[Novel admission procedure for medical students leads to equal opportunities for the individuals-but may aggravate the shortage of rural doctors].

Background: In 2017, the Federal Constitutional Court ruled several aspects of the German student admission process unconstitutional. Consequently, the waiting time quota was replaced by an aptitude quota in 2020. Students are now allowed to simultaneously apply to all German medical faculties and an adjustment algorithm for school leaving grades from different federal states was introduced. The present study investigates the impact of these changes on the new study cohorts.

Methods: Records from the federal admission trust were used to compare the final two winter semesters before the change to the first three thereafter.

Results And Discussion: The impact of the new procedure on students with previous medical training cannot yet be conclusively assessed. While grade point average (GPA) and sex of the students remained comparable and students still prefer to study close to home; however, they have become younger. The adjustment for school leaving grades indeed led to equal opportunities for the individual applicant; however, this may aggravate the shortage of rural doctors. The current adjustment mechanism considers applicant numbers, yet less people apply from rural areas while at the same time these areas suffer from a shortage of physicians. As rural upbringing and education are the best predictors of rural practice after licensing, the shortage may worsen. To counteract this, the compensation mechanism for the school leaving grades could easily be adjusted.