, there has been a greater emphasis on soft skills and extracurricular activities in medical school admissions over the past several years. Although decreased reliance on hard metrics like GPA and MCAT may be perceived as making medical school admissions easier, it also increases the time that students must spend on extracurricular activities.

Students are expected to participate in volunteer work, research, and leadership roles. They’re also expected to gain clinical experience through physician shadowing or other clinical roles and receive glowing letters of recommendation from their teachers and mentors. Medical schools want to see students who are well-rounded–which can often make it difficult for students to know exactly what they should be doing to gain acceptance.

 

2 | Medical School Curriculum

Next, let’s talk about medical school itself. How does medical school today compare to medical school in previous years?

Medical students today have much more information to learn compared to previous years. According to a 2011 article, the doubling time of medical knowledge in 1950 was approximately 50 years. In 1980, it was 7 years. In 2010, it was 3.5 years. And today, medical knowledge is believed to double every 2-3 months.

Although there is a lag between the primary literature and the information that is added to medical school curricula, students are still learning much more information today than in previous years. Despite these vast increases in knowledge, medical school is still the same duration that it has been for decades. Students complete 2 years of preclinical coursework followed by 2 years of clinicals. This means that students have to cram much more learning into those 4 short years.

That being said, the way that today’s medical students learn is very different than what it was for students in the past. We have a much better understanding of how to optimize learning today. People have developed countless methods to be more efficient with studying. From the Pomodoro method to the Feynman technique and spaced repetition, we have hacked our study strategies so that we can learn more in less time.

There are also far more resources nowadays to help students learn information in medical school. There are comprehensive question banks with thorough explanations. There are extensive libraries of flashcards covering everything you need to know for the USMLE Step exams and shelves. There are even resources that use pictures and funny stories to help you memorize all of the small details about microbiology and pharmacology. And if those aren’t enough, the explosion of the internet over the past couple of decades means that all the information you could want is at your fingertips.

In the past, medical students had to flip through their textbooks or notes to find the information they needed. Nowadays, you can take out your phone, put your question into Google, and have more information than you could want on whatever topic you’re trying to learn.

Beyond the amount of information and resources, however, there is also the fact that many schools nowadays are transitioning to pass-fail curriculums. In fact, within the last year, USMLE Step 1, which has long been the most important test in determining your competitiveness for residency, has also become pass-fail.

The goal of these changes has been to decrease stress and burnout among students as research has shown that student well-being is enhanced and academic performance is not negatively affected by pass-fail curriculums. That being said, due to the nature of these curricula, students may need to spend more time on extracurricular activities such as research and leadership to stand out for residency applications.

In addition, just because medical school curriculums and Step 1 are pass-fail doesn’t make them easy. Students must still put in significant time and effort to pass while managing their other activities. As such it can be difficult to gauge how much time to put into medical school classes vs studying for boards vs extracurricular activities. Achieving the perfect balance between all of these responsibilities can often feel near impossible.

 

3 | Cost of Medical School

Another factor that we’ve talked about many times on this channel is the rising cost of medical school.

In 1978, the average medical student graduated with approximately $13,500 worth of debt. When adjusted for inflation, that is around $54,000. In 2000, this number jumped up to $124,000. Now, in 2022, the average medical student graduates with approximately $240,000 of student loan debt. That’s almost 5 times what it was just 40 years ago. Given current interest rates and the amount of time it takes to pay back the loan, the average physician ultimately pays between $365,000 and $440,000 for their educational loans plus interest.

Although this doesn’t make medical school more challenging from an academic standpoint, it adds psychological and financial stress on top of training to become an effective doctor.

That being said, there are more options available today to help you pay for medical school. In the early 1960s, it is estimated that approximately 83% of a student’s total spending was from family contributions, and only 31% of students incurred educational debt. This means that most students likely came from wealthy families who could afford to pay for medical school.

Today, approximately 76-89% of medical students have educational debt. Due to the accessibility of financial aid, grants, scholarships, and student loans, medicine is much more accessible to students from less-privileged backgrounds.

 

4 | Burnout & Depression

Lastly, the culture of medical school has changed significantly.

Although it is difficult to find information regarding rates of depression and burnout among medical students over the decades, there has been an increased emphasis on improving these in recent years.

There have been long-standing stigmas within healthcare regarding mental health among medical students. It hasn’t been until the last decade or so that schools have started to take these more seriously and take actionable steps to improve them. This has been a big reason for the shift that we’ve been seeing to pass-fail curriculums.

Although it is difficult to draw objective comparisons between now and previous years due to the lack of information and the issue of underreporting, there are certainly more resources available to students who are struggling today than there have been in the past. That being said, we still have a long way to go in terms of destigmatizing mental health and improving the well-being of medical students.

So who had it easier? Medical students of the past or medical students of today? The answer is: we’ll never know.

Countless factors play into how challenging medical school is. It’s impossible to account for every single one of them—and that’s not even considering all of the individual variation that exists. You can have two medical students who attended medical school at the same institution, during the same year, and had the same instructors and clinical rotations, and they can still have completely different experiences. There are simply too many variables to objectively say who had it easier.

The reality is that medical school was likely harder back then in some respects and easier in others. Arguing about “who had it worse” only creates an “us vs them” mentality between older and younger generations of physicians. Instead, we should just accept that getting into medical school and becoming a doctor is hard, regardless of the generation. Just because you had to walk 15 miles in the snow every day uphill both ways doesn’t mean that everyone else should.

There are still many issues within medical education that need to be addressed including the rising cost of medical tuition, burnout, the residency bottleneck, and looming physician shortages, to name a few. It is only by fostering a collaborative relationship between all physicians that we will be able to take steps toward making things better for future generations of doctors.

If you enjoyed this article, be sure to check out the Cost of Medical School Explained or Burnout in Medical Students & Residents – What To Do About It.

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