The Crushing Loan Burdens of Medical School

Sophie Baldwin, 8/12/24

The journey to medicine is not easy. Throughout their four years of college, prospective students must take the MCAT, gain clinical experience, and pursue research opportunities in order to have the best chance of getting into medical school. If they are lucky, they will get in the first year they apply. But, throughout this process, students are forced to consider an additional factor: cost. Undergraduate degrees alone are not cheap, with the average private school tuition totaling over $230,000 for four years while an in-state public school bachelor’s degree totals over $180,000 (Education Data Initiative). If many students come out of college already in debt, how are they expected to foot the bill of four more years of medical school tuition?

According to the Education Data Initiative, 73% of medical school graduates take out loans, and the average medical school debt is $202,453. The sticker price for medical school has increased exponentially over the past few decades, even accounting for inflation. In 1978, the average medical school debt was $13,500, or $53,648 when adjusted for inflation (EDI). To make matters worse, scholarship opportunities are much more limited for medical school. Unless a student attends a tuition-free medical school such as the Cleveland Clinic Lerner College of Medicine or the NYU Grossman College of Medicine, they can expect to pay tens of thousands of dollars a year in tuition and fees.

A common myth is that doctors are vastly wealthy. While that is the case for some, for most doctors, it takes many years to start making a good salary. After eight years of education, doctors must undergo 3-7 years of residency, plus another year or two of fellowship, if desired. During residency, most doctors only make around 60,000 per year, despite working up to 80 hours a week. The paltry salary during residency causes many physicians to delay loan repayment, which only means they will rack up more debt in interest. Depending on the payment plan, some physicians can expect to be paying off debt for decades after they begin their career.

These exceedingly high costs are barriers to aspiring doctors in low socioeconomic groups and contribute to growing disparities in medicine. With sticker prices nearing 100,000 each year, many simply cannot afford to achieve their dreams. In addition, high medical school costs contribute to physician shortages in rural areas. After coming out of residency, many doctors look for jobs with high starting salaries so that they can begin to chip away at their debt. Since doctors in rural areas are typically paid less than those in urban areas, many physicians are driven away from these areas. This drives inequities between rural and urban areas.

What are some options for reducing medical school debt? One of the biggest options are loan forgiveness programs, which come in many different forms. There are many government forgiveness programs, including the National Health Service Corps Loan Repayment Program, which offers up to 50,000 for primary care physicians in underserved areas, or the National Institute on Minority Health and Health Disparities, which offers loan repayment in exchange for research on health inequities. Many government loan forgiveness programs are geared towards primary care physicians and encourage them to help reduce health disparities. Essentially, this attacks two problems at once: understaffing in certain areas and vast physician debt. Another option for physicians is to serve in the army, navy, or air force. Physicians who work in the armed forces for a certain number of years will have some loans forgiven.

While loan forgiveness programs are taking steps in the right direction towards reducing medical school debt, the root cause lies at exponentially increasing medical school tuitions. In order to truly reduce healthcare disparities, medical schools must get their tuitions under control.

References

American Medical Association: How med student loan burdens can deepen health disparities

https://www.ama-assn.org/education/medical-school-diversity/how-med-student-loan-burdens-can-deepen-health-disparities#:~:text=The%20Association%20of%20American%20Medical,repayment%20to%20reach%20nearly%20%24450%2C000.

American Academy of Family Physicians: Loan Forgiveness for Medical School Debt

https://www.aafp.org/students-residents/medical-students/begin-your-medical-education/debt-management/funding-options/forgiveness.html

American Medical Association: 6 things medical students should know about physician compensation

https://www.ama-assn.org/medical-students/specialty-profiles/6-things-medical-students-should-know-about-physician

Education Data Initiative: Average Medical School Debt

https://educationdata.org/average-medical-school-debt 

Education Data Initiative: Average Cost of College & Tuition

https://educationdata.org/average-cost-of-college