The average age of U.S. medical school matriculants has steadily increased as gap years have shifted from optional exploration to competitive necessity. Nearly three quarters of recent matriculants are age 23 or older, reflecting delayed entry into medical training. Because medical education is heavily subsidized through federal research funding, graduate medical education payments, and publicly backed student lending, delayed entry into practice carries system-level consequences. This manuscript introduces physician-years as a measure of return on public investment, defined as cumulative years of clinical service delivered after training. Applying observed and projected graduation ages to retirement benchmarks demonstrates a measurable decline in expected physician-years across recent cohorts, with even modest age increases translating into tens of thousands of forfeited physician-years nationally. Simultaneously, admissions incentives that reward prolonged credential accumulation function as socioeconomic filters and misalign with institutional missions centered on diversity, primary care, and service to underserved communities. Realigning admissions incentives to decouple time from competitive advantage offers an upstream strategy to improve workforce supply, equity, and the return on public investment in medical education.