Editor’s Note: A version of this story first appeared in Mile Markers, a twice monthly newsletter from Open Campus about the role of colleges in rural America. You can join the mailing list at the bottom of this article to receive future editions in your inbox.
The hidden hurdles rural students face with online testing don’t just stop at undergraduate admissions tests like the SAT or ACT.
They also challenge those taking tests to get into professional schools, with deep ramifications for first-gen and historically underserved students, as well as for the makeup of the nation’s future doctors and lawyers.
When Karla Rosario first immigrated to West Philadelphia from the Dominican Republic as a high school junior, one teacher told her she was never going to be more than a bodega store clerk or a drug dealer’s girlfriend.
Rosario learned English and graduated from the Community College of Philadelphia and Temple University.
After two years working as a paralegal processing asylum claims at the U.S. border with Mexico, Rosario quit her job just over a year ago. She planned to live on savings for three months while studying for the LSAT.
She lives in Brownsville, Texas, which faces challenges rooted in its poor, rural history.
Its notoriously unreliable internet made studying even more difficult as Rosario, 26, studied online using free Khan Academy courses, unable to afford a tutor or expensive LSAT prep books.
Three months became seven, her savings nearly gone as October arrived. And Rosario still didn’t even know where she could take the test.
Due to the pandemic, students could take the LSAT online from any location, so long as they followed certain security protocols. But the unreliable Brownsville internet meant her apartment was out of the question.
The local library only had two private rooms, which couldn’t be reserved, and had a two-hour limit. The test is three hours long. A local test center told her to try another in Edinburgh an hour away — she drove there, only to find it couldn’t offer the LSAT either.
She called the Brownsville school district, but got shunted between departments before finally giving up.
She called the city council, but got a busy signal; She even emailed billionaire Elon Musk’s company SpaceX, asking if the region’s largest private employer might have a space for her to take the test, but never got a response.
Eventually, Rosario called a former professor at Community College of Philadelphia, who called Brownsville law firms vouching for her until one of them let her take the test in an empty office.
After spending years of savings to take the LSAT, Rosario finally got back her score. 132: two points less than the practice test she took before she started this process all those months before.
If there are disproportionate barriers to getting into law for rural students of color like Rosario, that affects the types of lawyers we get — as barriers in medicine, education, and other fields will affect the professionals we get in those spaces too.
“The funny part is, I don’t want to go to law school to get rich. I want to do public service, to help asylum seekers and people in need, ” Rosario told me.
Rosario took a break the last few months, to work and build up her savings again.
More Rural Higher Ed News
Get Funded: White House Launches ‘Rural Playbook.’ The White House is embarking on a 30-stop rural infrastructure tour led by president Joe Biden and various cabinet officials, promoting the release of its Rural Playbook aimed at telling rural governments the “what, when, where, and how” to apply for infrastructure dollars.
- Why It Matters. Since I started my newsletter in December, experts and sources have made one thing clear: There is more funding available for rural schools and students than ever, yet they often don’t have the resources or capacity to stay abreast of those opportunities or to apply for them. This playbook seems to address the awareness gap head on.
How cyberattacks sealed a rural college’s fate. Hacks are rising, and this sobering Forbes piece tells the story of Lincoln College in Illinois, which paid a ransom to get back access to critical data only to realize too late that enrollment was dangerously low.
A six-hour commute to chemistry class. Each week, Ashlyn Adakai and her father drive 300 miles roundtrip from Navajo Nation to Northland Pioneer College’s campus in Winslow, Arizona. The first of her six siblings to go to college, she dreams of becoming a doctor to serve her medically underserved community.
On April 28, she is traveling to Temple University for a ceremony after being named to her alma mater’s 30 under 30 list.
And in May, she will enroll in a summer LSAT prep course and begin studying for the test again — this time, in Philadelphia.
New Routes and Requirements
A year ago, my sister moved in with me while studying for the MCAT, with goals of attending med school that she has since left behind.
Seeing her experience, and hearing about Karla’s, I became fascinated with what I call “the missing year,” when recent graduates prepare to take the LSAT, MCAT or other admissions tests and apply for professional schools.
We don’t currently have a good way to track these students who spend their undergrad years preparing to become lawyers or doctors, only to drop out in this missing pre-professional year.
Still, some are trying to create new routes into the medical and legal professions to make it easier for students like Karla and my sister.
Latham & Watkins, one of the largest law firms in the world, has seen more than 50,000 people participate in its free virtual learning programs launched in October 2019 to reach students who otherwise might not be exposed to the profession.
Students in rural areas, many of which have few if any local lawyers, often don’t have examples of people from their own community who have successfully pursued law school.
They might not consider it a viable path, says Robin Hulshizer, a Northwestern theater major who herself didn’t consider law until she took a career profile test suggesting it.
“This is just another way to open their mindset to something they might not have thought of,” says Hulshizer, now a Latham partner. She grew up on a farm in rural Martelle, Iowa.
“They’re going to have a different view and perspective to any problem, but also a passion for, and sensitivity toward, areas that people in the big city may not necessarily have.”

Rural areas are similarly underserved when it comes to medical professionals, with only about 13 physicians, compared to 31 in urban areas, per 100,000 people.
It’s an issue dear to David Lenihan, president of Ponce Health Sciences University (PHSU) in Puerto Rico, one of the largest producers of Spanish-speaking doctors in the United States and its territories.
“My two children are in medical school. They’re going to be great doctors, they’re academically gifted, they care. But they’re not going to practice in rural Nebraska.”
They grew up in St. Louis, where he’s based, and haven’t experienced life in a rural area. His point: If you want rural doctors, you need to accept rural students. But many are overlooked.
They are more likely to come from areas with higher poverty and lower wages, meaning finances can keep them from attending.
The average medical school applicant applied to 15 schools in 2018-19, racking up more than $750 in application costs, according to the Association of American Medical Colleges. That cost alone can be prohibitive.
PHSU de-emphasizes the MCAT in admissions, Lenihan says. “It’s not a good test to see who is and who is not going to be a good doctor.”
Rural students may have lower GPAs in undergrad, often starting behind due to not having access to the same science courses or resources as their urban peers in high school.
PHSU offers a Master of Science in Medical Sciences (MSMS), which Lenihan says helps students who couldn’t get into medical school initially get on track before re-applying.
“They now have their feet under them,” Lenihan says, “and, through this program, are the leaders in class because they’re already familiar with the subject matter.”
Even More Rural Higher Ed News
A checkup for rural Washington. The Rural Health Initiative at Washington State University’s pharmacy school just accepted its inaugural five-student class after receiving a $2.2 anonymous gift to fund the three-year track, which includes specialized coursework in rural demographics and employment as well as rotations in rural settings.
The rootEd Alliance grows. The counselor-placing nonprofit serves about 6,200 students in 56 rural high schools across Texas, Idaho, and Tennessee, and Missouri — and the latter is scaling its pilot program statewide after FAFSA completions grew by 10% and nearly a quarter of students said they wouldn’t have attended college otherwise.
Upcoming: A Rural Summit. Next week, Partners for Education at Berea College and co-host Education Forward Arizona are leading the 2022 Rural College Access and Summit in Scottsdale. Check out the schedule here.
The program says that 82% of MSMS graduates applied, gained acceptance and continued on to their preferred health school — and Lenihan says they are often the types of doctors more likely to return to rural areas and practice.
“This problem will take generations to fix, but we have to start looking outside the box.”

This article first appeared in Mile Markers, a twice monthly newsletter from Open Campus about the role of colleges in rural America. Join the mailing list today to have future editions delivered to your inbox.