The reality is the "bar" ensures most people in medical and dental schools come from upper middle and upper class families. It works to deter not those who are

The reality is the "bar" ensures most people in medical and dental schools come from upper middle and upper class families. It works to deter not those who are more than capable, but those that cannot incur huge costs to get into medical school. That includes volunteer time, extracurriculars, going on "mission trips" in undergrad to volunteer to help in medical clinics abroad, very expensive application costs (if you aren't in the 0.1% academically you NEED to apply to a lot of schools), paying to travel for medical school interviews, etc. Not to mention the opportunity costs of doing these things instead of working a paying job. It doesn't end there. I have twice this year hosted friends from out-of-state that came to my city to interview for fellowships. Even after completing a residency most (all?) hospitals and medical groups will not pay for your travel to interview with them. One of these friends told me he is paying ~10k in travel costs to interview across the country for a fellowship position...thankfully he has a trust fund. I believe he faced similar costs when applying for residency. It is insane. And that's just one aspect of medical education that deters otherwise great people. If Cuba can figure out how to output a huge number of successful physicians (to the point that they placed them in other countries) there's no reason America can't other than apathy.