Training in medicine requires high-quality instruction and access to specific, often expensive, facilities and resources. But, even if the value of medical school matches its price-tag, doctors do not always scrape up enough money to quickly and comfortably pay back their loans. As Dr. Westby Fisher, a cardiologist and medical blogger, notes, the image of the wealthy physician, flush with cash, no longer corresponds to the experiences of many doctors.
As a result of mounting costs, some students are opting out. Having to borrow hundreds of thousands of dollars to attend school can dissuade many would-be doctors from applying. It can also encourage those who do apply to flock to high-paying specialty fields. This hurts low- and middle-income students, and it robs society of doctors dedicated to serving the public interest.
Medicine is a public service, and students rarely pursue medical degrees for money alone. The prestige associated with the profession—which persists more from cultural inertia than from an accurate conception of physicians’ incomes—continues to lure some, but many who enter the medical field do so to apply their knowledge and training to help treat illness and improve wellbeing. It concerns us that individual medical schools and the government at all levels are not doing more to ensure students who want to practice medicine have access to medical training. In our view, students interested in medicine and qualified to study it should be able to attend medical school, regardless of their means.
Government and medical school budgets are tight, but both should make financial aid for medical students a priority. Ideally, medical training would be free or highly subsidized, as Ph.D. programs often are. Many doctors, like many academic researchers, apply their skills in the public interest, and subsidizing their training is not only fair, but pragmatic.
Because, however, resources are scarce and budgets lean, medical schools should at the very least offer some form of debt forgiveness for graduates pursuing low-paying jobs that serve the public good. Some law schools, like Yale, encourage graduates interested in low-salary, public service work to pursue those jobs by agreeing to forgive a portion of their debt. Although defining “public good” is a difficult task, medical schools ought to consider relieving the debts of doctors who eschew lucrative specialty practices for general practice or non-profit and government work.
Graduate study, especially professional training, is often astonishingly costly, and governments and universities should seek ways to lower financial barriers of entry for those interested in graduate school. This is particularly important for fields of study, like medicine, whose graduates often work in the public interest.
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