Despite mounting pressure from the medical community to expand in the face of a national physician shortage, the first-year class at what is arguably Yale’s most selective school — the School of Medicine — contains 100 and only 100 students. Staff reporters Raymond Carlson and Florence Dethy investigate.

More than 4,000 pre-meds applied to the Yale School of Medicine this year, but only about 250 of them will receive offers to join its incoming class. Yet even if their applications do not bear fruit, medical school applicants need not despair: Many other schools across the nation have expanded or plan to expand the size of their incoming classes.

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“If you’re thinking of applying to med school, now is a great time to do it,” said Amjed Mustafa, director of pre-health programs for Kaplan Inc., a company specializing in college and professional school admissions. “There are going to be class size increases and schools will be looking at more diverse groups of students and will perhaps consider different parameters.”

A recent Kaplan survey found that 44 percent of medical schools interviewed are considering increasing the size of their entering classes. Of them, more than a third said they would likely expand their class sizes as early as this upcoming fall.

But here at Yale, the medical school has no intention to grow its incoming class, Yale School of Medicine Dean Robert Alpern said.

“Our mission is to train individuals who will be leaders in the medical community,” he said in an interview. “Our ability to do that well would be hampered if we were to increase the size of the class.”

ADMISSIONS TRENDS AT YALE

After this fall’s economic collapse, students fled the job market and sought the safety of graduate school in record numbers. But the School of Medicine did not see an uptick in applications similar to that of the University’s Graduate School of Arts and Sciences, as evidenced by the medical school’s relatively unchanged application total this year.

This may be in part due to medical schools’ early national application deadline of Oct. 15 and the hefty premed requirements, said Richard Silverman, the dean of admissions for the School of Medicine.

“Most people apply to med school in the summer,” he said. “I do believe there will be an impact [on application numbers], but there will be a little bit of a time lag for medical schools as opposed to business or law schools.”

The school’s application statistics are not unique. Admissions officials from four other top medical schools said in interviews that they too have not seen a major rise in applications. Across the nation, applications to medical schools have remained flat, seeing a 0.2 percent drop in the past year, according to the Association of American Medical Colleges.

At top medical schools, the standards for the applicant pool are so high that a major shift in application totals would be surprising, said Edwin Dodson, dean of admissions at Washington University School of Medicine in St. Louis.

“We have a lot of self-selection in that we have a very academically talented applicant pool,” he said.

WashU medical school’s application numbers have been relatively stable in the past seven or eight years, he added.

PRIMARY CARE SHORTAGE

It is common knowledge that getting into medical school is an ultracompetitive process. But over the past two years the AAMC and the American Medical Association have begun steadily applying pressure on medical schools throughout the United States to increase the size of their incoming classes and to expand their existing facilities.

However, since the goal of the effort is to increase the number of primary care physicians across the country, the School of Medicine has no plans to increase the size of its first-year class, as it does not recognize the recommendation as being in alignment with the school’s core values, Alpern said.

Indeed, though the issue of whether or not to expand the size of the school’s first-year class arises every year, Alpern said such a change would hamper the school’s ability to develop the future leaders of the medical community.

Silverman echoed Alpern’s sentiments, citing the disconnect between the medical school’s mission and that of the AAMC.

“Yale is not in the business of training large numbers of primary care physicians,” he said. “We see ourselves as educating leaders in medicine, public health … not producing gigantic numbers of folks to address the concerns of the AAMC or the American Medical Association.”

Indeed, it has been state medical schools that have been the main source of expansion in the two years following the AAMC’s 2006 call for medical schools to increase enrollment by 30 percent by the year 2015.

“Where you’re likely to see the biggest changes are in state schools or schools designed to serve certain populations,” Mustafa, of Kaplan Inc., said.

The University of California’s medical school system, which comprises five medical schools, has been expanding the size of its first-year class by 10 percent since 2007. The increase is part of a program aptly titled the Program in Medical Education. PRIME was created to increase the number of doctors in California and the amount of primary care available to its underserved populations, said Corrina Kaarlela, a spokeswoman for the University of California at San Francisco.

Additionally, the University of Washington School of Medicine increased the size of its incoming class by 20 students last year after opening a new site in Spokane, Dean of Admissions Patricia Fero said. The growth is meant to encourage future doctors to practice in rural areas, she said.

Still, both Dodson of WashU and an official from the Duke School of Medicine asserted that like Yale, their medical schools — both private — have no intention to expand their class sizes.