A 10-Year Review of U.S. Medical School Revenue, Fiscal Years 2012 to 2021.

Abstract

Purpose: This study examines how U.S. medical school revenue diversification has changed over time, particularly growth of practice plan, hospital, and research revenue sources, and explores how these revenue changes have occurred alongside changes to the number of full-time faculty, student enrollment, and tuition and fees revenues.

Method: Aggregate census data for fiscal years (FYs) 2012 to 2021 are from fully accredited U.S. medical schools and affiliated organizations. Most revenue source data are from December 2022. Tuition and student fees analysis was conducted in June 2023. The numbers of full-time faculty for FY 2012 to FY 2018 are from the Association of American Medical Colleges (AAMC) Faculty Roster and for full-time faculty for FY 2019 onward from the Liaison Committee on Medical Education Annual Medical School Questionnaire Part II. Student enrollment data are from the AAMC Student Records System. Faculty and student enrollment data are from June 2023.

Results: Between FY 2012 and FY 2021, total U.S. medical school revenue increased by 48%, from $95.8 billion to $142.0 billion (in constant 2012 dollars). Most (78%) of this growth came from practice plans and hospitals, whereas revenues from federal research grants and contracts saw attenuated growth (12%). The number of full-time clinical faculty increased by 35% compared with a 9% increase in basic science faculty. Total undergraduate medical education student enrollment increased 17%, with average enrollment per school increasing 2%, from 602.6 to 616.3 students.

Conclusions: Practice plan and hospital revenue accounted for the largest portion of total U.S. medical school revenue. The number of total full-time clinical faculty increased, potentially reflecting robust clinical service-related medical education activity. Although U.S. medical school revenue has continued to increase despite environmental fluctuations, concern remains that current trends in the diversification of U.S. medical school revenue could hinder education, research, and clinical missions.