Where you live changes your medical school odds independently of your MCAT score and GPA -- and AAMC's own state-by-state data shows exactly how much, without needing a single anecdote about a "state school bias."
The national split, and why it's less useful than it looks
Nationally, of 54,699 applicants in the 2025-2026 cycle, 25.4% matriculated to a medical school in their own state, 17.4% matriculated out of state, and 57.1% didn't matriculate anywhere that cycle. That national blend hides an enormous range, though -- individual states run anywhere from 55.4% in-state matriculation down to a flat 0%.
The states with the best in-state odds
At the top of AAMC's Table A-5, by share of applicants who matriculate to their own state's medical school: West Virginia (55.4%), Puerto Rico (50.9%), Mississippi (47.9%), Arkansas (47.2%), South Carolina (46.9%), Kentucky (45.7%), Indiana (43.4%), and North Dakota (42.5%). These are almost all lower-population states with a comparatively small number of in-state applicants competing for a state medical school's seats, many of which explicitly prioritize residents in admissions.
The states with the weakest in-state odds (that still have a school)
At the other end, among states that do have at least one in-state MD-granting school: New Hampshire sits lowest at just 3.1% in-state matriculation, followed by Maryland (10.7%), the District of Columbia (11.9%), Colorado (12.3%), Rhode Island (14%), Utah (14.3%), Connecticut (15.2%), and California (16.4%) -- despite California producing by far the largest raw number of applicants nationally (7,216), only about 1 in 6 of them matriculates to a California school. Texas, by contrast, sends nearly as many applicants (5,446) and matriculates 31.2% of them in-state -- almost double California's rate, from a similarly large applicant pool.
The six states with zero in-state matriculation
Alaska, Delaware, Idaho, Maine, Montana, and Wyoming all show 0% in-state matriculation -- not because these states reject their own residents, but because none of the six has an MD-granting medical school within its borders at all. Idaho and Maine do have osteopathic (DO) medical schools, which fall outside this MD-specific dataset; Alaska, Idaho, Montana, and Wyoming residents instead access medical education through the WWAMI program, a regional partnership based at the University of Washington's medical school (Washington itself is the fifth WWAMI state, and shows a real, nonzero 21.3% in-state rate). Delaware residents typically pursue medical school through separate regional agreements, most commonly with Philadelphia-area schools.
What this means if you're deciding where to go to college
- If your home state runs high on this list, staying in-state for undergrad can be a real, quantifiable advantage for your eventual medical school odds -- not just a vague "in-state feels safer" instinct.
- If your home state is one of the zero-percent six, or runs low like New Hampshire or Maryland, you're competing nationally either way -- there's no in-state advantage to protect by staying close to home for undergrad, so other factors (cost, fit, pre-med infrastructure) should carry more weight in that decision. See what actually predicts your medical school odds for what those other factors are.
- This is state-level aggregate data, not a specific school's policy. For how individual public medical schools weigh in-state versus out-of-state applicants directly, see the real in-state vs. out-of-state acceptance gap at specific public medical schools.
- None of this changes what your MCAT and GPA are worth on their own -- see the real national MCAT/GPA acceptance grid for that half of the picture.