By taking a gap year after college, pre-med students jockeying for admission to selective medical schools may gain maturity and assurance in their field of choice.

According to last year's admissions statistics from Duke's School of Medicine, the average age of matriculating students was 23 years, two years above the average applicant age of 21.

The higher mean age of matriculating students is an indication that increasing numbers of medical student hopefuls are taking time after college to pursue other interests, said Dr. Brenda Armstrong, director of admissions at the School of Medicine.

"Many people use the time off to explore areas that they will not have the opportunity to [explore] in medical school," she said. "Some do Teach for America or Peace Corps; some need to work to try to offset some of the inevitable costs of medical school."

Moreover, the higher matriculation age of the first-year medical school class is not only a trend at Duke, she said, but a national trend-one that she believes will only continue. Nationwide, the average matriculation age is 24 years, Armstrong said.

"The time away allows students to mature, have some real world life experience before they get to medicine," she said. "Our experience is that the older students are much better prepared for the challenges of health care, having taken some time to grow up themselves."

Similarly, Daniel Scheirer, director of the Office of Health Professions Advising and associate dean of Trinity College, said more pre-med students at Duke are deciding to postpone the application process to senior year or later, instead of preparing for medical school admissions at the typical time during junior year.

During the last application season at Duke, 190 applicants were juniors, while 105 students were graduating seniors, he said. In addition, 60 alumni applied to medical school.

Taking a gap year to engage in unique experiences can improve one's standing in the admissions process, Scheirer added.

"Medical schools find that students who take a gap year are more mature and more confident of their choice of medicine as a career," he said.

Moreover, the grueling nature of medical school may influence students to delay their applications, he said.

"Once you are a med student, your training is pretty much continuous for the next seven to 12 years," Scheirer said. "Then you are faced with beginning your practice and starting to pay off the student loans. You do not have the luxury of taking a year off at this point."

Some medical students, however, said they believe they made the right decision to enter medical school directly after college. Tammy Ho, a first-year medical student, said she simply felt no need to take time off, even as the majority of her pre-med friends took gap years before entering medical school.

"I knew what I wanted to do with my life, and there wasn't anything in particular that I wanted to do for a year," she said.

And though there are some obvious benefits for those who wait, such as "extra time to have relevant medical experiences to add to your application," Ho does not feel any drawback as a younger student among relatively aged peers.

"I do not feel at any disadvantage compared to my older classmates," she said. "I do, however, like the diversity of experiences and backgrounds that comes with having a class with many older students."

Indeed, the broad range of applicant age, which was 21 to 49 years at the School of Medicine last year, is cultivating more diversity in the classrooms.

"The biggest impact [of the age distribution] is an increasingly rich diversity of backgrounds and experience which plays out during the discussions and student interactions that occur on a daily basis," said Dr. Edward Buckley, vice dean for medical education at the School of Medicine. "This is especially true in our 'practice course,' which is a small group course dealing with doctor-patient interactions, the practice of medicine and ethics."

Dr. Eugene Oddone, vice dean for clinical research at the School of Medicine, directs the Clinical Research Training Program at Duke, and personally knows several medical school students who have taken time off after their undergraduate years to engage in research as lab technicians.

"There is no doubt that additional research training before medical school would give those folks a better understanding of the process of research, but it may not provide more in-depth knowledge about medicine in general," he said.

In the past few years, new classes in medical genomics and translational research have been incorporated, Oddone said. But it may take more time to determine how students' varied experiences before medical school affect the school's research program and curriculum.

"It may be that we haven't seen the recent trends hit this cohort of trainees," he said.