Easing medical student debt: Some solutions

Summer is drawing to an end, and a new group of bright-eyed, idealistic first-year medical students is settling into campuses. These students should be focused on anatomy as they begin their journey to become the nation's next generation of physicians -- not worried about how they will pay for their education.

Unfortunately, though, how to pay for classes is increasingly on medical students' minds.

The median price tag for a year of allopathic medical school in 2004 stood at more than $19,000 at public institutions -- 169% more than in 1985 when adjusted for inflation. Students at private schools granting MDs paid more than $37,000 in tuition -- a 53% increase over 1985 when adjusted for inflation.

Those figures come from data the Assn. of American Medical Colleges collected. And not surprisingly, the data show that the median student debt has soared as well.

In 2005, the median debt for those who earned their MDs at public schools was $115,000. That figure jumps to $150,000 for MDs who attended private schools. The story is similar for doctors with new DOs. Students graduating from DO-granting medical schools in 2003 had an average $134,000 in debt, according to a report from the American Medical Association.

That's a lot of numbers to digest. But those numbers have a real impact on medicine.

Specifically, debt can play a role in everything from whether the nation's best and brightest go to medical school to, perhaps, what specialty future physicians choose.

The AAMC conducted a national survey that found that students academically qualified for medical school but didn't apply decided against medical school, in part, because of the cost.

And although no studies have found convincing evidence of a connection between specialty choice and indebtedness, anecdotally, some students have reported that they choose a higher-paying specialty, in part, to help pay back their student loans.

The AMA has numerous policies directed at reducing young physicians' debt burden. It lists reducing debt as a high priority for legislative and other action.

It's a problem that requires a broad-based set of solutions, and these are among the things that need to happen:

• Stable funding for medical schools to eliminate the need for increases in tuition and fees to compensate for unanticipated decreases in other sources of revenue.
• Financial aid opportunities, including scholarship and loan repayment programs, so that individuals are not denied an opportunity to pursue medical education because of financial constraints.
• A sufficient breadth of financial aid opportunities so that a student's specialty choice is not constrained based on the need for financial assistance.
• New and expanded medical education financial assistance programs from the federal government, the states and the private sector.
• Legislation that allows interest from medical student loans to be fully tax deductible.

With collaboration on these issues among the AMA, members of the House of Medicine, the medical education community, private sector and government, students could see their debt burden eased. In turn, medical students could worry less about the cost of tuition and focus that energy on the hard-enough task of studying for a career that fills a critical need in society.