UMKC 6-year BA/MD Program

[marcopolos]

My observation was most MD schools are in large metro areas while many DO schools (not all) are in more rural areas which makes sense based on your explanation as MD schools have residencies and research which needs larger academic hospitals while DO schools seem to be focused on the pre-clinical/clinical education (mostly seem to be pre-clinical as they usually may not have affiliated teaching hospitals with all required specialties located near schools).

For the reasons that you cited, since KC metro has >10x population of Columbia, I would have expected more departments/larger student population at UMKC than Mizzou. Even now, I think Mizzou students have to go to springfield for clinical rotations for probably same reasons - like access to diverse patient experience/larger hospital to accommodate all students. So I find it a bit surprising that UMKC doesn’t have as many clinical departments/funding as Mizzou - may be because KU med school is nearby (from meeting the needs of local population perspective). If you contrast that with Indiana the combined size of the med school and number of campuses (didn’t realize there were 9) may help to secure a lot of funding from NIH etc. (which may be reflected in their ranking)

On the flip side, a teaching hospital in a rural area may bring medical expertise/more money/jobs to the rural community (as teaching hospital may get usually gets higher reimbursement). This is where IN model is attractive as it spreads the increased revenue across all geographic areas in the state and not limited to larger cities.

Usually IN, IL BS/MD programs were limited to in-state students. If this new program is open to all, that will be interesting as IU is higher ranked school though MCAT requirement of 512 for the program seems to be same as their average MCAT.

[WayOutWestMom]

@marcopolos

I am not sure if there are any MD schools with tuition and fees below $65k for OOS students.

Actually, there are quite a few: New Mexico, Louisiana-Shreveport, Marshall (WVA), South Carolina, Meharry, Ohio State, Penn State, Texas A&M, Texas Tech-E Paso, Texas Tech-Lubbock, Univeridad del Carribe (Puerto Rico), Univeridad del Puerto Rico, Arizona-Phoenix, Arizona-Tucson, UC-Davis. UCLA, UC-Riverside, UCSF, UCSD, UC-Irvine, Central Florida, U Cincinnati, Florida, Houston, Iowa, Minnesota, Nebraska, Tennessee, UT-San Antonio, UT-Medical Branch, UT-Rio Grande, UT Southwestern, UT-Austin, Wisconsin, Virginia Tech.

Also, with the recent laws to let IMGs to practice without residency in US (passed in TN and FL in a very bi-partisan vote), it will be interesting to see how long these competitive specialties can remain “competitive”.

Be careful in stating this. There are substantial restrictions in the new IMG rules.

In order to be eligible, IMGs must have completed an “equivalent” residency outside the US (IOW, in a first world country) and have practiced as fully licensed attending for 3 of the last 5 years. Additionally, IMG are required to work for 2 years “under supervision” at US hospital that hosts a residency in their specialty. (So essentially they are required to complete 2 years of a residency-equivalent program.)

Lastly, the expedited IMG program does NOT lead to specialty board certification in the US. While the IMG physician will eligible for state-specific (non-transferrable) medical license, there are structural issues that will prevent them from opening shop in the US. Without board certification/eligbility, doctors cannot qualify for medical malpractice insurance and insurance companies won’t reimburse them for services.

(The issues aren’t problem if the IMGs go to work for the Federal Bureau of Prisons, the BIA or a large corporate healthcare system that self-insures and bills insurers in the name of the healthcare system not the individual physician. Or if they want to to “go bare” and open a cash-only practice.)

[marcopolos]

1. You are listing state colleges in TX with a heavy instate bias while I was talking generally about private schools with little instate bias for OOS students for comparison purpose with UMKC(may be I should have been clearer). Also CA schools like UCLA cost almost $63k with their $10k summer tuition. Once you factor in higher COLA (may be 25% higher) in CA, total COA it will be much higher at those CA schools compared to most other med schools.

2. Regarding the new laws that help to skip residency - not sure if it is just a coincidence that the laws were first passed in TN and FL where one of the largest healthcare systems (that also fund a number of residencies) has a significant presence. Those type of healthcare systems with significant clout could hire IMGs in those states. The bills were passed in a very bi-partisan manner. You can see that similar laws are already in progress in VA, AZ, WI, ID legislatures.

https://www.cato.org/blog/more-states-move-let-experienced-foreign-doctors-serve-their-patients

Regarding “first world” residency requirement - I don’t think there is such a thing any longer, it is a “flat world” as Tom Friedman would put it. Ultimately, quality will be measured using objective criteria, not first vs third world.(By many of the key metrics for healthcare - life expectancy at birth, infant mortality etc. - China is fairly close to US at this point or may have even surpassed in a few). It won’t be too hard for most countries that supply IMGs to US today (India, Pakistan, Jordan etc.) to establish equivalencies as they all may have residency programs that are 3-6 years long - especially if large health systems support that. For primary care, some of those countries may have an extra year of residency.

Considering the current fiscal debt/high interest rates and the need to moderate healthcare spending (since significant portion of federal spending is in healthcare), I wouldn’t be too surprised if law makers want to open up the supply side citing looming physician shortage. Then on the demand side, throw in the changing reimbursement methods that emphasize value over procedure. With the help of technology/data/AI, it may become easier to quantify value vs procedures performed.

Also there is potential evolution of consumer driven healthcare that encourages consumers to shop around - especially potential extensions of Trump-era transparency laws regarding prices, implemented for hospitals. Let us say, once a patient is recommended to have a non-emergency procedure/surgery, what if the patient could shop around for the cost in a very convenient app where they could review multiple bids that will help to minimize their out of pocket costs since most patients have high deductible plans?

Buying a car involved countless hours of haggling and paperwork at dealerships not too long ago(was probably a worse experience than a surgery or dental work), today it is a few taps/swipes on your mobile phone. So you will never know how things change in the next 30-40 years - the duration for a current high school senior to go through their med school training and practice medicine. It will be an interesting ride.

[Roentgen]

So UMKC is the most recent allopathic medical school in the state of Missouri having started in 1971. All the others: Mizzou (1872), SLU (1836, private), and Wash U (1891, private) have been there for much longer. It has nothing to do with the population size of the city in this case. When the proposal for UMKC’s medical school was first given, it was based on a very different educational model at the time than what was traditionally undertaken.

So the reason that Mizzou’s medical school has more in terms of clinical departments, ongoing research/scholarly activity, and resources is because it has been around a LOT longer. A lot of Missouri state legislators have done their education at Mizzou undergrad as well. Not surprisingly, Mizzou’s overall budget is a lot huger than that of UMKC’s: https://www.umsystem.edu/sites/default/files/media/fa/budget/fy2024-operating-budget-book.pdf, and receives more funding as it has been there a lot longer. The Springfield campus that you mention for Mizzou’s med school is only rotated at by 25% of their medical students and that only opened up in 2016 (https://medicine.missouri.edu/about/clinical-campus-locations). All the rest rotate at their main University Hospital campus. Essentially those interested in rural medicine or those who are from rural areas of the state would be more likely to want to rotate in their 3rd and 4th years of medical school at these sites.

[Roentgen]

To those who will be starting up in the Fall (or taking classes in the summer at UMKC if you’re in the KC area), here are the UMKC bookstore websites. There is one at the undergraduate campus and one at the Health Sciences campus. The courses with the MED or BMS course designation will be found in the bookstore at the Health Sciences campus.

Most us just purchased textbooks through Amazon or used Bigwords.com to compare prices across different online bookstore websites, but you can use the links below to see what the required textbooks are.

UMKC Bookstore: https://www.umkcbookstore.com/

UMKC Health Sciences Bookstore: https://www.umkc-hsbookstore.com/

[Roentgen]

For those who may want to watch, the UMKC School of Medicine graduation ceremony is tomorrow which you can watch on livestream: https://med.umkc.edu/commencement/

You can watch previous years’ graduation ceremonies here:

2023: https://med.umkc.edu/commencement2023/
2022: https://med.umkc.edu/commencement2022/
2021: https://med.umkc.edu/commencement2021/
2020: https://med.umkc.edu/commencement2020/

[Roentgen]

Congratulations to the UMKC School of Medicine Class of 2024 that graduated today!

If you missed the Hooding Ceremony, you can watch it from earlier today on Youtube.
https://www.youtube.com/watch?v=5bpIVgi5Li8

[Rhode-Shore]

@Roentgen or any other senior member – would appreciate your input on this question:

It’s rare for regional/OOS students to gain an in-state resident rate at UMKC. However, if UMKC has to approve residency changes according to the Missouri state decision, why is the residency change so much easier at Mizzou?

Also, some public medical schools give IS residency to OOS students after one year of attendance. Why doesn’t UMKC do this?

Is UMKC more money-hungry than other medical schools?

[Roentgen]

So I’ll be honest, I’m not sure how common or how rare it is for a regional or OOS student to gain in-state tuition at UMKC. I wish I knew! For the longest time, UMKC School of Medicine used to actually require that matriculating students who were not Missouri residents to sign a waiver agreeing to pay their non-resident tuition rate for all 6 years (or longer if individual circumstances required) and to not apply for any non-resident scholarship. I believe that restrictive waiver was finally done away with once parents of BA/MD students in recent years were ready to sue the university as BA/MD students were being treated differently than all other UMKC students in the university. So at least now there is a possibility/pathway to do so.

You can read how the Missouri state law is written here (I’m not an attorney so I’m not good at the legalese, but it should match up with what university websites are saying):
https://www.sos.mo.gov/cmsimages/adrules/csr/current/6csr/6c10-3.pdf

Most states require living in the state for a specific period (usually 12 months) before qualifying for in-state tuition. What varies among different states is the number and type of documents that are required in order to prove residency (in-state driver’s license, voter registration, utility bills, etc.).

You can see here: https://www.instateangels.com/state-tuition-rules-search/, but actually Missouri is not considered one of the more difficult states to gain in-state tuition in, although it does seem to state what you are saying that it’s easier at some schools in Missouri to gain that in-state tuition status than others. I’m not sure why that is or if that applies to UMKC being harder than Mizzou, which shouldn’t matter as both are required to follow the same state law. I actually liked the Mizzou website as it seems to be a lot more user-friendly in terms of being able to explain in a user-friendly way on what exactly the residency requirements are and how to get there.

I would say overall that UMKC is VERY dependent on school tuition and by extension very dependent on its health care professional schools for its overall budget, since most undergraduate in-staters who go to Missouri’s public flagships tend to go to Mizzou over UMKC.

[marcopolos]

Is it just UMKC? How different is the following policy from UCLA?

https://registrar.ucla.edu/fees-residence/residence-requirements/classification-as-a-resident

A student who is in California solely for educational purposes is not eligible for California residence for tuition purposes, regardless of the length of stay. If a student returns to their former place of residence (outside California), they are presumed to be in California solely for educational purposes and only strong evidence to the contrary can refute this presumption. A student seeking to establish California residence who accepts employment or conducts research outside of California will be questioned regarding attempts to find employment and/or conduct research within California.

Here is UIUC policy. Unlike UMKC, there are no discounts for even neighboring states
Qualifying for In-State Tuition FAQ, Undergraduate Admissions, University of Illinois Urbana-Champaign.

If you are a dependent: Your family must live in or move to Illinois for at least 12 consecutive months immediately preceding the first day of classes. The in-state tuition rate would begin at the start of the next term.
I’m a resident of a state that borders Illinois. Does the university offer tuition reciprocity?
No, UIUC does not offer in-state tuition to residents of states other than Illinois.

UMKC has BA/MD program with high demand/competitive and many higher ranked universities stopped similar programs for OOS students. I think it is basic economics of supply vs demand.

Mizzou is not a high ranked university like UCLA or UIUC. So they may need to lower the tuition to attract OOS students and may be willing to be more flexible. This may be true for other lower ranked universities as well.

With the predicted enrollment cliff expected to occur around 2025 in response to domestic demographic trends, it will be interesting to see how universities respond to that starting next year as the capacity(faculty, infrastructure etc.) are not elastic. So they may have to generate more demand if the demand doesn’t exist domestically.

[Roentgen]

To those who wanted to see how the CHEM 320: Elementary Organic Chemistry course looks like over the summer, you can see how the course looks like here. As you can see, since it’s only 8 weeks long, it goes at double the speed as the normal 16 week semester and exam frequency is twice as fast (so instead of an exam once a month, it’s once every 2 weeks): CHEM 320.

Usually it’s Dr. Peng who teaches the course (who uses a different textbook), although this time it seems to be Dr. Gounev.

CHEM 320 + CHEM 320L are only offered in the Spring Semester and Summer Semester. It’s not offered in the Fall Semester.

So if you can find a way to come into the fall with credit for at least General Chemistry I + General Chemistry I Lab, that would be helpful, although not required.

[Rhode-Shore]

@Roentgen @marcopolos Thank you for your responses.

Also, there seems to be a long discussion on the OOS cost of attendance for UMKC’s program, calling the cost INSANE and UNJUSTIFIED. I agree with this testament in the 2010s when UMKC’s OOS tuition stood out amongst other medical schools.

However, now that many medical schools (regardless of rank/caliber) are priced similarly to UMKC’s out-of-state tuition (with the exception of Texas schools) – ranging from high 60k to low 80k.

For example, let’s say I am a resident of Virginia. I follow the traditional path via in-state undergrad, but I get accepted into a public OOS medical school after two gap years.

Undergraduate: UVA
38k (listed COA on Google) x 4 = 152,000

2 gap years: MCAT Prep and Working CV-filler Jobs
20k (assuming the low cost of living in VA) x 2 = 40,000
*This assumes you’d be volunteering/shadowing/researching w/o compensation during those gap years.

Medical School: UPitt
96k (listed COA on UPitt SOM website for OOS) x 4 = 384,000

TOTAL: 152,000 + 40,000 + 384,000 = 576,000.

This total is very close to the total six-year cost of attendance for UMKC OOS (at the 23/24 rate). Therefore, I’m wondering why it would be a bad financial decision to go down the 6-year path. Almost the same price, but NO MCAT, NO ADDED STRESS of checking off ECs and getting into a US MD school, and TWO YEARS EARLIER to the attending salary (so loan repayment can start sooner).

This calculation assumes you’d be an outstanding applicant who gets accepted to UPitt SOM. However, there are many low-ranked medical schools without an accelerated program, like NEOMED (MD), Touro COM (DO), and Western University (DO), that charge the same, or if not more, than UMKC OOS. Therefore, does the argument that UMKC’s cost is insane as a T100 medical school still hold true?

Unless a high school senior is 100% confident that they can go down the traditional path through an in-state undergrad and in-state medical school without gap years, shouldn’t the wiser choice be to go to UMKC?

Would appreciate your thoughts and advice. Thanks.

[marcopolos]

Even schools with considerable sources of income outside of tuition - like UCLA or UIUC - don’t seem to offer a whole lot of OOS waivers and the rules appear to be fairly strict.

Honestly, is there a lot of legal room for OOS parents to sue? UMKC seem to be using a consistent approach for all professional schools in healthcare - pharmacy, dental and medicine.

Pharmacy program tuition per semester (UMKC pharmacy seems to be their highest ranked program) , dental is very similar
Instate - $5902
Heartland - $8440 ( ~1.4x)
Non-resident - $13,932 (more than 2x)

Pharmacy and dental school tuition seem to be cheaper or at par with private school options.

[marcopolos]

@Rhode-Shore
I agree with you. I couldn’t really find any evidence that UMKC charged exorbitant tuition- at least when I looked at tuition for colleges with no OOS bias. Some of the DO school tuitions are even higher(which may be your ONLY option after gap years if you didn’t manage to get into an allopathic med school).

I am also not very convinced that a 4 year degree as a pre-requisite somehow makes you a better doctor or med student when that 4 year degree could have much less science content than a 2 year community college for another graduate program like pharmacy (example a pre-med student going for an undergrad in English or Humanities and take just the pre-requisite for med school which is Basic PCB, Organic Chem and BioChem). Except Organic and Biochem, rest are really AP course level content or may be slightly higher. Many countries cover organic chem in highschool itself.

Following is the UMKC phramcy pre-reqs that is more or less same as med school pre-reqs (I am surprised to see that pharmacy school has mandatory requirements around anatomy, microbiology, cell biology etc. that are not in the pre-reqs for most med schools). Almost all pre-reqs can be taken in a local community college for free.

st-louis-community-college.pdf

[marcopolos]

Couple of scenarios that I can think of an an exception

Exceptional high school senior
Full ride for undergrad - national merit/other scholarships
Live in a state like KS or OK (could be others as well, but I don’t know) with a heavy instate bias where almost 1 in 3 applicant can get into instate school and instate tuition is around $30-40k. In that case, you could end up with a total COA of $240k between undergrad and med school assuming no gap years.

Other option may be to go to the cheapest med school in the country - LECOM ($40k tuition+ $25k living expense) through their affiliated EAP program with select undergrad schools in most states (which may cost average $140k). So the total may be $410k. LECOM has good board pass rates and decent match stats for a DO school.

First one of course is not a guaranteed option.

[Roentgen]

Oh I totally agree with you, and I was in the UMKC BA/MD program at a time when tuition for OOS/non-resident students was like in the 50K to 60K range. This was higher medical school tuition than even many top-tier and Ivy League medical schools at the time (just without the top tier and/or Ivy League med school prestige to go along with it). I can’t even imagine what it’s like now for an OOS student to be paying nearly 80K per year. And that does not even include basic room & board, which are separate expenses. I could very much see now the price tag for the UMKC BA/MD program giving OOS students & their parents real pause as to whether it’s really worth doing this type of program with that level of debt. Depending on the person, it’s a lot of stress to carry on such young shoulders and on their families.

If you add up Year 1 & 2 tuition (what most people consider the “undergraduate” part of the program, although in terms of coursework taken it’s not really like that, especially in the second half of Year 2), that pretty much adds up to a full undergraduate education in terms of the price tag, so there really isn’t that much cost savings there in that regard.

The UMKC undergraduate campus (Volker campus) has actually widened the ability to get lower tuition at UMKC with their newer Heartland Rate but, you guessed it, 6 year BA/MD students don’t qualify: Heartland Rate | Office of the Registrar | University of Missouri - Kansas City

Most OOS students are comparing UMKC’s BA/MD program Year 1 & 2 costs to going to their home state’s public flagship that is much more heavily taxpayer subsidized, and ALSO to where students can additionally qualify for university sponsored needs-based or merit-based scholarships. The Years 3-6 costs of the UMKC BA/MD program would be compared to their state’s medical school(s) tuition, usually not a private med school like Pitt (and this is before considering that many medical schools can also give really great scholarships, including even full-ride scholarships: https://www.reddit.com/r/premed/comments/132erig/full_ride_scholarships/?rdt=49489). I would also say that your calculation is a bit different as it includes 2 gap years (vs. the average is usually just one).

So using this year’s numbers:

Year 1 & 2 OOS tuition = $114,712
Year 3-6 OOS tuition = $316,652

It would be helpful for future students to know whether OOS BA/MD students get much scholarship support at UMKC, so if there are OOS students who are entering this fall or current ones who know, feel free to tell us!

You can download and compare med school tuition & fees from the AAMC in different years at different allopathic medical schools, including UMKC, here: Tuition and Student Fees Reports | AAMC. These will likely only be tuition in the last 4 years of the program.

[Rhode-Shore]

@Roentgen Were you an OOS student? If so, have you managed to pay off all the student loans from UMKC? Sorry if it’s a personal question, but it’d be nice to hear a real student’s perspective.

[marcopolos]

@Roentgen - Pitt SOM is a public school. They charge around $65k tuition for OOS and slightly les ($62k)s for instate students (in this case instate students may complain how they are paying same as OOS despite paying taxes to support the public university).

Comments in the reddit thread on scholarship seem to imply <5% getting full ride and often it seems to be a recruitment tool (for those who may have received multiple admissions) than a merit aid for accepted students. Interestingly, it also talks about how half of the candidates may only get just one acceptance. So these scholarships could be different from undergrad scholarship/merit aid.

Heartland rate at UMKC seem to exclude pharmacy and med school, probably because pharmacy school is highest ranked school within UMKC graduate schools.

We are proud to offer the Heartland Rate to undergraduate students who are residents of the listed states. Students admitted to the six-year medicine and Pharm.D. programs are excluded

Looks like Pitt has a health sciences complex like UMKC(dental, medicine, pharmacy, nursing, public health may be in the same campus). Interestingly, Sr. Vice Chancellor for Pitt Health Sciences(including SOM) is an IMG(most likely went through a 6 year med school) and he seems to have led IU SOM(largest med school the country) prior to his current position (for anyone worried about entering med school without a proper 4 year undergrad degree and 2 gap years ).

[Roentgen]

So I won’t go into too great detail here on my in-state, regional, or out-of-state status, but to answer your question, I will say that of all the OOS students I know, none have had a problem in paying it back over the long term after residency completion, and that’s regardless of chosen residency, whether primary care or specialty care. I will say that finances can sometimes be a little stressful for OOS students while actually in the BA/MD program (how mentally stressful it will be I think will vary and depends very much on the person and their particular family financial circumstances & situation) but people manage to do it with a combination of parental financial support, PSLF (Public Service Loan Forgiveness), and forbearance or deferment during residency training. Oh, and of course any scholarships amassed whether through the School of Medicine or through private sources (the latter being through scholarship databases like Fastweb).

A lot of this comes down to your own personal thinking and psyche and how much student debt is acceptable to you. And there are no right or wrong answers. I actually think this is where talking with a financial advisor/financial planner (Selecting A Financial Planner | Students & Residents) is a good idea, so that you can get a more concrete view in terms of the numbers for your particular financial situation. You can find some that do it pro bono (FREE) as well: https://www.forbes.com/advisor/investing/financial-advisor/free-professional-financial-advice/.

The AAMC also now has a financial wellness website for medical students and premeds called FIRST (Financial Information, Resources, Services, and Tools): FIRST (Financial Information, Resources, Services, and Tools) | Students & Residents which has newsletters, videos, webinars, and a Youtube channel.

[Roentgen]

Sorry, you’re correct, Pitt is a public institution, although it is one of the nation’s priciest public universities in the country. The reason for this is due to the downward trending investment by the state of Pennsylvania. Compared to 1975 where state appropriation made up 32% of Pitt’s budget, state appropriation now is only 10% of Pitt’s budget. It’s usually not THAT severe in terms of investment at many other public state flagship institutions across the country.

Correct, tuition scholarships tend to be used as recruitment tools in the traditional med school admissions process (whether that’s a full ride scholarship or not). Med schools want the top notch students they want to go to their school and so when students are deciding among and comparing their med school acceptances, those things can be what flips the decision making process in their favor. I don’t know what the exact statistics are in terms of the percentage of a given matriculating class receiving non-loan based financial aid at the med school level.

The Heartland rate applies to undergraduate students only and so it has nothing to do with rankings of individual professional schools, as the overall university decides who it can apply to. Both the 6 year BA/MD program and the 6 year Pharmacy program have students who enter as freshman and are not eligible for that tuition rate. That is because UMKC gets a lot of its budgetary revenue from its health sciences schools, including the 6 year BA/MD program and 6 year Pharmacy program which have their own tuition rates. At the time I was there, the one exception in terms of getting lower tuition for their students was the School of Dentistry because they were rolling in money. Maybe they just had very generous donors, I don’t know, LOL.