Exploring Which Medical Schools Cost the Most: An Assessment of Medical School Characteristics Associated with School Tuition

Abstract Purpose To assess medical school characteristics associated with school tuition. Methods and Materials U.S. medical schools’ tuitions, and various medical school characteristics, were extracted from the Association of American Medical Colleges’ online MSAR database, using in-state tuition when applicable. U.S. News ranking and National Institutes of Health award ranking from the Blue Ridge Institute for Medical Research were obtained, when available. Geographic population density was obtained using Governing magazine's online database. Cost of living estimates were obtained from online ACCRA Cost of Living Index. Spearman correlations were determined, and multivariable linear regression was performed. Results Among 148 included medical schools, adjusted average ± SD tuition was $47,612 ± $23,765 (range $12,761-$141,464). Tuition demonstrated positive correlations with regional population density (r=+0.577) and years established (r=+0.265). Among ranked schools, tuition showed negative correlations with U.S. News rank (r=-0.469) and NIH rank (r=-0.336). Average tuition varied by geographic region: Northeast: $49,662, Midwest: $43,560, West: $37,701, South: $34,270. Among states with at least three medical schools, average tuition was highest in MA ($53,520), PA ($53,034), $51,547 (DC), and lowest in TX ($21,002), FL ($30,440), LA ($36,066). At multivariable linear regression, the strongest independent predictor of tuition was U.S. News rank (β=-396.0, p=0.05). Conclusion U.S. medical school tuition is highly variable by over a 10:1 ratio. Tuition is greater in higher ranked, longer established schools, in more densely populated regions. Objective data regarding medical education quality may be warranted to assess whether higher tuition in schools with higher U.S. News and NIH rankings is justified.