In-State vs Out-of-State at US Medical Schools: Who Gets the Seats, School by School (AAMC 2025-26)

The National Picture: 22% of the Applications, 59% of the Seats

Table A-1 in the AAMC's FACTS tables counts, for every US MD-granting school, the applications it received and the students who matriculated, each split by in-state and out-of-state status. In 2025-26 it covered 1,066,896 applications from 54,699 applicants (an average of 19.5 each) and 23,440 matriculants. Combining the table's percentages with its counts gives the national split:

Source: AAMC FACTS Table A-1, 2025-26. Counts and the per-100 rates are AdmitBase's arithmetic on the table's published counts and percentages.

An application from a resident of the school's state became a matriculant about 5.2 times as often as one from outside it. The national figure hides the real story, because it averages schools that behave very differently.

How to Read These Numbers

"Per 100 applications" divides matriculants by applications, not applicants. An applicant who sends 19.5 applications appears in the denominator many times, and a matriculant is someone who was accepted and then chose to enroll, so the figure is a funnel rate, not an acceptance rate and not an applicant's chance. Its use is comparison: the same school's in-state and out-of-state rates, or one school against the national 1.15 for out-of-state applications. The table is organized by the applicant's state of legal residence, so "in-state" here means the applicant's legal residence is the school's state; a school's own residency rules for tuition or preference can differ.

Schools That Fill Their Classes From Their Own State

Of the 160 schools in Table A-1, 26 enrolled a class that was at least 90% in-state and 58 enrolled at least 75%. The median school was 66% in-state. The ten highest, among schools with at least 300 applications, are below.

Source: AAMC FACTS Table A-1, 2025-26. School names as printed by the AAMC.

For an in-state applicant the funnel at these schools is far wider than the national 5.9 per 100: at Mississippi, 52.5 of every 100 in-state applications ended in a matriculant. For an out-of-state applicant, a school that enrolled no or almost no non-residents leaves almost no seats to compete for, whatever its median says.

Schools With Few Home-State Students

At the other end, 37 of the 160 schools enrolled a class that was 30% or less in-state. The ten lowest, again among schools with at least 300 applications:

Source: AAMC FACTS Table A-1, 2025-26.

Several of these draw almost all of their applications from outside their own state too (the three Washington, DC schools received under 1% of their applications from DC residents), so "out-of-state" there is the ordinary case, not a handicap.

Where Out-of-State Applications Turn Into Seats Most Often

For schools that matriculated at least 20 out-of-state students, the table ranks out-of-state matriculants per 100 out-of-state applications. The national rate is 1.15.

Source: AAMC FACTS Table A-1, 2025-26.

These are the schools where an out-of-state application had the best funnel conversion in 2025-26, at roughly 2 to 7 times the national out-of-state rate. They are not necessarily easier schools: a small, newer or specialized class can have a high conversion for reasons the table does not show. Treat the list as a place to look, not a recommendation.

The Applicant's View, State by State

Table A-5 turns the question around. It starts from where the applicant lives and reports whether they matriculated in their own state, in another state, or nowhere. The edition used here is 2024-25, a different year from the school tables above. It covers 51,946 applicants: 26.7% matriculated in-state, 17.9% out-of-state and 55.4% at no US MD school.

States whose applicants most often stay home

States with a school where applicants most often leave

States with no MD school in Table A-1

Source: AAMC FACTS Table A-5, 2024-25. States with at least 150 applicants (first table) or 500 applicants (second table).

The big states diverge. Of 5,078 Texas applicants, 33.0% matriculated in Texas and only 6.5% elsewhere. Of 6,700 California applicants, 17.8% matriculated in California and 24.3% elsewhere. In the six states with no school of their own, between 38.3% and 53.7% of applicants matriculated out of state, well above the national 17.9%. Table A-5 does not say why, and we do not guess.

What an Advisor Does With This

• Start with the applicant's state. Count the public schools in it and check each one's in-state share above. A resident applying to a school that enrolls 90% residents is competing mostly for seats that go to residents.
• For an out-of-state list, use the school's out-of-state share. A school with a class that is 4% in-state is a different proposition from one that is 98% in-state, even at the same median. For an out-of-state applicant the out-of-state conversion column is more relevant than the school's overall figures.
• Do not average the two. A school's published median covers residents and non-residents together. The AAMC does not publish scores by residency per school, so an out-of-state applicant at a heavily in-state public school should read a Target as closer to a Reach (an advisor's judgment, not a published rule), as the worked example on sorting a list from medians explains.
• Spread the list. With about 19.5 applications per applicant, a list that is half schools that rarely enroll non-residents is a thinner list than it looks. See how many medical schools to apply to.

AdmitBase's medical school chances calculator scores an applicant against whole-class figures and does not separate residents from non-residents, so it understates an in-state applicant's position at a public school and overstates an out-of-state applicant's. Adjust by hand with the tables above.

Limits

• Two different years. The school tables are 2025-26; the state tables are 2024-25. Do not subtract one from the other.
• Applications, not applicants. The AAMC counts each application to each school. The per-100 rates are funnel rates.
• Derived counts. Counts of in-state and out-of-state applications and matriculants are rebuilt from the table's rounded percentages, so small cells can be off by a fraction of a student.
• Left out. The school tables exclude the City University of New York School of Medicine (59 applications, too few to compare), the Uniformed Services University (a federal school, not a state one), one row the AAMC prints only as "California", and any school with fewer than 300 applications.
• Not a rate. Nothing here is the probability that a given applicant is accepted. The AAMC publishes no acceptance rate by residency for individual schools.