The implementation of new debt-free scholarship programs in four top-tier medical schools could have a tremendous impact on the future of the physician workforce. Often a huge disincentive to attending medical school, the grave cost of a medical education can place an insurmountable barrier for students with great financial need. However, large donations by various foundations and university alumni are aiding universities in making medical school a tuition-free endeavor.
Schools implementing this initiative are attempting to address the high debt and loan dependence of affording a medical education. To this end, schools like Columbia University, New York University, Cornell University, and the Kaiser Permanente School of Medicine, are implementing new financial aid programs that replace student loans with scholarships. In addition, some of these scholarships are not only covering tuition, but also books, food, and other related expenses. The funding for these initiatives is supported by multiple funding sources including an endowment fund, and donations from various foundations, organizations, and alumni. Moreover, this tuition-free initiative does not ignore dual-degree students who pursue M.D.-Ph.D. degrees. Students seeking a dual-degree will be provided full tuition and living expenses stipends from different funding sources including the National Institutes of Health.
The scholarship program comes as a result of high medical school tuition costs. Currently, the median cost of tuition and fees of attending a private medical school averages at almost $83,000 per year. Medical students who take out loans to afford these costs graduate with a median debt of $200,000. Universities hope that these scholarships can remove the financial burden of taking out such loans.
Notably, these tuition scholarship programs are expected to also encourage more students from all backgrounds to apply and ultimately attend medical school. A surge in applications to NYU School of Medicine serves as a testament to the increasing numbers of students applying from underrepresented backgrounds. In fact, NYU School of Medicine experienced an increase of almost 3,000 applications with applications from underrepresented minorities up more than 100 percent.
However, donors and university leaders hope that students will be encouraged to seek a diversity of medical paths without regard for debt. Indeed, past studies show that debt can have an impact on the practice that students choose to pursue. A survey fielded by the Association of American Medical Colleges’ Medical School Graduation found that about twenty percent of medical students consider their student debt to be either a strong or moderate influence on the specialty they choose to follow. In addition, a 2014 Medical Education Online study of 3,032 medical students, found that higher-debt students were less likely to have plans to practice in underserved areas. By removing students’ sizable loans, donors hope students can diverge from lucrative career paths to pursue careers in research-oriented specialties, family practice or pediatrics.
Perhaps most importantly, these scholarships have implications for the future workforce of primary care physicians. A 2014 study, examining the relationship between educational debt and primary care specialty choice suggests that limiting high levels of debt, particularly for students with need-based loans, could promote a larger workforce of primary care and family medicine physicians. Through a retrospective multivariate analysis of data on more than 130,000 physicians who graduated in the years 1988-2000, researchers found that students were more likely to practice in primary care or family medicine, when their debt was low (debt levels of $50,000-100,000). The conclusions of this study hold deep implications for lower-income students and suggest that if scholarship funds are targeted effectively it could grow the primary care physician workforce.