When Siena DeFazio was younger, she dreamed of opening a free veterinary clinic. Growing up in rural Florida with lots of official and unofficial pets, her family seldom had the means to pay to save an animal’s life after an illness or accident. Now that DeFazio is a junior at Hopkins, she is interested in treating a different set of patients.
“A lot of things that happen to animals that I saw, still happen to people, and I had deaths in my family that I felt were really preventable because there was a lack of preventative care going on,” DeFazio said in an interview with The News-Letter.
In her interview, DeFazio explained that she hasn’t given up her dream of starting a free clinic. As a Public Health major, her internship at a local nonprofit and studies of community clinics run by the Black Panther Party and the United Farm Workers have informed her vision of running a health-care cooperative. Unlike a traditional clinic where care flows in a single direction from doctor to patient, DeFazio envisions a center where community members could also take a yoga class or learn how to get lead paint out of their homes.
“The idea of cutting that rope and having that physical building exist in reality just makes me very happy,” she said.
According to the Pre-Professional Advising Office, approximately two-thirds of incoming freshmen at Hopkins express an interest in pre-health. DeFazio entered Hopkins with similar intentions. However, this spring DeFazio is joining a slimmer cohort of students who are preparing to fill out the American Medical College Application Service (AMCAS) for medical school matriculation in 2023. While students still have some time to commit to applying this year, they have until March 1 to request a committee letter from the Pre-Professional Advising Office.
These considerations are occurring after a surge in applications for 2021 matriculation in the wake of COVID-19. According to data collected from the Academic Services Assessment and Analysis office, 441 Hopkins students requested a committee letter in the application cycle before COVID-19. Although complete data for entry year 2021 applicants is not yet available, Director of Pre-Professional Programs and Advising Ellen Snydman estimates that upwards of 530 students received a committee letter.
Nationally, applications rose from 53,030 for entry year 2020 to 62,443 for entry year 2021, even while the number of matriculants only increased from 22,239 to 22,666.
Commentators cite both more lenient application policies due to the pandemic and the more abstract “Fauci effect” as a reason for the rise in applications. In describing the Fauci effect in an NPR article, Geoffrey Young, senior director of student affairs and programs for the Association of American Medical Colleges, compared it to the rise in military enlistment after 9/11.
In an interview with The News-Letter, Snydman agreed that the Hopkins students who applied to medical school in the wake of the pandemic were responding to a need.
“What I see with Hopkins students is really wanting to make a difference, feeling that they can make a difference and wanting to be on the front lines,” Snydman said. “People were enthusiastic: ‘I want to jump in, I want to be on the front lines, I want to be part of the solution.’”
However, Snydman did note that she is seeing hesitation from some students about the impact COVID-19 has had on the strength of their applications. For example, although physician shadowing was once a vital piece of the medical school application, many hospitals are no longer allowing undergraduates to do so.
DeFazio similarly noted that it was difficult for her to find clinical experiences due to pandemic restrictions. In addition, she noted the difficulties inherent in the medical school application process for underrepresented individuals without connections to the medical profession.
DeFazio is currently employed by the Johns Hopkins Underrepresented in Medical Professions (JUMP) program. While she values the support and advice that the program has offered her, especially pre-pandemic, she also observed that pandemic-related restrictions have led to the program having less of a community aspect than in previous years.
“A lot of the way you find out information is from these really hard-to-get sources, and so it's really difficult for people to figure out all the nitty-gritty stuff,” she said.
For limited-income students at Hopkins, cost is another crucial factor when considering when to apply. A 2019 article from CNBC estimates that a single medical school application cycle can cost $10,000 between application fees, interview travel and other expenses.
Pandemic uncertainty means that students can’t anticipate if they will need to pay to travel to interviews this year. While it does account for expenses related to taking the Medical College Admission Test (MCAT), the estimate does not account for fees associated with the new Casper situational judgment test required by some medical schools. While it costs only $12 to take Casper, students are asked to pay $12 per school to which they send their scores. Given that the average applicant applies to 18 schools, this could be up to $230. Other medical schools are asking that students submit a similar exam called PREview, with a flat fee of $100 and unlimited score distribution.
Snydman commented on the excess of financial and logistical requirements asked of applicants.
“I understand medical schools want more information by which to evaluate their applicants. I don’t blame them for that, they want the most information possible,” she said. “But I have concerns that the requirements are adding to applicants’ financial and emotional stress.”
Despite these setbacks, DeFazio feels confident in her decision to apply now, seeing it as the fastest way to make the impact she wants to have.
“I see my future as a doctor, and I think that is the way I will make the most leeway in what I want to do. And the impact I want to make is with a medical degree because you are very limited when you don’t have a degree in what you can do as a volunteer,” DeFazio said. “I don’t see a reason to wait.”
Ellie Rose Mattoon is a sophomore from Austin, Texas majoring in Molecular and Cellular Biology and Public Health. Project MD 2027 documents the challenges, inequities and triumphs of Hopkins students applying to medical school for entry in 2023.