To your first point about virtual interviews:
I think the financial aspects of interviewing are overstated and the cost of virtual interviews have actually harmed more low-income / non-traditional applicants. While traveling for med school interviews can be costly financially, the major constraint is time. Traveling across the country during a semester can eat valuable days needed for studying or other work. This provides downward pressure on the number and location of schools people are willing to apply to and interviews people are willing to accept. This cycle, from what I've heard, the total number of applicants in the pool did not change dramatically, but each applicant applied to many more schools. Acceptances and interviews tend to follow a Pareto distribution (the top cohort of applicants hold a significant chunk of them) the cost to those applicants helps even everything out. Because of virtual interviewing, there was no time or financial cost to accepting every interview you were given, regardless of distance from the school or other acceptances. This specifically works against low-income students who are probably more likely to be constrained to their state school for the tuition benefits. That is to say, if I am low income it might be cost prohibitive of me to go anywhere else besides an in-state medical school. If the 10% of applicants nationally all start throwing applications into the pot of interviews in my state, and then accepting those interviews because they come at no-cost (to them), then I might get shut-out from the few schools I can financially manage to go to. This is compounded by the significant challenges AMCAS had (seemingly) in getting applications out the door. My application was not finalized by AMCAS until September which means I was competing for the few remaining interview seats, in fact none of my interviews happened before January. At this point, surely, I was interviewing with students who already had been tendered acceptances to other schools, as some schools begin interviewing as early as August/September. Thus, because of the "cheap" interviews, students who probably already held acceptances to numerous other programs accepted interviews to schools that they otherwise would not entertain because "why not?" I know anecdotally that this has happened this cycle.
As for non-traditional students, I'm pretty non-traditional starting med school at 30 and having been a military veteran and previously homeless (when I got out) among other things. If interested in more details, I can pm you a profile my school did on me but for anonymity purposes I can't post it here.
I think mileage varies among schools, but there are two sides to the coin. First, med schools have fairly well established expectations and generally do not seem to budge on these things. As a non-trad student this boils down to a lot of structural hoops you have to jump through. On the flip side, if you do jump through these hoops, med schools seem to express great interest in non-trad students with diverse life experiences. The bottleneck is more-or-less getting your foot in the door. Initial applications can cost thousands of dollars, and you need to invest significant time and money in order to even have a solid application (I spent hundreds of dollars on MCAT prep, for instance). Furthermore, as someone who started college at 25, who transferred schools, and who took multiple semesters off in order to work full time (so I could focus on school when I attended) securing all the things necessary for a good application was difficult. It can be challenging to get good recommendations from professors, research experience, volunteer hours, ect. For instance, I had to specifically address a glaring lack of research in my application (and weak volunteer hours) given that I had to postpone my college career twice in order to work. Under those circumstances, no lab at school would take me. Furthermore, it seems that some schools and adcoms have varying opinions and interpretations of the non-trad experience and how much "traditional" application experiences they want carried over. I was surprised that my application gained traction among many solid schools while I was wholly ignored by very service-oriented schools that I thought my background was better suited for. For instance, one local school that I was flat-out rejected too demands a couple hundred hours of volunteer experience that is non-clinically related, like volunteering at a soup kitchen. Having actually been homeless, and with 10 years worth of rather arduous public service professionally, I felt that my application was more value-aligned to this school, but that I may have been screened out due to a lack of dedicated non-clinical volunteering.
Another big hang-up for me was getting clinical experience with actual physicians, which I actually was unable to secure. Most of my advisors (and people on this website) will tell you that physician shadowing is a must, or at least highly beneficial. However, when I asked classmates of mine how they were getting their shadowing hours, I would get answers like "my dad is chief X department at Y hospital so I shadow in the summer." I never grew up around any physicians and don't have any in my immediate family (or even close to immediate family, a few distant cousins I've never met), gaining shadow opportunities was a challenge I was never able to really overcome.
Furthermore, I'll say that being a non-trad med applicant can be very, very intimidating. Many med applicants have to reapply, some multiple times. Sometimes, non-trad students are already coming from fairly lucrative and well established careers (one guy I interviewed with had a PhD in computer science, and there are more than a few nurse-to-doctor non-trads) but I was essentially a manual laborer in a far from lucrative public service job. Despite the distinct lack of upward mobility my previous profession afforded me, it did pay the bills and many of the people I worked with continued in the job and gained further qualifications and higher status within the field. For me, pursuing med school was a very high-risk, high-reward thing. I was not otherwise interested in pursing anything else in the Biology field. Had I not achieved an acceptance, I would be returning to my previous low-wage, dangerous, manual labor job, probably permanently. Traditional med applicants have a little more flexibility in this. While it is unpleasant, they are applying at a younger age than I was when I got out of the military. They can accept a few gap years to work on their application. Approaching my thirties, there are only so times I get to reinvent myself and there is only so much time I can dedicate to dead-ends before I have to think really critically about my long-term career. I suspect that this is the case for many non-trad students, especially those of the working class. Probably more than any other barrier for non-trads, I think a general uncertainty of how their life experiences will be received, and how very challenging and often times non-productive commitment a premed education can be, represents the biggest bottle-neck.
One commenter here noted the issues with AMCAS and the process for means-testing financial support from them which I wholly agree with. At this point I have been financially independent for over 10 years and my folks are retired. Regardless of how one feels about the financial obligations parents owe their children, I can't think of one working class adult who would go to their parents for money order to cover education-related expenses. I certainly didn't, hence why I interrupted my education multiple times to raise the cash on my own. There is certainly a lot more the medical community can and should do to recruit non-traditional students into the field, which I think would be invaluable to the profession.
Lastly, another commenter spoke about the apparent ease in assuming debt and how these things are "expected" if you "really want to be a doctor." This is a distinctly non-trad non-working class attitude. Having graduated High School during the great recession, I avoid debt like the plague. I've seen how much student debt has hampered the financial growth of my college-educated peers. As well, being older, I have less time to work off this debt and pursuing medicine postpones my entrance into the workforce by many more years. A medical school education cost as much as a house and if you pursue longer residency (psych, surgery, ect) then it would be 9-10 additional years before you could seriously start paying down that debt. That would place us non-trads in the 40-50 y/o range when we get to
start paying off that debt, and at that point a significant amount of money would be going to
taxes.
Often the earlier one has children the more that is sacraficed related to career. However, children are optional and hose that choose to notmhave them shouldn't also have to sacrafice, or be impacted by those that do.
According to all the evolutionary theory I know.... children aren't optional, from a population perspective. One has to wonder what the value is in taking the best-and-brightest of your population and keeping them from reproducing.
