How much more competitive can applicants get?

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Everything has diminishing returns. GPA comes strongly to mind here. And when the MCAT gets out of hand they'll reset it like they did in 2015. Competitiveness may get so strong the gap year may become standard rather than the ~50/50 distribution it is now.

David D MD - USMLE and MCAT Tutor
Med School Tutors

How did things get out of hand on the pre-2015 MCAT?

My understanding is that there were fewer ultra high scores on the pre-2015 MCAT (39+) than on the current (520+).
 
Doctors have been saying this since the first HMO excluded the first doctor from its network over reimbursement rates and requiring pre-approval for treatment. And yet it is going to be more competitive to get into medical school this year than ever before. At some point you might be right, but doctors have been complaining about losing autonomy and earning power since the 1970s, and, other than a dip during the height of the dot-com boom, the best and the brightest have not looked elsewhere in all that time.
Wait until everything looks like pathology and radiation oncology. Those were the easiest fields to consolidate due to being hospital-based with expensive overhead. Those are heralds, not exceptions. It’ll take time, but we’re starting to see people in all specialties taking less desirable gigs, and employed positions. The private practice jobs of the old days are unicorns and are fraught with risk from greedy partners and reimbursement instability.
 
Another idea is that the differences between “research” and “primary care” (and another category or two maybe) focused medical schools will continue to polarize away from each other. Less competitive schools will always be around, and probably focus on clinical/primary care (less competitive specialties in general).
 
I've always wondered how insane the 'requirements' will be in say 2040. Will there be a point when the competition plateaus? With rising MCAT median every year and more and more gap years being taken with more hours/experiences, what do you think the 'average' applicant will look like 20 years down the line?

You want to know what every school will be like in 2040? Just take a look at Wash U's entering class of 2020...
 
What I wonder about with an ever increasing EC arms race, at what point will it be inevitable that there are just way too many humans who literally cant see themselves doing anything other than medicine vs. open seats. What will the fallout from this be? What will schools/the system do when systemic depression and anxiety plague even the most stable pre meds and inevitably increase suicide rates.
 
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