Are you in favor of public MD schools being required to take 90%+ instate?

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I'm from NY. The SUNYs typically take ~80% of their students from NY. Texas requires a 90% minimum instate. Other states' schools require 95, 98 or even 100% of matriculants to be from instate? Take NY and CA for example. They could easily do what states like Mississippi and Massachusetts and Georgia have done, and require 100% of matriculants to be NY residents, because these are two of the top 5 states in terms of MCAT scores for the average applicant. Matriculant quality wouldn't suffer in a state like NY as a result of this change. In addition, NY state is diverse enough that this might actually help increase URM enrollment at the four SUNYs.

Thoughts? There are myriad public policy arguments in favor of it. In state matriculants are
More likely to stay in state to practice, and their families have contributed taxes to state coffers for years. OOS applicants have not.

Please respond whether you'd be in favor of this or not. I'm interested to hear why you support or oppose the idea. Also, if you are from Cali, please disclose that. I know IS applicants have a tough road there and you love being able to apply to SUNYs.

One more point if you want to address it. NY grants in state tuition after your first year of med school here if you are OOS. This should change. Most states don't do that and Ny shouldn't either! Make the OOSers pay OOS rates for all 4 years! LOL.

I'm from Texas and I'm in favor of our 90% in state rule. I'm not going to lie, but I'm mostly in favor for it because it makes it slightly easier for me to get in somewhere, or at least get interviews On top of that they make applying to 8 schools about the same price as applying to one out of state school. For someone who doesn't come from the typical matriculant family that makes 100,000 a year, I am incredibly grateful. I would hate to be from California where schools can take 80% or less in state. I think it is a legitimate reason that some states like Texas prefer to take in state residents because residents are far more likely to practice in state. I think states like California are so desperate for money because they are so far in debt, that need OOStaters money.,

Would it make a difference to applicants if all instates accepted 90%? I think this situation is ideal.

I think maybe the problem comes when some instates decide to take on 99% and others don't. 10% geographical diversity in class population can do any instate some good.

Maybe I'm missing something here?

It would be interesting to do the math and compare number of mandatory in state seats offered by schools to the total number of residency spots in that given state.

For example, take the total number of state school first year class seats in Texas, determine the total number of seats that must be filled by in state applicants, and then compare to the overall number of residency spots available in Texas for all specialties combined.

I don't know if it makes a huge difference or not, but if the idea is to keep future physicians in the state, wouldn't it be prudent to make sure they can get the residency of their choice in that given state? I know there are a lot of factors that go into this, but if there is a huge disparity between total medical school graduates and total residency spots, wouldn't it be most reasonable to fill that gap in an effort to keep physicians practicing "close to home."

I must admit, I am a fan of the 90% rule here in Texas, but if we are losing a large number of future physicians when they go off to residency, then is it all for naught anyway?

Notably, UMass accepts massachusetts residents exclusively for its MD only program.

Originally Posted by tantacles

Notably, UMass accepts massachusetts residents exclusively for its MD only program.

Same with Southern Illinois U. and IL residents. Only MD/JD applicants can be OOS.

In regards to your point about keeping OOS kids paying OOS tuition, I'm completely against that. If you pay taxes to that state while residing there for a year or two, you deserve to be considered a resident.

I don't think the SUNY schools have any real restrictions on instate vs out-of-state.

I think those numbers just happen naturally due to:

a) Relative tuitions
b) Strength of the NY applicant pool

Originally Posted by CoolWhipp

Would it make a difference to applicants if all instates accepted 90%? I think this situation is ideal.

I think maybe the problem comes when some instates decide to take on 99% and others don't. 10% geographical diversity in class population can do any instate some good.

Maybe I'm missing something here?

URM diversity is a valid goal for numerous reasons that have been repeatedly elucidated on here. Please explain how geographic diversity adds a benefit to a med school class?

Originally Posted by tantacles

Notably, UMass accepts massachusetts residents exclusively for its MD only program.

Yes. Why can't SUNy do the same? Our in state applicant pool is just as competitive as the MA poll.

Originally Posted by Praefectus

In regards to your point about keeping OOS kids paying OOS tuition, I'm completely against that. If you pay taxes to that state while residing there for a year or two, you deserve to be considered a resident.

Please explain to me how a Cali student attending a SUNY med school for first year while paying no taxes contributes to the state? Why should they be considered in state for 2nd year? UC schools don't return the favor for NY matriculants to UCLA, etc.

Originally Posted by johnnydrama

I don't think the SUNY schools have any real restrictions on instate vs out-of-state.

I think those numbers just happen naturally due to:

a) Relative tuitions
b) Strength of the NY applicant pool

My point is that the NY legislature should mandate that the four SUNYs take at least 90% from instate and preferably 100%.

Kick all out of staters out of SUNY eligibility and give the spots to in-state URMs. Win win right? We diversify our class and do what other states do. I can already tell who the Cali people are on here.

Originally Posted by DanGee777

My point is that the NY legislature should mandate that the four SUNYs take at least 90% from instate and preferably 100%.

Why? They already take 80+% without any restrictions?

That would just serve to decrease the caliber of students at the schools.

I'd rather see the other states change their policies.

Originally Posted by johnnydrama

Why? They already take 80+% without any restrictions?

That would just serve to decrease the caliber of students at the schools.

I'd rather see the other states change their policies.

Flat out untrue. NY applicants are top 5 among states in mCAt average. Taking 20% extra instate wouldn't hurt the instate pool at all.

Originally Posted by DanGee777

Flat out untrue. NY applicants are top 5 among states in mCAt average. Taking 20% extra instate wouldn't hurt the instate pool at all.

Of course it would.

If you are currently taking the top NY applicants available plus top out of state applicants, restricting yourself to either pool will decrease the overall caliber.

Originally Posted by DanGee777

Flat out untrue. NY applicants are top 5 among states in mCAt average. Taking 20% extra instate wouldn't hurt the instate pool at all.

You're already taking the best IS students for the first 80% of your class, now you can either fill the last 20% of your class with the best OOS students or the more average IS students. Taking only IS students would theoretically decrease the average quality of the class (assuming you could get higher quality OOS students, which is debatable). There are certainly reasons in favor of taking a higher % of IS students (doing your taxpayers a solid, ensuring there are physicians who will remain in your communities, etc.) but increasing applicant quality isn't one of them.

Of course, the major reason to continue taking OOS students is probably not increasing student quality since, as you point out, there are plenty of qualified IS students in states like NY, but rather, increasing income from tuition. And offering IS tuition after 1 year is probably a good compromise between student quality and making money from OOSers: if you charge OOS tuition all four years, you probably lose the best OOS students, but charging extra first year provides an extra $20-40k, which can't hurt.

It's kind of ridiculous that NYS allows you to pay IS tuition after the first year. There are annual tuition hikes of 5-10% yet nothing is done to stop the changing of state residency. Same goes for NJ, OH and a couple of other states.

I wouldn't be surprised if that changes in a couple of years.

I'm definitely in favor for it... I mean public schools are funded by the state, and the people most likely to stay/practice/help the sick in that state are it's residences... And (I would think) it makes for more OOS applicants that actually want to be in said state (and then stay) because they actually want to be there since there is such a small chance of them getting in due to residency.

I have no problem with in state schools taking 80 or 90 percent in state applicants. It makes more sense for the schools, and there are usually plenty of private schools in the big states for out of state applicants.

I'm from New Mexico where we only have one medical school. They enroll every year nearly 100% in-state (with the only OOS being from the Navajo Nation generally).

If they did choose to accept OOS applicants then that would only increase the underlying problem in New Mexico which is not enough physicians. By only accepting in-state applications they hope to remedy that because they assume that if the matriculants are from New Mexico they are more likely to stay in New Mexico.

State funded medical schools need to give preference to people from that state.

Originally Posted by Osakhomen

I'm definitely in favor for it... I mean public schools are funded by the state, and the people most likely to stay/practice/help the sick in that state are it's residences... And (I would think) it makes for more OOS applicants that actually want to be in said state (and then stay) because they actually want to be there since there is such a small chance of them getting in due to residency.

Bingo.

Originally Posted by johnnydrama

Of course it would.

If you are currently taking the top NY applicants available plus top out of state applicants, restricting yourself to either pool will decrease the overall caliber.

Valid point, but Mississippi takes 100% in state and their MCAT avg is 27. The SUNYs average 31.5 with 80% in state. Even taking 100% in state would only lower the avg to 30.5 or so.

Originally Posted by wanderer

It's kind of ridiculous that NYS allows you to pay IS tuition after the first year. There are annual tuition hikes of 5-10% yet nothing is done to stop the changing of state residency. Same goes for NJ, OH and a couple of other states.

I wouldn't be surprised if that changes in a couple of years.

It's lame and it needs to stop.

I would rather all state schools only require 50% IS. I know they got their state finding matters and whatnot, but frankly i think its crap that you are better off being in a certain state (e.g. Mich or Cal if ur an awesome student, and Texas if ur avg), which most of us have no control over. I know there are other reasons for it, but that doesn't mean i have to like it.

Originally Posted by Sephiroth

I would rather all state schools only require 50% IS. I know they got their state finding matters and whatnot, but frankly i think its crap that you are better off being in a certain state (e.g. Mich or Cal if ur an awesome student, and Texas if ur avg), which most of us have no control over. I know there are other reasons for it, but that doesn't mean i have to like it.

No offense, but I'm glad almost anyone disagrees with you. If you really want to take
advantage of other states, do so. Move to Texas and work a minimum wage job for a year. Find cheap housing on Craigslist. Bam, in state residency for the next cycle. I've thought about it but not worth it to me to do that.

Originally Posted by DanGee777

Valid point, but Mississippi takes 100% in state and their MCAT avg is 27. The SUNYs average 31.5 with 80% in state. Even taking 100% in state would only lower the avg to 30.5 or so.

I don't think there's any question that NY is smarter than most states on average.

I'd rather keep our schools at a higher caliber than tip the scales in favor of less qualified students.

A place like Mississippi has to do that, or their entire class would come from NY, MA, and CA.

Originally Posted by Donnie1310

Same with Southern Illinois U. and IL residents. Only MD/JD applicants can be OOS.

Unless you do the MEDPREP program.

Originally Posted by johnnydrama

I don't think there's any question that NY is smarter than most states on average.

I'd rather keep our schools at a higher caliber than tip the scales in favor of less qualified students.

A place like Mississippi has to do that, or their entire class would come from NY, MA, and CA.

So it's ok for MS residents to get treatment from inferior doctors? We give prefences to URMs because although they may have less impressive stats, they are underrepresented. SUNY instate grads are more likely to stay in state than are OOS suny grads. Should we not expand the % of instate enrollment to better serve our state?

Originally Posted by DanGee777

So it's ok for MS residents to get treatment from inferior doctors? We give prefences to URMs because although they may have less impressive stats, they are underrepresented. SUNY instate grads are more likely to stay in state than are OOS suny grads. Should we not expand the % of instate enrollment to better serve our state?

Your logic is faulty. We should petition other states to open admissions, not NY to restrict theirs.

I think part of the problem is that, despite high in state preference, there is a major hemorrhage of talent from the parts of states that really need it: rural/underserved areas. Big shiny cities like NYC will always have plenty of docs relative to rural areas. The current solution is inefficient, in the sense that only a fraction of IS students will end up practicing in state, let alone underserved parts of that state. The true solution is to find ways to keep talent flowing to the areas in need of it most.

Originally Posted by mmmcdowe

I think part of the problem is that, despite high in state preference, there is a major hemorrhage of talent from the parts of states that really need it: rural/underserved areas. Big shiny cities like NYC will always have plenty of docs relative to rural areas. The current solution is inefficient, in the sense that only a fraction of IS students will end up practicing in state, let alone underserved parts of that state. The true solution is to find ways to keep talent flowing to the areas in need of it most.

I thought residency match was more correlated.

Originally Posted by johnnydrama

Your logic is faulty. We should petition other states to open admissions, not NY to restrict theirs.

Open admissions? What do you mean? Have every state get rid of instate preference
For public MD schools?

Originally Posted by Porfirio

I thought residency match was more correlated.

Yeah, residency slots and loan forgiveness are the way to keep people in state.

Medical school is pretty irrelevant.

Originally Posted by DanGee777

Open admissions? What do you mean? Have every state get rid of instate preference
For public MD schools?

Bingo. (Sorry for the terminology, I know "open admissions" means something else.) No instate preference aside from a tuition differential.

Gotta love Texas

I really wish stupid Virginia would have 90%. We have like 50%.

Originally Posted by DanGee777

No offense, but I'm glad almost anyone disagrees with you. If you really want to take
advantage of other states, do so. Move to Texas and work a minimum wage job for a year. Find cheap housing on Craigslist. Bam, in state residency for the next cycle. I've thought about it but not worth it to me to do that.

It's something I've thought about too, but I wou;dn't want to risk moving somewhere then not being able to secure a job. The kinds of jobs I could apply for while not their are quite limited.

From what I can tell, u scurred of OOS applicants outcompeting you for the highly desired area that is NY. NY and Cali state schools in particular I don't see why they would need to amintain a high # of IS students as so many ppl would want to go and stay there anyway that they could achieve their mission of providing doctors for their state regardless.

Frankly, I find the state delineation to be such a meaningless artifact in that state borders no longer really define distinct communities like they did when the original colonies were founded. The only justification then I can see is the whole state government funding matter.

The only real crappy thing is that they aren't equal, so people from states with lower IS requirements get screwed a bit.

Originally Posted by mmmcdowe

I think part of the problem is that, despite high in state preference, there is a major hemorrhage of talent from the parts of states that really need it: rural/underserved areas. Big shiny cities like NYC will always have plenty of docs relative to rural areas. The current solution is inefficient, in the sense that only a fraction of IS students will end up practicing in state, let alone underserved parts of that state. The true solution is to find ways to keep talent flowing to the areas in need of it most.

The biggest problem being that rural areas often have the lowest numbers of educated people, meaning that doctors are relatively socioeconomic ally isolated when in a rural community. This is the main reason I will probably practice in an area that is not undeserved in the least.

Originally Posted by DanGee777

I'm from NY. The SUNYs typically take ~80% of their students from NY. Texas requires a 90% minimum instate. Other states' schools require 95, 98 or even 100% of matriculants to be from instate? Take NY and CA for example. They could easily do what states like Mississippi and Massachusetts and Georgia have done, and require 100% of matriculants to be NY residents, because these are two of the top 5 states in terms of MCAT scores for the average applicant. Matriculant quality wouldn't suffer in a state like NY as a result of this change. In addition, NY state is diverse enough that this might actually help increase URM enrollment at the four SUNYs.

Thoughts? There are myriad public policy arguments in favor of it. In state matriculants are
More likely to stay in state to practice, and their families have contributed taxes to state coffers for years. OOS applicants have not.

Please respond whether you'd be in favor of this or not. I'm interested to hear why you support or oppose the idea. Also, if you are from Cali, please disclose that. I know IS applicants have a tough road there and you love being able to apply to SUNYs.

One more point if you want to address it. NY grants in state tuition after your first year of med school here if you are OOS. This should change. Most states don't do that and Ny shouldn't either! Make the OOSers pay OOS rates for all 4 years! LOL.

Hmmm.... if all state schools had 100% in-state requirements, I think I'd be pretty happy that I don't live in Maine, Delaware, Wyoming, Alaska, Montana or Idaho.... i.e. states without medical schools.

Originally Posted by whatbout2morrow

Hmmm.... if all state schools had 100% in-state requirements, I think I'd be pretty happy that I don't live in Maine, Delaware, Wyoming, Alaska, Montana or Idaho.... i.e. states without medical schools.

Well maybe they'd offer some financial incentives to attract physicians. But yes, It would totally suck for pre-meds.

As a PA resident, no, no I'm not.

Having a lot of state schools require ~90% of their students to be in-state is kind of unfair when I think about the fact that my one and only MD school (which is also a state school) is very OOS friendly. It sort of skews things in a direction that isn't in my favour. Oh well! At least I have a state school (:

The argument about "inferior doctors" in places like MS because their average MCAT is a 27 is ridiculous. There are thousands of qualified applicants every year to medical school who don't get in, and the MCAT score is just a small part of that equation. Furthermore, I believe that anyone who passes the boards is qualified to be a doctor. Scores on standardized tests don't indicate the inferiority or superiority of doctors. How well a doctor can relate to his patient and his patient's culture, traditions, socio-economic status, environment, family, etc. are all things that determine how competent a physician may be in his environment. A doctor practicing at a family clinic in MS probably wouldn't be qualified or even want to do serious research at Mass General; however, you can bet that he understands the nuances of medical issues that farmers encounter.

Furthermore, the assumption is that by not limiting the state to in-state applicants, superior applicants from states like CA and NY could/would attend schools in MS, probably even in greater numbers than MS residents. Does anyone really think that an individual who was born in CA or NY and went to college in NY or CA has any plans to stay in MS after medschool? The culture shock alone would probably make NY and CA students hate the school and state. MS has no reason to let others use its resources for nothing in return, especially when it has plenty of people who WANT to live in the state and have already demonstrated it be it through their family roots or where they did their undergraduate degree.

We have a REALLY broad country and quite an uneven distribution of medical resources. Perhaps a reasonable consideration would be to allow state schools to be more regionalized (assuming we're still operating on the assumption that MS medical students are subpar because of their 27 MCATs). I would be willing to bet good money that someone from LA, AL, or even GA who goes to medical school in MS would be more likely to practice in MS than individuals from NY and CA.

Is it necessarily fair that there's regionalized competition just to get into medical school? I can't answer that question because my opinion on the issue changes too often. One thing's for sure, though: I don't expect an Andover Academy, Yale Undergrad to understand the culture or people of MS if he has no prior experience in the South.

The NE already has an over saturation of physicians compared to the remainder of the country. Not only that, but the region always has an abundance of highly qualified applicants. It's very reasonable to expect a Harvard or Hopkins graduate to practice in VA once they finish; it's much less likely he would practice in Idaho. In such an instance, what incentive does the school have to take more VA applicants only?

Originally Posted by Anonymous01

The argument about "inferior doctors" in places like MS because their average MCAT is a 27 is ridiculous. There are thousands of qualified applicants every year to medical school who don't get in, and the MCAT score is just a small part of that equation. Furthermore, I believe that anyone who passes the boards is qualified to be a doctor. Scores on standardized tests don't indicate the inferiority or superiority of doctors. How well a doctor can relate to his patient and his patient's culture, traditions, socio-economic status, environment, family, etc. are all things that determine how competent a physician may be in his environment. A doctor practicing at a family clinic in MS probably wouldn't be qualified or even want to do serious research at Mass General; however, you can bet that he understands the nuances of medical issues that farmers encounter.

Furthermore, the assumption is that by not limiting the state to in-state applicants, superior applicants from states like CA and NY could/would attend schools in MS, probably even in greater numbers than MS residents. Does anyone really think that an individual who was born in CA or NY and went to college in NY or CA has any plans to stay in MS after medschool? The culture shock alone would probably make NY and CA students hate the school and state. MS has no reason to let others use its resources for nothing in return, especially when it has plenty of people who WANT to live in the state and have already demonstrated it be it through their family roots or where they did their undergraduate degree.

We have a REALLY broad country and quite an uneven distribution of medical resources. Perhaps a reasonable consideration would be to allow state schools to be more regionalized (assuming we're still operating on the assumption that MS medical students are subpar because of their 27 MCATs). I would be willing to bet good money that someone from LA, AL, or even GA who goes to medical school in MS would be more likely to practice in MS than individuals from NY and CA.

Is it necessarily fair that there's regionalized competition just to get into medical school? I can't answer that question because my opinion on the issue changes too often. One thing's for sure, though: I don't expect an Andover Academy, Yale Undergrad to understand the culture or people of MS if he has no prior experience in the South.

Let's clarify something first. I never said those with 27s on the MCAT were inferior. I was responding to someone who said that he is opposed to making SUNYs 100% instate because it would reduce the quality of the class. I obviously don't share that view. I was responding to johnnydrama's posts defending keeping MS 100% instate while being opposed to that for NY. Obv a 27 is not inferior. Plenty of great DO doctors scored 27 or less on their MCATs. I get care from one. My inferior comment was a tongue-in-cheek response to him.

Originally Posted by DanGee777

Let's clarify something first. I never said those with 27s on the MCAT were inferior. I was responding to someone who said that he is opposed to making SUNYs 100% instate because it would reduce the quality of the class. I obviously don't share that view. I was responding to johnnydrama's posts defending keeping MS 100% instate while being opposed to that for NY. Obv a 27 is not inferior. Plenty of great DO doctors scored 27 or less on their MCATs. I get care from one. My inferior comment was a tongue-in-cheek response to him.

Given the assumption of some objective way to rank applicants, if even one out of state applicant is more highly ranked than one instate applicant, the pool of all instate applicants is weaker than the combined pool.

That's all I was saying, and I could probably put it in a formal mathematical proof if you so desire.

Originally Posted by johnnydrama

Given the assumption of some objective way to rank applicants, if even one out of state applicant is more highly ranked than one instate applicant, the pool of all instate applicants is weaker than the combined pool.

That's all I was saying, and I could probably put it in a formal mathematical proof if you so desire.

Would you include GPA as a significant part of it? I'm biased, but if someone has a 3.3 GPA, and a 36 mcat, I think that makes them at least as qualified for med school as someone who has a 3.9 GPA and a 28 mcat. Yet according to AAMC stats, the 3.9/28 has a 68% chance of admittance, while the 3.3/36 has only a 60% chance. If someone goes to a less academically rigorous college and diligently selects some of the easier professors using RateMyProf, should they be rewarded for it? There's a valid argument to be made that they should, and that the other student should have done the same. Still, considering that the MCAT is the only standardized metric that we have to compare applicants, shouldn't we make the MCAT ~70% of the decision and the GPA ~20% of the decision? This is similar to the ratio most law schools use with LSAT/GPA. Or, at the very least, make BCPM GPA a bigger part of the decision than cGPA?

Originally Posted by DanGee777

Would you include GPA as a significant part of it? I'm biased, but if someone has a 3.3 GPA, and a 36 mcat, I think that makes them at least as qualified for med school as someone who has a 3.9 GPA and a 28 mcat. Yet according to AAMC stats, the 3.9/28 has a 68% chance of admittance, while the 3.3/36 has only a 60% chance. If someone goes to a less academically rigorous college and diligently selects some of the easier professors using RateMyProf, should they be rewarded for it? There's a valid argument to be made that they should, and that the other student should have done the same. Still, considering that the MCAT is the only standardized metric that we have to compare applicants, shouldn't we make the MCAT ~70% of the decision and the GPA ~20% of the decision? This is similar to the ratio most law schools use with LSAT/GPA.

Assume there's some formula f(x,y,z) = S where x is MCAT, y is GPA, and z is school caliber.

I'm just going by S, I'm making no assumptions about which particular f() you should use.

Originally Posted by johnnydrama

Assume there's some formula f(x,y,z) = S where x is MCAT, y is GPA, and z is school caliber.

I'm just going by S, I'm making no assumptions about which particular f() you should use.

Fair enough. You have to include a URM component. I happen to believe that the URMs from the great state of NY are more deserving of SUNY spots than certain ORMs (who shall not be named) from states that begin with the letter... C, and end with the letter... A.