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All of the schools you mentioned are ranked top 20 (with the exception of Tufts) and sport 8-12% admission rates. I'm not sure if this is just due to some doctor's backgrounds (i.e. coming from money and always being top 1% academically), but it's a huge accomplishment to be accepted into a top 20 American university. Even with immense privilege, most kids are not getting accepted into top 20 universities. I cannot even begin to imagine how many parents would pay $100k to ensure their kid was accepted into a top 20 university. If you wanted to get your child accepted based on raw donation it would cost a factor of magnitude+ from what these consultants are charging.The meta hasn't changed, it's parental anxiety that has changed significantly. These consultants do very little that can't be figured out by just talking to other parents (or these days, using Chat GPT). Consultants are alleviating parental anxiety, nothing more. And their results are mediocre. I have an uncle who's very wealthy (like lower end of mid 8 figures net worth). Was at a gathering he hosted where there were many parents of his similar socioeconomic background who were talking about college consultants they'd dropped 100k+ on and were raving about how helpful they were in getting their kids into great colleges. And the colleges were....Northwestern, Wash U, Tufts, Carnegie Melon, etc. All good school, sure, but if I was paying 100k+ for a consultant, my kids better be getting into Harvard/Stanford/MIT. They can't guarantee that because no matter how you slice it, there's a finite amount of things that can be done to maximize your chances of getting into a top school and those things are relatively straightforward.