Christianna McCauslandWhen Mark Gladwin, MD, became dean of the University of Maryland School of Medicine (UMSOM) in 2022, he detailed what he called the “tripartite mission” of an academic medical center: “The mission is to take care of vulnerable patients and serve the community. The mission is to train the next generation of health care workers and scientists. And the mission is discovery, to solve and meet need through science.”
Never has the need to make good on that mission felt more urgent as the nation faces a significant shortfall of physicians. In its report, “The Complexities of Physician Supply and Demand: Projections From 2021 to 2036,” the Association of American Medical Colleges (AAMC) notes that physician demand is projected to grow faster than supply leading to a total projected shortage of between 13,500 and 86,000 physicians by 2036. That shortage will have profound implications for primary care, which is expected to see a shortfall of 20,200 and 40,400 physicians, but will have a significant impact across all nonprimary care specialties. Even as the dearth of physicians grows, the need is only increasing as the population generally ages — and the physician population ages and retires.
“The projected physician shortage we are facing — across both primary care and critical specialty fields — represents a significant challenge facing our future health care in the U.S.,” says Gladwin. “National analyses from the AAMC and the National Center for Health Workforce Analysis warn that the country could need as many as 200,000 additional primary care physicians and a similar number of specialty providers over the next two decades, with more than one-third of the current workforce poised to retire in the coming years.”
Fortunately, the shortage is not due to a lack of interest in medicine as a career. On the contrary, AAMC announced that it saw a record 100,000 students enroll in medical school in 2025, driven primarily by women and first-time applicants. The interest in medical education is very much in evidence in admissions at Maryland, says Sandra Quezada, MD ’06, MS, associate dean for admissions.
“Our applicant pool has steadily increased over the past 10 years from approximately 4,500 to 5,000 applications 10 years ago to 6,500 to 7,000 applications present day,” she says. “We’ve also noticed a consistent increase in the quality and competitive credentials among our applicants, all despite challenges like the pandemic, which decreased applicant pools in other health care areas, and despite threats to research funding.”
Quezada says the rising interest in medical school may be attributed to any number of factors, such as stronger STEM curricula starting from a younger age. In addition, “with the COVID-19 pandemic, young people in high school and college were all inevitably exposed to the reality of disease impact and the need for strong health care,” she says, adding that, “I think medicine is still seen as an inspiring profession that offers job security and solid earning potential with the opportunity to make a more meaningful impact compared to other fields that may have higher earning potential, but volatile job markets and less altruistic impact.”
The challenge that thus arose was that a larger pool of applicants was competing for the same 150 classroom spots. Now, UMSOM is increasing its class size to 200 students, which will enable it to meet this pressing need while also opening new pathways to medicine to a broader pool of students. The expansion will also move the school from mid-size to large school designation, on par with institutions like Georgetown University and New York University.
“Our responsibility as a leading public medical school is to meet this challenge head-on,” says Gladwin. “Expanding our MD program class size allows us not only to train more physicians, but to build innovative programs that address particular areas of unmet need.”
Meeting Community Health Care Needs
Throughout its history, the school has managed its class size to meet community health needs. The school’s first class contained seven students; by the outset of the Civil War, class size was approximately 75 students for the academic year 1860-1861. At the turn of the last century, academic requirements had grown more rigorous and uniform — not to mention growing from a two-year course of study to four — bringing class size to roughly 90. In the 1960s, the Board of Regents approved the expansion of the incoming class size from 100 to 200, leading to increases that peaked in the 1980s at 180 students before rolling back to the 150-student class size of the recent era.
Donna Parker, MD ’86, FACP, senior associate dean for medical education, explains that the move to expand class size now “has to do with Dean Gladwin and his vision of a moral imperative to educate enough students to fulfill our mission to serve our community as we face looming physician shortages.”
For example, for many years, the school has wanted to assist Maryland’s Eastern Shore, which is home to 25 percent of the state’s population but is almost entirely designated by the federal government as a medically underserved area. Consider, for example, that Caroline County has only one physician per 2,500 residents. The Rural-MD Scholars Program, launched in 2024, enables the school to meet its mission of improving health outcomes in an underserved area while also expanding its class size. The program provides free tuition to up to 10 students per class — 40 added students in the school when the program is fully enrolled. In exchange, the students agree to give four years of service post-residency training to a practice on the Shore.
The medical school has always taken a broad view of the definition of a medical career, and Parker explains that school is looking at expanding class size while also opening new career pathways for MDs. Enter the new BS-MD Program that prepares highly motivated undergraduate students at the University of Maryland, College Park majoring in bioengineering, math, or computer science fields to excel in medical school. Parker explains that these future “physicianeers” who will bridge engineering, artificial intelligence (AI), and data science with clinical practice to improve patient outcomes, are undergraduate students in their sophomore year who are granted conditional acceptance to Maryland. These students participate in structured research, clinical, and service activities in coordination with the medical school during their undergraduate years. In this, its first year, the program has enrolled seven students and anticipates enrolling seven to 10 annually.
“This puts those students on a path to impact patient care at both the individual and the population health level,” Parker explains. The physicianeers are uniquely relevant now, “especially with the rise of AI and the use of computer models to analyze population health.”
The school is still examining the possibility of a three-year curriculum that would fast track those on a path to primary care. Modeling what other schools have successfully achieved, the school’s three-year curriculum would be designed to appeal to those interested in primary care careers, would save students one year of tuition, and would guarantee them a residency position in pediatrics or family medicine at Maryland.
Rigorous Review to Increase Student Body
As Parker explains, a school can’t simply open the admission door and let in more students. The Liaison Committee on Medical Education (the medical education accreditation authority) has a rigorous review process for any school looking to increase its student body by more than 10 percent. This ensures there is an adequate qualifying applicant pool, facilities space, faculty support, and financial aid for the larger capacity. Parker says the school’s 33 percent increase will be incremental and will coincide with regular reviews by the curriculum committees to ensure resources and facilities are keeping pace.
Parker says the larger student body — and the faculty and facilities augmentations it may require — will be funded through the additional tuition dollars more students bring, support from the state, possible federal funding, and philanthropy. Financial contributions will play a key role in the ongoing renovations of academic spaces, and alumni willing to be involved in teaching will help meet the need for more clinical placements.
Financial aid will continue to evolve to meet student needs as well. Quezada explains that with increasing class size there will be an increasing need to utilize scholarship funding as a recruitment tool.
“Even with the current class size, our funds are falling short and we can only offer small scholarships to fewer students than we would like,” says Quezada. “We often lose our most competitive accepted applicants to other institutions who are able to offer full-tuition scholarships. With a class size of 200, we will need to proportionately increase our scholarship capacity if we expect to continue to recruit highly competitive applicants to our medical school.”
It remains to be seen how the new caps on federally funded academic loans (which went into effect in July 2026) may impact student capacity to attend medical school. Loans for professionals, like aspiring physicians, are now capped at $50,000 annually and $200,000 total. Parker hopes that, with its average student debt generally below the national average for public institutions, the caps won’t negatively impact admissions. And Quezada says, “While this may give some applicants pause, the overlapping scarcity in the job market may also balance that hesitation and sustain medicine as a career consideration that presents job security. Hopefully, their enthusiasm and motivation for medicine will prevail.”
Most certainly new programs and a larger student body will bring more perspectives to the classroom and to the field of medicine. And the tripartite mission Gladwin detailed at the onset of his leadership is continuing to manifest.
“Our goal is clear: to train the physicians of tomorrow and ensure that every community — urban or rural — has the physicians it needs,” says Gladwin. “This expansion is a strategic and necessary step toward fulfilling that mission.”
This story originally was published in the spring 2026 issue of University of Maryland Medicine Bulletin.
