Everything has a history. As physicians, when you see a patient for the first time you will ask for a medical history. As a general rule, knowing the historical development of anything and everything provides better understanding of why they are, how they evolved and how they work. Case in point: secondary applications.
In the good old days, when medical school was accessible mostly to the well-to-do and white Anglo-Saxon Protestants, the education was affordable and places available to the relatively few who met those requirements. A sea change took place shortly after World War II. Returning veterans had access to a number of the benefits a grateful Congress authorized, commonly known as the "GI Bill." College enrollments increased and a large pool of medical school aspirants appeared. About that time, the number of medical schools was too small to accomodate the wave. New medical schools developed, with larger class sizes, many of them funded by the individual states.
At the same time, rumblings of dissatisfaction grew over the irrelevant restrictions on who could become a physician. The first barrier to fall, about 1955, was anti-semitism. As all the religious barriers began to fall away, so did others. About 1965-1970, all the barriers based only on race and religion began to erode.
As the number of medical schools increased--now standing at 106--so did the number of individual applications and fees.
The American Association of Medical Schools (AAMC) looked into the problem; out of that came AMCAS. The original idea was to have a single application and a single fee. The application would consist of the basic information all the medical schools might be able to agree on. But 106 different independent entities could not agree; the solution was to use the AMCAS application as the basis and each medical school was left free to devlop secondaries if they desired. Of course, the more paperwork, the higher the financial cost of dealing with it.
Admission offices usually have to cover their own expenses. There are personnel costs, computer costs, telephone and other bills to pay. Admission Committees depend on voluntary faculty time for interviewing and decision making.
Some medical schools send secondaries to everyone who files an AMCAS application. That, of course increases applicants' cost. One rationale I have heard, and I can understand it: if students are not selective in where they apply, including to medical schools where they never had a chance of being admitted, that's too bad. The cost to the medical schools for just processing their applications remain.
Agree or not, this is the basic history and rationale.
If you still think how AMCAS handles this is not to your liking, consider what the alternative will become: individual, different applications to each medical school, and still with fees that may or may not exceed what the AMCAS system costs.
Beoming a physician entails large outlays of money throughout the trail to medical doctorhood. Most of you are looking to a future where the outlay will eventually pay big dividends. This is a deferred payout: you invest heavily now, even going into debt, in anticipation of recouping more than you invested. I am not writing of monetary reward alone; how many justify your ambition of saving lives as being reward enough? As you expect to be paid for your services, all the steps--from kindergarten to license--involve thousands of entities and people who do not earn their keep through altruism, even the cleaner who sweeps the Admission Office floor. In a way, even that lowly office, by being involved in your medical education, indirectly contributes to saving lives! It ill becomes those who whine about their costs on their way to a "rewarding" career to carp about the relatively tiny expense of applying to medical school. You still have an alternative; forget medical school and get a job.
I have no connection with medical education, nor am I a physician, nor have I ever been wealthy.
