Student Debt—The Real Story
Physicians and surgeons spend an average of twelve years in post-graduate school, half of which they are paying hundreds of thousands of dollars for their education. The other half they are being paid less than the typical plumber. Once they begin as practicing physicians, nearly all of their income will go back out towards repaying loans, spending into their private practice, and malpractice insurance. A recent article in the New England Journal of Medicine illuminates how high some of the tuition increases are. Tuition increases for both private and public medical schools have risen exponentially beyond the consumer price index (CPI) over the last several years, and continue to rise. Having recently finished the medical school application process, I can attest to the fact that public versus private medical schools are no longer offering a significant difference in tuition. Students are looking at possibly a $10,000 difference in overall expenses between an in-state public and private school, but when overall expenses are $60,000 at the public school to $70,000 at another, does it really make much of a difference?
Perhaps the most frustrating part of this article is when the author explains that over half of students currently in medical school come from high income families. It is argued that the major issue with the high cost of medical schools is deterring students from low-income families from going to medical school. Now, that is just flat out wrong. I am on the inside of this process, and that is certainly not the case. The high prices of medical school right now are deterring students from high-income families from attending medical school. Why? Because financial aid programs factor in what they call “parental contribution” to medical school expenses. What this means is that for students coming from high-income families, they are left to fund 100% of their education on their own. After graduating from college, I would venture to say that nearly all students, minus one or two in each class, are entirely independent from their parents, especially from their income. At this age, our parents are nearing retirement, and very few people in their fifties and sixties have hundreds of thousands to spare. How is one student, who’s parents are very successful financially, but who are not going to pay a cent for their child’s medical education, any different from a student who’s parents do not make very much so they are not able to contribute to their child’s medical education? Either way, medical students are almost always entirely independent. Thus there is a divide: there are the students from low-income families who are receiving loads of government scholarships and grants, as well as low-interest and subsidized loans, and there are the others, who are equally “needy” but who are paying $70,000 a year in unsubsidized loans of 8.5% interest per year.
It might be said that students who come from high-income families should go to their state school or choose a school where they can afford to go, but there are two things I have in response to that: 1) It’s medical school. Students typically get into one or two schools, if any at all; hardly a “choice,” especially if both schools give the same financial aid and 2) is that not discrimination? Sure that sounds harsh, but would we say it is alright to suggest to students of low-income families that they just attend their state school, because it’s cheaper? Or that they choose a school that they may not like because it has a better financial aid package? No!
I hope that the reality of the situation is truly recognized (and by the right people) during this time of health care reform, because there is no way that those students looking at half a million in debt at the time of graduation (some students only twenty five years old) are going to charge you less for an operation. They are going to do too many each day, see too many patients, and make too many mistakes, because the money has to roll in. Someone has to put food on their table so that they can have families of their own; lives of their own, and it’s a sad outlook for many medical students today. It’s no wonder health care is so expensive.
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