Welcome to College Transitions’ “So you want to be a…” series. Designed to help career-minded high school students think intelligently about their postsecondary journeys, these blogs look at the financial, academic, and personal factors one should consider when exploring various professions.
Medicine is a field where the numbers change every year, and 2026 brought plenty of new ones: record enrollment, a record residency Match, higher debt, and a sweeping overhaul of federal graduate student loans. Below, we walk through what a teenager with a white coat in their future should know today.
How competitive is medical school admission right now?
Very, though not in the way many families assume. According to the Association of American Medical Colleges (AAMC), 54,699 people applied to U.S. MD-granting medical schools for the 2025–26 cycle, a 5.3% jump over the prior year. The entering class of 23,440 first-year students was equivalent to roughly 43% of that year’s applicant count. (That ratio isn’t any one applicant’s probability of admission, since each applicant applies to many schools and the pool varies widely in strength.) Total enrollment at MD schools crossed 100,000 students for the first time in the organization’s history.
So the odds are not Ivy League odds. The catch is that the applicant pool is heavily self-selected. First-year MD students in 2025–26 brought a mean MCAT score of 512.1 and a mean undergraduate GPA of 3.81. The AAMC’s applicant data show how strongly acceptance rates are associated with those two numbers:
| Undergraduate GPA | MCAT score | Share of applicants accepted |
| 3.80 or higher | Above 517 | 83.3% |
| 3.80 or higher | 514–517 | 77.2% |
| 3.40–3.59 | 502–505 | 30.3% |
| 3.00–3.19 | 498–501 | 15.4% |
| All applicants | All scores | 45.1% |
Source: AAMC FACTS Table A-23, applicants and acceptees to U.S. MD-granting schools, 2023–24 through 2025–26 combined. These are observed acceptance rates, not the effect of raising a GPA or MCAT score; applicants in the top rows also tend to differ in coursework, research, experience, and school lists.
The takeaway for a high school student is that medical school admission is decided mostly by what you do in college: your grades, your MCAT, and your experiences. Our guide to average MCAT scores and GPAs breaks these numbers down school by school.
Should I be a pre-med major?
This may come as a surprise, but “pre-med” is not a major at most colleges, and biology is not a secret password. According to AAMC Table A-17, humanities, math, and physical science majors all had higher matriculant-to-applicant ratios than biology majors in the 2025–26 cycle:
| Primary undergraduate major | Applicants | Matriculants | Matriculants per 100 applicants |
| Math and statistics | 335 | 192 | 57 |
| Humanities | 1,453 | 755 | 52 |
| Physical sciences | 4,243 | 2,175 | 51 |
| Social sciences | 4,758 | 2,014 | 42 |
| Biological sciences | 32,038 | 13,480 | 42 |
| Other | 9,288 | 3,783 | 41 |
| Specialized health sciences | 2,584 | 1,041 | 40 |
Source: AAMC FACTS Table A-17, applicants and matriculants to U.S. MD-granting schools by primary undergraduate major, 2025–26.
The MCAT tells a similar story. In the 2024–25 cycle, humanities majors who enrolled in medical school averaged 513.3 on the exam, compared with 511.6 for biology majors. One caution in reading these tables: a philosophy major who applies to medical school has already completed every science prerequisite on top of their major, so the students in the smaller groups are self-selected and highly motivated. The data don’t show that switching to French will raise your odds. They do show that you are free to pursue any academic major on the road to med school.
That being said, if you choose to pursue your dream of majoring in a foreign language, there will be a laundry list of prerequisites that you will have to squeeze into your academic schedule. The AAMC’s baseline is one year of biology, one year of English, and two years of chemistry through organic chemistry, but each school sets its own list, and most add physics and lab work. The requirements have also shifted over the past decade. Harvard Medical School, for example, expects mastery of biochemistry and encourages coursework in statistics and the behavioral sciences, while calculus is no longer required for its main MD track. The MCAT itself now tests biochemistry, psychology, and sociology alongside biology, chemistry, and physics. Our guide to pre-med requirements walks through a typical four-year course plan.
If you can balance a non-pre-med major and these demanding courses, go for it. If you start accidentally labeling hydrolytic enzymes in French on your biology final, it may be time to consider a more focused course of study.
Do I need to attend a prestigious undergraduate school?
No, you do not have to attend an Ivy-caliber undergraduate institution to be admitted to med school. Admissions committees do consider the rigor and context of your college, but far more important than undergraduate prestige is what you accomplish there: your GPA, MCAT preparation, coursework, research, clinical exposure, service, and recommendations.
Consider Johns Hopkins, one of the most selective medical schools in the country. According to its class statistics, the 129 students who enrolled in the Class of 2028 were chosen from 4,409 applicants and posted an average MCAT of 520, which sits around the top 2% of all test-takers. Those 129 students came from 62 different undergraduate institutions. The pattern holds elsewhere: the University of Miami’s Miller School of Medicine drew its Class of 2029 from 68 colleges, and UTHealth Houston’s McGovern Medical School enrolled students from 66 undergraduate schools the same year.
Where you live can also matter a great deal. Many public medical schools, which are funded by state taxpayers, give substantial preference to in-state applicants, though policies vary widely and some enroll large numbers of nonresidents. A student from a state with several public medical schools that favor residents starts with a real advantage, so it pays to learn your home state’s options early.
Selecting a school with ample research opportunities for undergraduates can also be advantageous. Be forewarned, however, that schools with the most state-of-the-art and expensive laboratories are not necessarily the places that let undergrads get hands-on with equipment. Many leading research universities reserve those opportunities mostly for graduate students, while smaller liberal arts institutions often let students get their hands dirty in a laboratory from their first or second year. Our lists of the best colleges for pre-med students and the colleges that send the most graduates to medical school are useful starting points.
Consider BS/MD programs
If, at 18 years old, you are 100% committed to becoming a medical doctor, you might want to consider applying to a combined BA/MD or BS/MD program. These programs admit students straight out of high school with a conditional seat in medical school, which removes much of the stress of the traditional med school admissions process. Some compress the timeline to six or seven years; others keep the standard eight. The AAMC maintains a 2025–26 list of participating medical schools, and our Dataverse directory of combined medical programs lets you sort them by state and length.
Read the fine print. Many programs that once waived the MCAT now require it. George Washington University’s program is a good example. It is now structured as an eight-year, 4+4 BA/BS–MD with GW’s Columbian College of Arts and Sciences. According to GW’s program page, students must keep a 3.60 overall GPA with no grade below a C in science courses and earn an MCAT score that meets the program’s cutoff.
Because a small number of seats attracts thousands of top students, many of these programs post acceptance rates below those of highly selective undergraduate institutions; our rundown of the best BS/MD programs includes program-by-program details. Our guide on how to get accepted into a BS/MD program covers what the strongest applicants have in common.
Don’t overlook osteopathic (DO) medical schools
Many families don’t realize that there are two paths to becoming a fully licensed physician in the United States. Doctors of Osteopathic Medicine (DOs) complete four years of medical school, meet physician licensing-exam requirements (most take the COMLEX-USA series, and many also take the USMLE), enter the same residency Match as MD students, and practice in every specialty in all 50 states. Osteopathic training adds instruction in osteopathic manipulative treatment and places particular emphasis on the whole patient.
The DO sector has grown quickly. According to the American Association of Colleges of Osteopathic Medicine (AACOM), there are now 48 accredited colleges of osteopathic medicine teaching at 75 locations in 36 states, and DO students account for nearly 30% of all U.S. medical students. AACOM’s enrollment data show that in 2025–26, 23,114 people applied to osteopathic medical schools and 10,297 matriculated, a 6.9% increase over the prior year. Residency outcomes are strong, too. In the 2026 Main Residency Match, 93.2% of U.S. DO seniors matched to a first-year position, the highest rate on record for that group.
Many DO schools emphasize primary care and community-based training. Students should consider whether osteopathic education fits their goals rather than treating the two pathways as interchangeable. Applicants who are comfortable with both models often build school lists that include MD and DO programs. We explain the differences in more depth in From Pre-Med to MD: Understanding the Pathways to Medical School.
Gain experience in the field
Not only will gaining experience in the field help you decide if a medical career is right for you, it will help you build a record demonstrating a sustained commitment to the profession. Medical schools expect it. The AAMC reports that the 2025 entering class had contributed more than 16.8 million hours of community service before enrolling.
Most recent medical students also took time between college and medical school. In the AAMC’s 2023 Matriculating Student Questionnaire, as summarized by the University of Connecticut’s pre-health advising office, 73.2% of entering students reported taking at least one gap year, up from about 69% in 2021. For that cohort, going directly from college to medical school was the minority path. Those years are typically used to work as a medical scribe, EMT, or clinical research coordinator, to shadow physicians, to volunteer in a hospital or clinic, or to participate in a formal post-baccalaureate or gap-year program.
High school students can start small. Volunteering at a local hospital, earning an EMT or CNA certification where your state allows it, or shadowing a family physician will tell you far more about whether you want this life than any television drama.
Plan the financial end
Medical school is expensive, and it has gotten more so. According to the AAMC’s debt fact card for the Class of 2025, 70% of new physicians graduated with education debt, and the median debt among those borrowers was $215,000, up 5% from the prior year. The median cost of attendance for four years of medical school reached $297,745 at public schools and $408,150 at private schools. Those figures don’t include the debt many students carry from college; 27% of the Class of 2025 also had premedical loans, with a median balance of $28,000.
Federal loan rules changed for new borrowers on July 1, 2026
Families planning for medical school should know that the One Big Beautiful Bill Act, signed in July 2025, rewrote the federal loan rules for professional students. As Harvard’s student financial services office summarizes the changes:
- Grad PLUS loans, which previously let medical students borrow up to the full cost of attendance, ended for new borrowers on July 1, 2026.
- Professional students, including medical students, can now borrow up to $50,000 per year in federal Direct Unsubsidized Loans, with a $200,000 aggregate limit.
- A lifetime federal borrowing cap of $257,500 now applies, not counting Parent PLUS loans.
- Students who already had federal loans for their program before July 1, 2026 keep the old limits for up to three more years or until they finish, whichever comes first.
With a four-year cost of attendance near $300,000 at public schools and above $400,000 at private ones, many future medical students will face a gap that federal loans no longer cover. That gap will be filled by savings, institutional aid, service programs, or private loans. Programs that pay tuition in exchange for service, such as the military’s Health Professions Scholarship Program and the National Health Service Corps, deserve a closer look than ever. So does keeping undergraduate borrowing to a minimum, since every dollar borrowed for college counts against the new lifetime cap.
Public Service Loan Forgiveness (PSLF) remains available for physicians who work for qualifying nonprofit or government employers, which includes many hospitals. A 2025 Education Department rule that would have narrowed employer eligibility was vacated by a federal judge on June 30, 2026, so the existing rules remain in force for now.
How long does it take to become a doctor?
Longer than most teenagers imagine. The standard path is four years of college, four years of medical school, and three to seven years of residency, with additional fellowship years for many specialties. Add the gap year or two that most applicants now take, and a student who starts college at 18 will usually be in their early-to-mid 30s before practicing independently in a specialty like surgery or cardiology.
Residents are paid, but modestly. According to the American Medical Association, drawing on AAMC survey data, the average first-year resident earned $68,166, which is a fraction of what the same person will earn a few years later. Residency placement is its own competitive step. The 2026 Main Residency Match was the largest in the National Resident Matching Program’s history, offering 44,344 positions. Among 48,050 active applicants, 38,354 matched to a first-year (PGY-1) position, and U.S. MD seniors posted a 93.5% PGY-1 match rate.
Those years of training represent a significant opportunity cost. A classmate who took a job after college will have a decade of earnings, retirement contributions, and compound interest before the typical new attending physician sees a full salary. Those with a burning desire to join the medical field will find the rewards well worth the sacrifice, but it is a decision to make with eyes open.
What do doctors earn?
The good news is that, unlike with law school, just about everyone who makes it through med school and residency will end up with a six-figure career. According to the Bureau of Labor Statistics, the median annual pay for physicians and surgeons was $275,930 in 2025. Pay varies enormously by specialty, and so does the length of training. The table below pairs Doximity’s 2026 Physician Compensation Report, which surveyed about 23,000 full-time physicians on their 2025 earnings, with typical residency lengths from the American Medical Association.
| Specialty | Average annual compensation (2025) | Typical residency length |
| Neurosurgery | $829,161 | 7 years |
| Orthopedic surgery | $696,852 | 5 years |
| Cardiology | $604,635 | 3 years of internal medicine + 3-year fellowship |
| Internal medicine | $339,274 | 3 years |
| Family medicine | $325,040 | 3–4 years |
| Pediatrics | $273,665 | 3 years |
Sources: Doximity 2026 Physician Compensation Report; American Medical Association. Doximity figures are survey averages and are not directly comparable to the BLS median.
In other words, a neurosurgeon earns roughly three times what a pediatrician does, and the gap has been widening. Doximity found that surgical specialists earned 90.1% more than primary care physicians in 2025, up from 87.3% a year earlier. Doximity also found that three of the four most recruited specialties in 2025 were internal medicine, family medicine, and pediatrics, fields in which lower compensation makes heavy educational debt especially consequential. Students shouldn’t choose a specialty for money alone, but they should understand how pay and debt interact before they commit.
Will there be demand for doctors when I finish?
Current projections say yes. The Bureau of Labor Statistics projects employment of physicians and surgeons to grow 4% from 2025 to 2035, and estimates about 22,100 openings each year once retirements and other departures are counted alongside new positions. The AAMC’s most recent workforce projections point to a physician shortfall ranging from 13,500 to 86,000 by 2036 across its modeled scenarios, driven largely by population growth and aging. Many federal and state loan repayment programs specifically target primary care and rural or underserved areas, where recruiting physicians has long been hardest.
Keep in mind that projections are estimates, not guarantees, and that where you practice will shape your job market as much as your specialty. A physician willing to work in a rural or underserved area will have far more options, and often far more loan relief, than one determined to live in a major coastal city.
College Transitions’ Final Thoughts
A career in medicine asks for more years, more money, and more persistence than almost any other path a high school student can choose. The data also show that it remains open to students from a wide range of colleges and majors, that the DO route and BS/MD programs offer real alternatives, and that projected demand for physicians remains strong. The students who fare best are the ones who test their interest early through real clinical experience, choose a college where they can earn top grades and get hands-on research time, and plan for the financial side before the first tuition bill arrives.
If you’re a family mapping out a pre-med path and would like help building a college list with strong advising, research access, and a realistic cost, our counselors work with students on exactly these decisions every year.
