The number of applicants to U.S. medical schools fell again in 1998, to 41,004, according to new data from the Association of American Medical Colleges.
That was a 4.7% drop from 43,020 in 1997, which was an 8.4% drop from the previous year. The 1996 total of 46,968 applicants was the all-time high.
About 17,300 applicants were accepted in 1996, 1997 and 1998, and about 16,200 applicants entered medical school each year.
This trend of declining applicants appears likely to continue, said Barbara Barzansky, director of the division of undergraduate medical education at the American Medical Association.
As of early May 1999, medical schools had logged about 2,000 fewer applicants than in early May 1998.
The AAMC collects the numbers from 125 U.S. medical schools. Final numbers for the 1999 entering class will be available later this year.
This isn't the first recorded drop in medical school applications. They declined almost every year from 1974, when 42,624 people applied, to 1988, when 26,721 did. In 1989, things picked up a bit and continued to rise through 1996.
While the numbers of both male and female applicants have declined in the past two years, the enrollment of women into medical school has continued to increase in absolute and percentage terms (See story, below).
Women made up 43.4% of applicants and 44.3% of the entering class in 1998, the highest portion ever.
"I don't think we have enough data on why these changes are occurring," said Yank Coble, M.D., an endocrinologist in Jacksonville, Fla., who's an AMA trustee.
Still, Coble said, "it's reassuring that of the applicants who enter medical school, their qualifications are superb. They have committed a great deal of investment of education and time, when they could be taking more leisurely courses and playing."
Or going to business school.
"Kids may be saying, 'Why do I want to do 12 years to be a hamster on a treadmill when I can go to law school or business school and be driving a Porsche within 10 years?' " said Ian Morrison, a healthcare futurist in Menlo Park, Calif.
Indeed, some observers draw a link between the decline in applicants and the leveling off of physicians' incomes.
According to the latest available AMA figures, physicians' net income barely budged in 1997. The median declined 1.2% to $164,000, while the mean rose slightly to $199,600 from $199,000 in 1996.
The downward pressures on physician incomes, including managed care, Medicare cuts and the sale of physician practices, have produced stark headlines that may be influencing the career choices of young people.
"Our society is changing so rapidly in terms of opportunities," Coble said. "Information technology and other fields may be becoming more attractive. We don't have data on that."
Morrison pointed out that medicine is declining in relative terms as a high-paying profession.
"There are a lot of places where the absolute income and possibility of increased income (are) vastly higher. Any kid who starts at Arthur Andersen (business consulting firm) is at six figures after a few years."