Variability in tuition and curriculum among allopathic and osteopathic medical schools in the United States. (September 2021)

• Record Type: Journal Article
• Authors: Lin, I-Chun; Sen-Crowe, Brendon; Pasarin, Anthony; McKenney, Mark; Elkbuli, Adel
• Is Part Of: Annals of medicine and surgery. Volume 69(2021)
• Publication Date: 2021-09
• Subjects: Medical school tuition -- Medical school pre-clerkship and clerkship curriculum -- Allopathic and osteopathic medical schools -- Regional variation -- Medical education; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2021.102737
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Background: Medical school tuition has increased dramatically. We aimed to characterize allopathic and osteopathic medical school tuition and its association with geographic region, pre-clerkship and clerkship curriculums, and compare tuition between allopathic and osteopathic schools. Methods: US allopathic and osteopathic in-state tuition were extracted from the AAMC and AACOM databases and adjusted for cost-of-living. Schools were divided by geographic regions (West, Midwest, South, Northeast). Pre-clerkship and clerkship curricula characteristics were collected from school websites. Pre-clerkship curricula were categorized into one of six categories: 1) discipline-based, 2) organ system-based, 3) combined discipline/organ system based, 4) team-based learning, 5) mixed, and 6) other. Clerkship curricula characteristics collected included; required research block, out-of-state elective option, and global health (international) elective option. This study was reported according to STROCSS guidelines. Results: For allopathic schools, unadjusted and adjusted tuition was significantly higher in the Northeast. After adjusting for cost of living, the West displayed significantly larger in-state tuition than the South. No association was seen between tuition and pre-clerkship curriculum. Of the clerkship characteristics, presence of a required research block or global health electives corresponded to higher tuitions. For osteopathic schools, tuition in the West was significantly higher than the South and Midwest. Schools that offered a discipline-based pre-clerkship curriculum had higher tuitions than other curricula. Clerkship characteristics were not associated with tuition variation. Conclusions: US medical school tuition is highly variable, demonstrating associations with geographic regions and curriculum characteristics. There is increasing value in team-based learning modalities in improving professional communication skills. Highlights: A cross-sectional analysis of 151 Allopathic and 37 Osteopathic U.S. medical schools were assessed for variations in mean in-state tuition (MIST), preclerkship curricula, and curriculum features. Allopathic and Osteopathic medical schools demonstrated variable tuition even after adjusting for the cost of living (COL), and exhibited the greatest MIST in the Northeast and West regions, respectively. Allopathic medical schools with a discipline-based exhibited significantly greater MIST, whereas those with a team-based curriculum were significantly reduced. Allopathic medical schools requiring a research/scholarly project or global health elective (GHE) exhibited significantly greater adjusted MIST than those that did not. Future studies may consider investigating the effect of academic match results, funding/resources, and student quality of life on MIST of Allopathic and Osteopathic medical schools.