Made of Dough?

'Tis the season when seniors trudge between Harvard Square and Logan Airport carrying overnight bags and leather binders, decked out in business suits.

But not all of them are traveling to investment banking and consulting firms, which cover the costs students incur traveling to interviews.

Students interviewing with medical schools have to cover all the costs themselves. Two rounds of applications, flights to far off schools and other travel costs can add up--to more than $4,500. And students generally interview with more than five schools, taking them away from classes and activities for days at a time.

All this to earn the right to pay more than $30,000 in annual tuition, room, board and fees.

But there has been little drive for a more affordable (or "humane," according to one House tutor) admissions process. By the time applicants realize the full costs of the process, they are in the middle of it and just focused on getting admitted.

Prelim Pennies

From the start, the medical school admissions process is grueling and costly. Students usually take the Medical College Admissions Test (MCAT) in the spring of their junior year.

The test itself costs $165. And many premeds take a Kaplan or Princeton Review course--running at about $1,000--to prepare for the grueling eight-hour exam.

During the summer before their senior year, students send schools a preliminary application.

Shearwood "Woody" McClelland '00 initially applied to 21 medical schools.

American Medical College Application Service charges a $435 fee to send a student's applications to the first 12 schools, and $30 per school thereafter.

So McClelland spent $675 just to send his preliminary applications.

"If you want to play you've got to pay," McClelland says. "It's a part of the process."

Twenty-one schools may seem like a lot, but it is an average number for medical school applicants. Unlike undergraduate programs, which could admit hundreds, or thousands, of students into an entering class, medical schools often have only 100 spaces.

There is a more narrow range in quality among medical schools than undergraduate colleges.

Since the 50 top medical schools all have acceptance rates under 10 percent, students normally apply to more than 15 schools.

This makes the total number of applications high, forcing schools to weed out unacceptable applicants with a preliminary round.

"No medical school wants to produce doctors that kill," McClelland says. "The minimal standards are very high."

If students are selected to submit a secondary application, they are faced with another fee, which could range from $40 to $95. This additional cost infuriates many applicants, who say the secondary form rarely asks for more information than the preliminary application did.

"Why am I filling out this secondary?" McClelland says. "They just want more money from me."

But he was lucky enough to reach all 21 schools' second round, meaning he had to shell out $1,250 more.

By the time he had started his senior year, McClelland had shelled out over $2,500 to apply to medical school.

A Just Reward?

The next step--the required interview--is probably the most expensive and critical part of the application process.

Because the interview helps schools to differentiate between many outstanding applicants, it is crucial to the process. Since the interview is so important, most schools require students to travel to their campus.

Connie M. Ng '00 shelled out the same amount in the initial application process as McClelland but says the enormity of the expense did not occur to her until she began to make flight reservations to visit schools from Baltimore to St. Louis to Chicago.

Unlike application fees which students could avoid if eligible for fee waivers, no one can opt out of the costs of traveling to interviews.

Ng says she has become a pro at finding cheap airfares and enduring long bus rides.

She tries to buy her tickets at least 14 days in advance, but some schools did not give her that much time after notifying her that she got an interview.

Sometimes she had stay for two nights or stay into Saturday. And, of course she took buses whenever she could.

Ng says the strategies she uses to make travel plans can bring other costs. Being out of town several days every week means she misses classes and gets behind on school work.

"You feel really tired," she says, adding that traveling, especially by bus, takes a lot of energy and she has to keep her energy level up for the next interview.

McClelland, like Ng, developed similar money-saving methods. His father drives him to most schools on the east coast and he is waiting to visit schools lower on his list. If he gets into a preferred school, then he will cancel the remaining interviews.

Holding the Strings

Schools say they would like to make the process easier on students, but the various steps are all essential for their decision.

Like most schools, Harvard Medical School (HMS) does not offer regional interviews to its candidates.

Three years ago, HMS ended the practice of holding interviews in three cities in addition to Boston because it cost too much for them to send the administrative team. Plus, they argued, under the old system, the applicant does not get a chance to see the campus.

"Many medical schools consider the interview visit an opportunity to encourage the likelihood that, if admitted, the competitive applicant will accept the offer," Theresa J. Orr, associate dean for admissions at HMS, wrote in an e-mail message.

Like HMS, New York University (NYU) Medical School experimented with regional interviews 10 years ago, but they were conducted by alums.

Raymond J. Brienza, assistant dean of admissions at NYU, says faculty members make better interviewers than alums.

"They're knowledgeable on the school while alumni are not up-to-date on the school curriculum," Brienza says.

Still, even though Harvard and NYU do not offer regional interviews, they are trying to make the application process more convenient.

NYU offers Saturday interviews, which helps students find cheaper airfare.

HMS has made special arrangements with the Harvard Travel Center. Students can find reduced airfare though the agency when they are offered an interview.

"The hoped-for outcome and its importance to the person's life goals has to be considered when weighing the decision about how much of one's resources to expend on the effort," Orr wrote.

She adds, though, that students should use premed student organizations, or the National Association of Advisors to the Health Professions, if they want to change the current system.

"That is where the critical mass is and where any negotiations with airlines or alumni networks is likely to occur," Orr wrote.