The 2021 first-year class is larger and more diverse than any before. Did the pandemic, social justice, or remote interviews boost motivation among aspiring doctors?

The number of accepted students and new enrollments into medical school also reached new highs, making the first-year class of 2021 larger and more diverse than any before it. Among the 22,000-plus students who began medical school this fall, those self-identified as Black or African American rose by 21.0% from 2020-21, followed by increases of 8.3% among Asian students and 7.1% among those of Hispanic, Latino, or Spanish origin, the AAMC found.

No one can pin down one dominant force behind the boom. “I don’t think anybody knows why,” said Kevin Holcomb, MD, associate dean of admissions at Weill Cornell Medicine Medical College in New York City, where applications rose 15%.

Instead, admissions leaders believe an unprecedented mix of developments compelled many medical school aspirants to leap from “someday” to “now”: pandemic-related shutdowns that cut off other opportunities and accelerated medical career plans; increased awareness of how doctors can help to alleviate social injustices; and changes that reduced fees for some students and eliminated travel costs associated with applying.

“Most of the people who applied had been thinking about it for years” and got nudged by societal events, said Sandra Quezada, MD, associate dean for admissions at the University of Maryland School of Medicine (UMSOM) in Baltimore, where applications increased by almost 28%.

While most of those aspiring doctors probably never read the oft-quoted observation that “an optimist sees the opportunity in every difficulty,” many adopted that outlook in the face of adversities that struck the country in 2020-21.

“No one in our new class said they had this epiphany because of COVID,” said Woodson at Tulane University. “They were always planning on applying” to medical school.

The increased competition made it harder for people to get accepted. The number of accepted students did increase by 2.6%, but medical schools cannot quickly expand classes sizes significantly, as they need to develop everything from space and equipment to teachers and future clinical sites.

The unprecedented application increases of 2021-22 are unlikely to continue. Medical schools report that applications for the 2022-23 school year are coming in closer to pre-pandemic levels.

For the past 20 years, the number of applicants has fallen or risen by 2% or 3% each year. For 2021-22, they rose by 17.8%.

Highest previous increase: 8.2%, for 2007-08.
Total applicants for 2021-22: 62,443.
Previous record for applicants: 53,370, for 2019-20.
First-time applicants: 46,758, up by 21.2%.
Increase in applicants since 2002-03: 85.7%.

For the first time since the AAMC has tracked this figure, most of the 2021-22 applicants were not White. (Applicants could choose more than one racial/ethnic category.) Here are the figures for the largest categories

The class that started in 2021 (matriculants) is more diverse than in past years, with noticeable gains among those identifying as Black or African American and Hispanic, Latino, or of Spanish origin. The largest racial/ethnic categories are:

White: 51.5%.
Asian: 26.5%.
Hispanic, Latino, or of Spanish origin: 12.7%, up from 12.0% in 2020.
Black or African American: 11.3%, up from 9.5% in 2020.

Medical schools accepted more students this year than ever before: 23,711, up by 2.6% from last year. Acceptances have risen every year except one since 2002-03, usually by 1% or 2%, with a high of 2.9% in 2013-14.

For the third year in a row, women constitute the majority of applicants, matriculants, and total enrolled students. The number of accepted women reached a high of 13,152 for 2021-22, a record increase of 5.9%. The number of men accepted (10,537) dropped 1.0%, which is about the rate it has dropped each year since 2016-17.