How Much Do Medical School Secondaries Cost?

Post By

Ryan Brownlee

– Founder of AspiringMD

A current medical student breaks down medical school secondary costs, 2027 fee ranges, average fees, budgeting, fee waivers, and ways to save.

Medical school secondary applications usually cost around $100 per school, although the actual fee can vary substantially. In the AAMC’s current 2027 MSAR secondary application report, I found U.S. MD secondary fees as low as $30 and as high as $200, with many schools charging somewhere around $75 to $140. A 2025 systematic review of 222 MD and DO medical schools found that, among schools charging a secondary fee, the average was $83, with fees ranging from $30 to $200.

If you are trying to make a budget before secondary season begins, I would personally plan on about $100 for every school on your list unless you already know that you qualify for fee waivers. That means 20 submitted secondaries could easily add approximately $2,000 to your application expenses, and that cost comes on top of what you already paid to submit your primary application through AMCAS.

I remember how quickly secondary season became busy during my own application cycle. My secondaries began arriving around late June and continued throughout July, and the workload was not just writing essay after essay. You are simultaneously researching schools, tracking deadlines, checking application portals, proofreading, and paying another application fee almost every time you submit. If you are preparing for that stage now, my complete guide to medical school secondary applications walks through the entire process, while this guide focuses specifically on what secondaries are likely to cost and how I would budget for them.

What Is the Average Medical School Secondary Application Fee?

The best systematic estimate I found comes from a 2025 study published in The Advisor by the National Association of Advisors for the Health Professions. The researchers reviewed the secondary application requirements of 222 MD and DO medical schools using recent application-cycle information. Among schools charging a fee, the average secondary application cost was $83, with a standard deviation of $32 and an overall range of $30 to $200. The study also found that 96.85% of the schools reviewed required a secondary application and that 86.04% offered some type of fee waiver to qualified applicants.

I would still use $100 per secondary as my personal budgeting number rather than $83. The $83 figure is an average based primarily on 2023–2024 application data, while the AAMC’s current 2027 shows plenty of schools now charging $100, $110, $120, $125, $130, $135, $140, or more. Budgeting slightly high is much easier than discovering in July that you underestimated twenty separate fees.

How Much Do Medical School Secondaries Cost in 2027?

There is no standardized secondary application fee because each medical school sets its own price. Looking through the AAMC’s current 2027 MSAR report gives a much better idea of the spread than simply saying that every secondary costs $100.

For example, the current report lists several U.S. medical schools with $30 secondary fees, while Stanford lists $100, Yale $110, Johns Hopkins $120, UCLA $125, UC San Diego $135, Georgetown $140, the University of Hawaii $150, and one U.S. medical school in Puerto Rico lists a $200 secondary fee. Those examples are not meant to tell you which schools should be on your list; they simply show how much the fee can change from one application to another.

This is also why I would check the current fee for your actual schools rather than multiplying an internet average by the size of your list and assuming the result will be exact. The AAMC’s MSAR report includes the secondary fee, whether a secondary is required, who receives it, whether a fee waiver is available, and the secondary deadline, which makes it one of the most useful official resources for budgeting before the applications arrive.

How Much Should You Budget for Medical School Secondaries?

Using approximately $100 per school keeps the math simple and gives you a reasonable cushion for schools with above-average fees.

I prefer the right-hand column for planning because you do not want your application strategy becoming dependent on whether this week’s applications happen to cost $75 rather than $125. If you later spend less than expected or receive several waivers, you have simply created extra room in your application budget.

The timing of those expenses also matters. You usually do not pay $2,000 in one transaction. Instead, secondary invitations can begin accumulating rapidly during late June and July, which means you might suddenly have several $75–$140 payments hitting within the same couple of weeks. My guide to explains when that wave tends to begin, and my includes a fee field so you can track what has already been paid and what is still coming.

Are Secondary Application Fees Separate From the AMCAS Fee?

Yes. Your medical school secondary fees are separate from your AMCAS primary application fees.

For the 2027 AMCAS cycle, the AAMC charges $180 for the first medical school and $48 for each additional school designation. If you apply to 20 AMCAS schools, the primary application alone costs $1,092 before any secondary fees are added.

If those same 20 schools each eventually cost approximately $100 at the secondary stage, you would be looking at roughly $3,092 in primary and secondary application fees alone. That still does not include expenses such as the MCAT, PREview or CASPer when required, transcripts, interview-related expenses, or anything else you spend during the application process.

This is one reason I created the free 2027 AMCAS application checklist and medical school cost calculator. I think it is much easier to make rational school-list decisions when you can actually see the cumulative cost instead of treating every new $100 payment as though it exists independently from the seventeen payments that came before it.

Do All Medical Schools Charge a Secondary Application Fee?

No. Secondary application policies and fees vary by medical school, and not every school charges exactly the same amount or necessarily charges every applicant.

The AAMC explicitly tells applicants that most medical schools require a secondary application and that fees vary by school. Its MSAR report also makes the variation visible because some schools have substantial secondary fees while other entries do not list the same type of charge.

I would therefore check the actual school rather than assuming that receiving a secondary means another automatic $100 expense. Your school list may end up averaging below $100, while another applicant’s list could easily average above it.

Do You Have to Pay for Every Medical School Secondary You Receive?

No. Receiving a secondary does not obligate you to submit it.

This is especially important because some medical schools send secondary applications very broadly. As I explain in my guide to , some schools screen their primary applicants substantially before issuing a secondary, while others send the application to nearly every applicant who satisfies basic eligibility requirements.

If you receive a secondary from a school that no longer makes sense for you, you can decide not to complete it rather than spending another $100 simply because the invitation appeared in your inbox. This becomes even more important when you understand that receiving a secondary does not necessarily mean the medical school is especially interested in you. An automatically generated secondary should not make a financial decision for you.

I would still be careful about abandoning schools impulsively once July becomes stressful. If the program fit your original list and you would genuinely attend, the fact that another fee is annoying is probably not enough by itself to throw away the application. If you realize that you would not attend the school, do not meet an important requirement, have very poor mission fit, or added it only because you were anxious about your school list, then the secondary fee can be a useful moment to reconsider.

Should You Pay for a Secondary If You Are Not Competitive for the School?

I would look at this before paying, particularly when the school sends secondaries automatically.

One of the more interesting things I found while researching admissions-office guidance for this article was that Wake Forest’s medical school admissions page explicitly recommends that applicants review the previous year’s class profile to determine whether their application is competitive and whether returning the secondary is in their best interest. Wake Forest currently charges a $130 secondary fee, so this is not merely advice from another premed telling you to trim your list; it is an admissions office telling applicants to evaluate the decision before submitting.

Competitiveness should not be reduced to whether your MCAT is one point below a median, though. I would consider your GPA and MCAT alongside residency preference, mission fit, clinical and service background, research, prerequisites, and other characteristics the school values. My guide to building a medical school list explains how I would evaluate those factors together rather than deciding that every school is either a perfect target or an impossible reach.

Does the AAMC Fee Assistance Program Cover Secondary Applications?

The AAMC Fee Assistance Program can reduce application costs substantially, but there is an important detail that is easy to misunderstand: the AAMC does not universally waive every school’s secondary fee itself.

For the current program, approved applicants receive waived AMCAS fees for one submission covering up to 20 medical school designations, along with other benefits. The AAMC separately states that some medical schools waive their secondary fees for Fee Assistance Program recipients, and it recommends checking the individual school’s policy in MSAR. Fee Assistance benefits are also not retroactive, so applicants who may qualify should investigate the program before paying expenses that they hope to have covered later.

The current MSAR report makes the school-by-school differences much easier to see because it includes a dedicated secondary fee-waiver column. Some medical schools automatically recognize AAMC FAP status, while others may have a different process or additional circumstances under which they consider a waiver.

I would never avoid applying for legitimate fee assistance because you are worried that asking for help somehow makes you look like a weaker applicant. Fee-waiver programs exist specifically because the application costs are substantial, and admissions offices openly publish instructions directing eligible applicants toward them.

Can You Get a Medical School Secondary Fee Waiver Without AAMC FAP?

Sometimes, although this is completely school-specific.

Some admissions offices publish alternative hardship procedures. Others restrict their standard secondary waiver to AAMC FAP recipients, and some have additional categories such as military service or participation in specific access programs. Michigan’s medical school admissions page, for example, states that its secondary fee is waived for applicants approved for AAMC Fee Assistance and for active-duty military members, while other institutions publish their own case-by-case waiver processes.

If paying a particular school’s secondary fee creates a genuine financial hardship and the published policy does not clearly answer your situation, I think it is reasonable to read the school’s instructions carefully and contact admissions if the school invites applicants to request consideration. I would not assume that every school will grant an exception, but there is little benefit in quietly abandoning an application you genuinely want to submit before checking whether the school already has a process designed for your situation.

Are Medical School Secondary Fees Refundable?

Usually, I would assume the secondary fee is nonrefundable unless the medical school explicitly tells you otherwise.

Multiple medical schools state this directly in their admissions policies. Tufts currently describes its $130 secondary fee as nonrefundable regardless of the eventual application outcome, and Colorado similarly states that its secondary application fee is nonrefundable.

That makes the decision point before you click submit and pay. Verify that you meet the school’s eligibility requirements, make sure the program still belongs on your list, confirm that your essays are ready, and check the amount one final time. Once you submit, being rejected later does not generally create a reason for the school to return the application fee.

When Do You Pay the Secondary Application Fee?

The fee is generally associated with completing or submitting the individual medical school’s secondary application rather than with your original AMCAS payment.

The exact workflow varies because each school controls its own portal. Cooper Medical School of Rowan University, for example, currently states that its $100 secondary fee is payable when the secondary is submitted, while other schools have their own portal and payment instructions.

This means merely seeing a secondary invitation in your email does not necessarily mean the money has already been charged. You usually have time to open the application, verify its requirements, look at the prompts, and decide whether you still want to proceed.

Why Do Medical School Secondary Applications Cost Money?

Secondary application fees are school-specific processing fees associated with the supplemental admissions process. There is no single national formula telling medical schools what they must charge or precisely how the money must be allocated, which is why the prices vary so much.

I would be careful with claims online that every secondary fee is simply “profit” or, on the opposite extreme, that every dollar can be traced to a particular admissions expense. I searched applicant discussions extensively for this article, and there is plenty of speculation about why schools charge what they do, but very little public cost-accounting evidence that would allow me to make either claim responsibly.

For applicants, the more useful question is whether completing this particular secondary is worth the fee, writing time, and opportunity cost. You cannot control what a school charges, but you can control whether the school belongs on your list in the first place.

What Reddit and r/premed Say About Medical School Secondary Costs

For this article, I searched Reddit broadly and r/premed specifically and summarized the recurring themes rather than treating individual comments as authoritative admissions guidance.

The most consistent finding was that applicants frequently underestimate how painful secondary costs feel because the fees arrive after they have already paid for primary applications. In one recent 2026 cost breakdown, an applicant who applied through both AMCAS and TMDSAS reported that their AMCAS secondaries tended to hover around $100 while their Texas-school secondaries were often lower. Other applicants described planning on several thousand dollars across an entire cycle, and older threads repeatedly contain people realizing only after primary submission that another $75–$125 may be waiting at almost every school.

The second recurring theme was how dramatically fee assistance can change the math, although applicants also reported school-to-school differences. In a 2026 r/premed discussion, one FAP recipient who applied broadly reported spending under $1,000 for the cycle and having all of their secondary fees waived, while another recent discussion included applicants describing schools that still required some payment or used different waiver policies. Those are anecdotes rather than guarantees, but they line up with the AAMC’s official warning that some, not necessarily all, medical schools waive secondary fees for FAP recipients.

The practical lesson I took from r/premed is not that you need to save an arbitrary $5,000 before applying. It is that you should calculate your own list before June, build in enough cash for secondaries to arrive close together, and apply for fee assistance before paying expenses if you may qualify.

What Student Doctor Network Says About Secondary Application Fees

For this article, I also searched Student Doctor Network separately from Reddit and summarized the themes that were useful for a current applicant.

The SDN discussions show the same problem over many application cycles: applicants submit a broad primary school list, then realize that they did not fully account for the cost of receiving a secondary from most of those schools. Older threads contain examples ranging from roughly $50 to more than $100 and applicants discussing whether a particular secondary was still worth completing once the fee appeared.

I would not use the dollar amounts in an old SDN thread to build a 2027 budget, because individual school fees can change considerably over time. The useful part of those discussions is the behavior that keeps repeating: people underestimate secondaries, assume a primary designation is the last time they will pay for that school, and sometimes discover after the fact that they applied somewhere they are no longer willing to spend another fee on.

That is exactly why I would use the current AAMC MSAR data for numbers and SDN for applicant experience rather than reversing those roles.

What Medical School Admissions Offices Say About Secondary Fees

I also searched medical school admissions pages and admissions-side commentary specifically for this article because I wanted to see whether the advice applicants give one another matches what schools themselves are saying.

The most useful admissions-side message was not “pay every secondary.” Wake Forest’s admissions office explicitly recommends looking at its prior class profile and deciding whether returning its secondary is in your best interest. The University of Michigan admissions page, which includes commentary from Assistant Dean for Admissions Deborah Berman, explains its screening process and states that approved AAMC Fee Assistance recipients and active-duty military members receive a secondary fee waiver.

I also found an institutional admissions policy from Cooper describing a screening approach intended to ensure applicants who do not satisfy academic qualifications can be notified before remitting an additional fee. Its current admissions page now lists a $100 secondary fee and an automatic waiver for qualifying AAMC FAP applicants.

Those policies reinforce the way I would approach the cost as an applicant. A secondary invitation is another application decision, not a bill you are obligated to pay. Look at your competitiveness, eligibility, fit, interest in the program, and available fee assistance before deciding whether to invest more money and writing time.

How I Would Budget for Secondaries If I Were Applying Again

If I were applying again, I would finalize most of my school list before submitting AMCAS and put a $100 estimated secondary fee beside every school. If the actual fee were $50, I would have extra money left in the budget. If it were $130, I would only be $30 above my estimate rather than being surprised by the entire charge.

I would also research fee-waiver eligibility before AMCAS submission rather than waiting until July. The AAMC specifically notes that Fee Assistance benefits are not retroactive, which makes this one area where doing the financial planning early can have a direct effect on what you ultimately spend.

Once the secondary invitations began arriving, I would record the fee beside the receipt date, deadline, number of prompts, and submission status. That is one reason my has a cost section: the money and the writing workload are happening at the same time, so I would rather manage them in one place than discover both problems separately.

I would also keep moving reasonably quickly once I decided to submit. My guide to explains why I view approximately two weeks as a useful organizational goal rather than a universal admissions deadline. Paying early does not help you if the essays are careless, but paying for the secondary and then allowing it to sit unfinished does not accomplish anything either.

How to Reduce the Cost of Medical School Secondaries

The biggest savings usually come before the secondary arrives. A thoughtfully constructed school list prevents you from paying a primary fee for programs you would later abandon, while understanding automatic versus screened secondary policies helps you anticipate how many supplemental applications may actually arrive.

I would also use historical prompts before the cycle to understand how much writing a school may require. My Medical School Secondary Intelligence database organizes prompts by type, which can help you see what you may eventually be paying and writing for, while my can help you decide whether the program actually fits you before you invest more money.

If you are going to submit, I would try to make the application worth the cost by doing the writing carefully. My newer guide to answering “Why This Medical School?” without sounding generic gives you the framework I would use now, while my preserves an actual example and more of the perspective I had closer to my own application cycle. Before paying and submitting, you can also run the essays through my free 100-point secondary essay self-review rubric.

If your secondaries have already slipped later into the cycle, cost becomes part of prioritization rather than a reason to panic. My guides on whether August is too late to submit medical school secondaries and whether September is too late to submit medical school secondaries explain how I would weigh timing, competitiveness, school fit, and the likelihood that I would actually attend before putting more time and money into a late application.

Is $100 Per Medical School Secondary a Good Estimate?

Yes. I think $100 per school is a very reasonable planning estimate for an applicant who does not know their exact fees yet.

It is not the true fee at every medical school, and the published all-school study found a somewhat lower $83 average among fee-charging programs. I prefer budgeting $100 because current MSAR fees frequently reach or exceed that amount, and having money left over at the end of secondary season is much better than needing to find another $600 halfway through July.

How Much Do 20 Medical School Secondaries Cost?

At a simple budgeting estimate of $100 per secondary, 20 medical school secondaries would cost approximately $2,000.

Using the $83 mean found in the 2025 systematic review would produce an estimate of approximately $1,660, but your actual total depends entirely on the individual schools. For planning purposes, I would put $2,000 aside if I expected to complete secondaries at 20 schools and then be pleasantly surprised if the total came in lower.

How Much Do 30 Medical School Secondaries Cost?

Using the same $100-per-school planning estimate, 30 secondary applications would cost approximately $3,000.

That number is only for secondaries. If you are applying to 30 AMCAS schools in the 2027 cycle, your primary AMCAS fees would be another $1,572 before secondary applications, bringing the primary-plus-secondary planning estimate to approximately $4,572 before other application expenses.

Do Medical School Secondaries Cost $100 Each?

Many do, but not all of them. Current fees can be substantially below or above $100, which is why I would treat $100 as a budgeting estimate rather than a universal price.

The current AAMC MSAR data contain examples ranging from low-cost secondaries around $30 to substantially more expensive applications reaching $150 and even $200. Check each school’s current admissions information before assuming the amount.

Are Secondary Application Fees Included in AMCAS?

No. The AMCAS fee covers your centralized primary application and the medical school designations you select through AMCAS.

Secondary application fees are established by the individual medical schools and are paid separately as you complete their supplemental application processes.

Can You Skip a Medical School Secondary?

Yes. Receiving the application does not require you to submit it.

I would reconsider the school before paying if you discover that you do not meet an important requirement, would no longer attend, have very weak fit, or added the program without much thought. If the school remains a legitimate choice for you, then I would complete the application rather than allowing the fee alone to make the decision.

Are Medical School Secondary Fees Waived With AAMC Fee Assistance?

Often, but not universally. The AAMC states that some medical schools waive secondary application fees for Fee Assistance Program recipients and directs applicants to individual school policies for confirmation.

That wording is important because you should not assume that the AMCAS benefit itself automatically pays every future secondary fee. Check MSAR and the school’s admissions page before budgeting the fee as zero.

Are Medical School Secondary Fees Refundable?

Usually not once the application and payment have been submitted. Several medical schools explicitly state that their secondary application fees are nonrefundable, so I would assume the money is committed unless the school says otherwise.

This is another reason to make your school-list decisions before clicking submit rather than paying first and deciding later whether you really wanted to apply.

How Much Should I Save for Medical School Applications?

For secondaries specifically, I would take the number of schools you realistically expect to complete and multiply by $100. For 15 schools, I would reserve about $1,500; for 20, about $2,000; and for 25, about $2,500.

Then calculate the primary AMCAS fees and your other application expenses separately rather than pretending the secondary budget represents the entire cycle. The AAMC’s official guide to the cost of applying to medical school is a good place to check the current centralized fees and other categories of application expenses.

Going through medical school applications myself made me much more aware of how many separate decisions are hidden inside what looks like one application process. Secondary fees are frustrating because they arrive at the same time that you are trying to write quickly and make good decisions about dozens of schools, but they become much easier to manage when you know the likely cost before the emails arrive. Build the school list carefully, budget around $100 per secondary, investigate fee assistance early, and spend the money on applications you would actually be excited to pursue.