Making Medical School More Affordable

Always a trailblazer, The Mayo Clinic’s Medical School has had a generous scholarship program for the past 20 years that enables about 60 percent of its students to attend school tuition-free. The 50 students who started at Mayo last summer each received $25,000 to use towards tuition of $29,200. Students also are eligible to receive an additional $2,000 to $5,000 a year based on need, said David Dahlen, director of student financial aid at Mayo, based in Rochester, Minn.

Now, a few other schools are experimenting with much-needed financial relief for medical students. Most notably, the University of Central Florida’s brand new med school is offering four-year scholarships for tuition, fees and living expenses for every member of first-year class.  Students have until December to apply; already, the school has received 2,996 applications for its charter class of 40.

The Wall Street Journal reports that the $7 million needed to fund the charter class came from individuals and private philanthropies. There was no single donor who did most of the work; the two largest gifts were each a bit over $300,000. Perhaps other medical schools could follow this model.

The bad news is that this first class is the only one that will receive such a sweet deal. There will be some scholarships for students in subsequent classes, but essentially the University of Central Florida is using the financial packages to attract a top entering class, hoping that this will set the pace for the school’s future.

Mayo, of course, doesn’t need to offer financial enticements to draw the best students. It is simply part of the school’s “philosophy that your qualifications, motivation and commitment to service–rather than finances–should guide your decision to apply to medical school.”

Now, the Cleveland Clinic has set out to follow Mayo’s example. The 32 students entering the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University later this year will pay no tuition. The Cleveland Clinic will use its endowment and revenue from hospital operations to cover the $43,500 tuition bill to Case, which is affiliated with the clinic. And more scholarship aid will be given to current students.

The Clinic’s goal is to free students from the feeling that they have to choose high-paying specialties to pay off the debt, rather than going into academic and research oriented medicine, toward which the Clinic program is geared.

Finally, Harvard University has announced that it will reduce the cost of a four-year medical education by as much as $50,000 for families with an income of $120,000 or less. In the past, a student’s family had to pay about $12,500 annually toward the tuition, fees, and living expenses that make up the $65,000 cost of a year at Harvard Medical School, before the student became eligible for $24,500 a year in subsidized federal and institutional loans.

“Harvard’s initiative comes at a time of widespread concern among physician leaders that the rising cost of medical school discourages lower-income students from pursuing medical careers,” the American Medical Association reported, “and sways some medical graduates to pick high-income specialties.”

Of course, when it comes to financing medical school education, the U.S. remains an outlier. Most developed countries view medical education as a social good, and governments fund all or a significant part of the cost. Nevertheless, these changes suggest that medical schools are becoming aware of the need to attract a broader swathe of students. Today, 60 percent of all medical students come from the wealthiest one-fifth of all U.S. families. Another 20 percent come from families lucky enough to be on the fourth step of a five step ladder. According to the NEJM, a recent national survey of under-represented students reveals that the cost of attending medical school was the number-one reason they did not apply.

Maggie Mahar is an award winning journalist and author. A frequent contributor to THCB, her work has appeared in the New York Times, Barron’s and Institutional Investor. She is the author of  “Money-Driven Medicine: The Real Reason Why Healthcare Costs So Much,” an examination of the economic forces driving the health care system. A fellow at the Century Foundation, Maggie is also the author the increasingly influential HealthBeat blog, one of our favorite health care reads, where this piece first appeared.

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4 replies »

  1. With reference to National Health programs that sponsor medical students and require several years of payback after residency in needy areas, these “schalarships” are very competitive. Why haven’t our politicians expanded this program to an open federal program? It seems like an easy way to solve the problems of expense to attend medical school and service to the needy simultaneously, and the demand by medical students obviously already exists.

  2. Gary L. and Peter–
    Thanks for your comments.
    Gary L–These are, as you say,, relatively small programs–and there are no strings attached.
    The Cleveland Clnic expresses the hope that students will go into academic research–which is what the Clinic
    stresses in its med school prgram. Probably many/most will–
    Mayo’s philosophical bias has always been in favor of
    medicine where doctors are on salary, collaborating. Med Students who grow up in the Mayo culture are likely to go that route. (Reserach shows that this often (not always) leads to the best outcomes, so this is good news for patietns.)
    Harvard’s program is part of Harvard University’s overall push to open up elite universities to lower-income families. They’re also offering significant scholarships, based on need, to undergraduates and in other Harvard programs.
    Peter– Insofar as these programs are funded by private
    philanthropists, they probably are not going to ask for
    “Payback” to the larger society. Though I do think that both Mayo (because of their overall “philosophy” about healthcare and Harvard ( by diversifying their med school classes) may well do some social good.
    But if the federal government (i.e. taxpayers) begin to pay for loan-forgiveness and scholarship programs for med students, then I think we can definitely assume that we would be asking that students work in areas where they are needed for a certain number of years.
    While the programs I have written about are small, the news ones may well signal that people are beginning to realize that the cost of med school is too high for middle-class, lower income, and even many upper-middle-class students and their families.
    And I think people are beginning to realize the need to draw our doctors from a larger pool–and to begin to do some social planning in the form of helping students afford med school who are willing to serve where they are needed.

  3. I too would expect some payback from this. For instance can the graduated doc set up an exclusive concierge medical practice to treat the well heeled and deny the community another PCP?

  4. This sounds pretty good, and whatever can be done to help 50-200 students become physicians is a good thing.
    No one has mentioned that this is a drop in the bucket for what is needed.
    What type of ‘strings’ are attached to this benevolence?
    Will the recipients be required to work at Mayo, or be required to go into ‘primary care’? Will there be other requirements to serve in underserved areas?? If this is truly a service oriented rather than a financial plan what is the payback?
    There are several military programs already in place that offer scholarships of this nature to any school of medicine. What is the requirement to complete school, and what happens if someone drops out.

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