Variability in tuition and curriculum among allopathic and osteopathic medical schools in the United States

I-Chun Lin; Brendon Sen-Crowe; Anthony Pasarin; Mark McKenney; Adel Elkbuli

doi:10.1016/j.amsu.2021.102737

Variability in tuition and curriculum among allopathic and osteopathic medical schools in the United States

Ann Med Surg (Lond). 2021 Aug 18:69:102737. doi: 10.1016/j.amsu.2021.102737. eCollection 2021 Sep.

Authors

I-Chun Lin¹, Brendon Sen-Crowe¹, Anthony Pasarin¹, Mark McKenney^{1

2}, Adel Elkbuli¹

Affiliations

¹ Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA.
² University of South Florida, Tampa, FL, USA.

Abstract

Background: Medical school tuition has increased dramatically. We aimed to characterize allopathic and osteopathic medical school tuition and its association with geographic region, pre-clerkship and clerkship curriculums, and compare tuition between allopathic and osteopathic schools.

Methods: US allopathic and osteopathic in-state tuition were extracted from the AAMC and AACOM databases and adjusted for cost-of-living. Schools were divided by geographic regions (West, Midwest, South, Northeast). Pre-clerkship and clerkship curricula characteristics were collected from school websites. Pre-clerkship curricula were categorized into one of six categories: 1) discipline-based, 2) organ system-based, 3) combined discipline/organ system based, 4) team-based learning, 5) mixed, and 6) other. Clerkship curricula characteristics collected included; required research block, out-of-state elective option, and global health (international) elective option. This study was reported according to STROCSS guidelines.

Results: For allopathic schools, unadjusted and adjusted tuition was significantly higher in the Northeast. After adjusting for cost of living, the West displayed significantly larger in-state tuition than the South. No association was seen between tuition and pre-clerkship curriculum. Of the clerkship characteristics, presence of a required research block or global health electives corresponded to higher tuitions. For osteopathic schools, tuition in the West was significantly higher than the South and Midwest. Schools that offered a discipline-based pre-clerkship curriculum had higher tuitions than other curricula. Clerkship characteristics were not associated with tuition variation.

Conclusions: US medical school tuition is highly variable, demonstrating associations with geographic regions and curriculum characteristics. There is increasing value in team-based learning modalities in improving professional communication skills.

Keywords: Allopathic and osteopathic medical schools; Medical education; Medical school pre-clerkship and clerkship curriculum; Medical school tuition; Regional variation.