How Becoming a Doctor Works

Cost of Medical School

I thought medical school was expensive when I attended it. Now it is extremely expensive. The average first year tuition at a private medical school in the 1998-1999 school year was $24,917. The average first year tuition at a public (state-supported) medical school for in-state residents in 1998-1999 was $9,263 and for out of state residents it was $22,391. In addition, there are fees, housing costs, meals, books, equipment, car expenses, etc.

The high cost of medical school has implications that are not obvious at first. Most medical school graduates have large financial debts when they graduate. In 1996 the mean educational debt of medical graduates who had to borrow money was $75,103. Some medical students don't borrow money because they enter the military, which pays for medical school in exchange for a time commitment. One third of graduates of private medical school have financial debt greater than $100,000. As a result, many graduates tend to enter high-paying sub-specialties. This trend has left a need for primary care physicians.

In your 4th year of medical school you must decide which field of medicine (specialty) to practice. Each medical field requires a residency (a training period -- sort of an apprenticeship) of 3 or more years.

Information about residency programs can be obtained from the book Directory of Graduate Medical Education Programs published by the AMA ( or online through FREIDA online (Fellowship and Residency Electronic Interactive Database) at After deciding which specialty to enter, you must decide which residency program you like, then go visit and interview there. This is where the "Match" comes in.

Basically the Match is run by the National Resident Matching Program (a non-profit corporation). They conduct a sort of computer matching game. It works in the following way. After everyone has completed their interviews, the graduating medical student submits their list of residency programs in order of preference. At the same time, the residency programs rank the students that they prefer. The NRMP enters the info into a computer to match students and residency programs with their highest possible preference. Every graduating medical student finds out the results on the same day in mid-March on "Match day".

You are committed to accept the position you have matched into. If you did not match into a residency you are informed a few days prior to match day. A list of unfilled positions is provided to the unmatched medical students so that they can participate in the Scramble (getting unmatched medical students into unfilled positions).

In 1998, 16,000 graduating medical students and another 19,000 candidates (former graduates of U.S. medical schools, graduates of foreign medical schools, students in U.S. Osteopathic schools, and students in Canadian medical schools) competed for 23,000 positions through the Match. Approximately 80,000 physicians are in residency or fellowship programs at any particular time in 701 teaching hospitals offering residency programs in the U.S.

In the U.S., physicians complete a residency in one of numerous specialties. A residency takes a minimum of 3 years. Sub-specialty training (called fellowships) take additional years to complete.

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