The number of first-year students at U.S. medical schools that grant MD degrees rose 36.8% from the 2005-06 academic year to 2025-26, but fewer are staying in their home state.
Over the same period, the share of those students who come from the school’s home state declined, according to a study published Sept. 29 in JAMA.
The study’s authors, Barbara Barzansky, PhD, and Felicia Walker, work for the American Medical Association, which funded the research. They used data from the Liaison Committee on Medical Education’s 2025-26 Annual Medical School Questionnaire. Of the 160 medical schools the committee accredits, 158 responded.
Here are six things to know:
1. First-year enrollment grew from 17,039 students in 2005-06 to 23,303 in 2025-26. The number of accredited schools rose from 125 to 158.
2. About 41% of that growth (2,564 students) came from the 30 schools that opened after 2005-06. The other 59% (3,700 students) came from larger classes at existing schools. Larger schools are also more common: 36.7% of schools now enroll 700 or more students in total, compared with 22.4% in 2005-06.
3. The share of new students who are in-state residents decreased from 64.2% to 60.8%. The number of in-state students still rose 29.6%, from 10,942 to 14,177. The in-state share fell most sharply in these states:
- Arizona: 99.1% to 53.4%
- Oklahoma: 90.8% to 54.5%
- Nevada: 90.4% to 62.9%
- Colorado: 75.7% to 50%
- West Virginia: 71.5% to 50.8%
4. Texas added the most first-year students (683), followed by California (551), Florida (462) and Michigan (438). By percentage, Nevada grew the most (288.5%), followed by Arizona (126.4%), Washington (100%) and Rhode Island (97.3%). The District of Columbia was the only place with fewer first-year students, down 4.3%.
5. Pass-fail grading has become the norm in the early, preclinical years of medical school. In 2025-26, 81% of schools used pass-fail only for those courses, up from 47.2% in 2015-16. For required clinical rotations, the share of schools using pass-fail increased from 4.9% to 14%.
6. Many medical schools have new leaders. As of April 2026, 19 of 158 schools (12%) had an interim dean. Among schools with a permanent dean, 61.2% appointed that dean in 2022 or later. Twenty-eight deans serve as chief administrative officer of the medical school’s associated health system, and 10 serve as president or CEO of the school’s affiliated health system.
