Picking Your State of Residency for Medical School*
/Have you ever wondered what state you should list on your AMCAS application? Learn everything we think you need to know about establishing state residency for medical school and what impact this may have on your chances of getting in
How does state of residence impact medical school admissions?
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Part 1: Introduction
For many medical school applicants filling out the AMCAS application, listing their state of residency is a no-brainer. But for others, it reflects one of the most important decisions they must make during the admissions process.
If you’ve moved to a new state to attend your undergraduate university, if your parents have moved to a new hometown, or perhaps if you’ve relocated for a gap year opportunity, this decision can be quite challenging to make.
Many applicants wonder if their choice of state matters and how it will impact their medical school admission odds. In this guide, we’ll walk you through everything you need to think about when considering your state of residency during the medical school application process, including the different factors to take into account when choosing between states (if possible).
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Part 2: Does state of residence matter when applying to medical school?
Yes, but it depends on the state in question and even further depends upon your programs of interest.
For applicants who have reviewed our guide to the AMCAS application, you know this application is a thorough and complete review of who you are as an applicant. It makes sense that one of the factors admissions committees will be interested to learn is where you are from.
Data shows that this information is predictive not only of where you will eventually accept your offer of admission, but also of where you will continue your future training! For example, according to NYU Grossman School of Medicine's Match Day results, about 50% of the graduating class matched at a residency in the state of New York.
AAMC data shows that, as a whole, around 60% of current first-year medical students are in-state residents. Below, we will review some of the factors that go into this trend.
Interview, acceptance, and matriculation rates
It’s often assumed that most medical schools tend to interview, accept, and matriculate a larger portion of in-state applicants than out-of-state applications. This is especially true of public medical schools, up to the point that some do not even consider candidates from other states! Some extreme examples include Brody School of Medicine, Southern Illinois University, and University of Mississippi, all of which are 100% in-state.
In contrast, UCLA School of Medicine (also a public institution) interviewed in-state and out-of-state applicants at relatively similar rates of 6–7% in 2021. However, 60% of UCLA’s eventual matriculants were in-state compared to 40% out-of-state.
Some private institutions also demonstrate preferences for in-state applicants (though often to a lesser degree). For example, nearly 86% of Baylor College of Medicine’s most recent incoming class was in-state compared to just 14% out-of-state.
The data, however, should be reviewed at each individual university you are interested in applying to. Depending upon your region of interest, you will find that this trend does not always hold true when applying to private medical schools.
For instance, although Boston University interviewed 13% of its in-state applicants as opposed to 8% of its out-of-state applicants, only 14% of Boston University’s eventual 2021 matriculants were in-state compared to 86% out-of-state.
You can research in-state vs. out-of-state application and matriculation rates for each allopathic medical school here.
In-state vs. out-of-state tuition
Perhaps the biggest reason this decision matters is tuition! It goes without saying that medical school is expensive. If you have an opportunity to reduce the burden of this investment, it’s certainly worth considering.
Attending a public university as an in-state student will be significantly less expensive than attending as an out-of-state student. Although resident tuition is still costly, our medical school tuition guide consistently demonstrates that, comparatively, in-state students pay much less.
Take Florida State, for example, where in-state tuition and fees are $31,773 compared to $71,405 for an out-of-state student—more than twice as high. Although not quite as drastic, the same trend is true among California public med schools; for instance, in-state tuition to UC Riverside is $42,659 compared to $54,904 for out-of-state tuition.
Thus, before making this decision, it is critically important to work closely with your mentors on a well-balanced schools list that takes into account what impact your state residency may have on your chances of admission. Location certainly isn’t the only factor that goes into building an effective schools list, but, generally, your chances of admission will be highest at universities within your home state.
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Part 3: Which states can I declare as my state of residency on my AMCAS application?
Answering this question can be tricky, as it depends upon the specific states you are considering listing on your AMCAS application. Each state has its own rules and regulations to qualify for state residence, so you will need to review each state’s legal definition of state residence in order to ensure you qualify. If you have specific questions or your situation is more complicated, you should speak with an attorney to help you navigate your unique situation.
In general, for many applicants, your state of residence will be determined by one or both of your parents if they claim you as a dependent while filing taxes. In other words, if you are still financially dependent on your parents, there’s a good chance you’ll be considered a resident of the state in which they live, even if you go to school or live elsewhere.
In the case of divorced parents, according to the IRS, it appears that only one parent may claim you as a dependent for tax purposes. Thus, that parent’s location may determine your state of residence when it comes time to apply.
On the other hand, if you are able to prove “financial independence” from your parents, different rules may apply. Again, regulations vary widely from state to state, but nearly across the board, a financially independent applicant—generally, this means someone who pays their own taxes—might be able to establish residency in a state by living full-time in that state for over a year.
Establishing residency for medical school
While most states have residency rules along these lines, each may still require different proof of residence. In Texas, for example, it appears an applicant might receive Texas residency if they maintain a home in Texas for at least 12 consecutive months prior to application and demonstrate one of the following during that same period of time: gainful employment in Texas, ownership of Texas residential property, proprietorship of a business in Texas, or marriage to a Texas resident.
Alternatively, Texas residency might also be established simply by living in the state for 12 months prior to the TMDSAS application deadline if you also happen to have graduated from a Texas high school and lived in Texas for the 36 months before your high school graduation.
For Ohio, it appears that than an applicant is required not only to live in Ohio and be financially self-sufficient for the 12 months leading up to starting school, but also that they have changed all state-specific documents over to Ohio (e.g., driver’s license, voter registration, and more) and have not left the state for more than two weeks at a time or 30 days total during the 12-month period.
Some states, however, have different timelines for establishing residency. For instance, Arkansas seems to require applicants to reside in-state for just six months, during which time they must earn at least $2,000 (applicants must also demonstrate an intent to remain in Arkansas after graduation). In contrast, to be considered a resident of Massachusetts, it seems that applicants or a first-degree relative (defined as a parent, guardian, spouse, or sibling) must have lived in Massachusetts for a minimum of seven years.
Additionally, many medical schools and state university systems publish their own definitions of in-state residency that can serve as excellent resources for this research. In California, for example, the UC Guide to Understanding State Residency indicates that an applicant must be “continuously physically present in California for more than one year (366 days)” and is, as a graduate student, presumed to be financially independent unless claimed as a dependent by their parents.
As you can see, this question gets complicated very quickly. Thus, it is critical that applicants review the individual rules and regulations regarding the legal definition of “state residency” in each location they are considering. Additionally, if you cannot figure out a state’s rules on your own, it is always a good idea to seek independent legal counsel to help you understand how to approach your particular situation.
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Part 4: How should I choose my state of residency when applying to medical school?
With the above considerations in mind, applicants who may qualify for multiple states may want to take the following factors into consideration.
Matriculation rates
First, you should review admissions statistics from all the medical schools in each state you are considering and determine the advantage that in-state status may offer. This advantage will be much more pronounced in some states compared to others, so you should consider the degree of advantage that there is to be gained at the universities in each state.
State-wide matriculation rates can provide a general starting place for this process. Among Texas medical school applicants, for example, the overall matriculation rate at in-state schools is about 27%, as opposed to 6% at out-of-state schools. On the other hand, among applicants from California, 15% matriculate in-state while 20% attend medical schools elsewhere. (The two states have relatively similar rates of non-matriculation, which we can generally interpret as applicants who did not get into medical school.)
You can view in-state vs. out-of-state matriculation rates for each state here.
Average GPAs and MCAT scores
Next, you can review differences in average GPAs, MCAT scores, and other admissions criteria for the schools in the states you may qualify for. Although some universities admit a larger portion of in-state applicants, this applicant pool may be more competitive than the out-of-state pool.
For example, when examining in-state vs. out-of-state admissions statistics for public medical schools in Florida, New York, Pennsylvania, and Ohio (available through MSAR), you’ll notice that matriculated in-state applicants often have higher average GPAs and MCAT scores. Therefore, an applicant with below-average statistics may not actually gain much of an admissions edge by applying to these schools in-state.
The number of medical schools in each state
Finally, you should consider how many medical schools are located in the states you are considering. Even if the admissions advantage is significant as an in-state applicant, overall it may not be statistically beneficial if there are too few schools in the state. Depending upon the situation, a modest in-state advantage at a large number of medical schools in a state such as Texas may outweigh a substantial in-state advantage at a smaller number of universities in a state such as North Carolina or Georgia.
Applicants who appear to qualify for multiple state residencies should review their situation holistically, considering the impact of all of the factors above and how they affect their specific situation in combination. As a general rule of thumb, applicants should pay close attention to how their statistics match up against others in their potential applicant pool (i.e., in-state vs. out-of-state). You may be able to maximize your chances of admission by being part of an applicant pool that most closely matches your statistical profile.
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Part 5: Frequently asked questions
Do I have to list my state of residency on my AMCAS application?
As explained further in the AMCAS official application guide, the answer is yes!
Your state of residence is an important part of the information that medical schools will use in their evaluation of your application. On the AMCAS application, you will be prompted to select your country, state, and even county from a drop-down list of options.
Is is possible to list multiple states as my state of residency for my AMCAS application?
The answer here is no. The AMCAS application will only allow you to pick a single state as your state of residency.
Can I change my state of residence on my AMCAS application after submission?
Yes! The AMCAS official application guide indicates than an applicant is able to change their state of residency after submission of their AMCAS application by contacting AMCAS using the information provided.
To be clear, this does not mean that you can apply as an in-state applicant in multiple states. If your application update is approved, universities to which you have already applied will be notified of the update. Thus, although AMCAS does allow you to change your decision after submission, you can still only apply as a resident applicant in a single state.
Does AMCAS verify my state of residence?
Although there does not appear to be a formal verification process through the AMCAS system, any of the medical schools you apply to can (and will!) ask for verification of your chosen state of residency and reach out directly to collect further information or proof. This is generally true for all of the information listed on your AMCAS application.
Therefore, you should be ready to present evidence of your residency at any point in the application process.
What happens if a medical school rejects my state residence claim?
This will likely vary from school to school. However, making unsubstantiated claims on your medical school application is never advisable. A rejection of your residence claim could put you at risk of having your entire application thrown out at a time in the cycle that would require you to reapply to medical school the following year.
Thus, we strongly recommend this situation be avoided through a thorough review of your state’s—and even individual universities’—legal definitions of state residence. If, after reading this guide, you are still confused based upon your specific questions, you should always reach out to a licensed attorney to help you navigate the laws as they relate to your unique situation.
Final thoughts
Determining your state of residence is an important decision you must consider carefully when applying to medical school. Although the relative weight may vary from school to school, your state of residency will impact your chances of admission to medical school in some form or another. Therefore, it is important to be aware of this impact and understand how it affects you specifically!
Generally, for applicants dependent upon their parents financially, their parents’ home state may likely determine their state of residence. For applicants who are financially independent, the legal definition of residency may be different and applicants may be able to establish resident status after living in a state for one year.
If you have the option to choose between different states, you may be able to maximize your chances of earning an acceptance by reviewing the statistics related to each state’s medical schools and holistically assessing how much of an advantage you stand to gain as a resident applicant.
However, it is crucially important to ensure you meet the legal requirements for establishing residency in any state that you declare yourself a resident of. We recommend reviewing your state’s legal definition of residency, which can generally be found on states’ websites as well as on your state universities’ admissions websites, and to speak to an attorney if you ever have any complicated residency questions.
About the Author
Dr. Shirag Shemmassian is the Founder of Shemmassian Academic Consulting and one of the world's foremost experts on medical school admissions. For nearly 20 years, he and his team have helped thousands of students get into medical school using his exclusive approach.
*The information provided in this guide does not, and is not intended to, constitute legal advice; instead, all information, content, and materials are for general informational purposes only. Should you have specific questions about your legal status, you should make sure you speak with an attorney familiar with your residency status in your relevant jurisdiction.