Mortgaging Your Life: The Hidden Costs of Medical School Loans

I recently tweeted about a blog post, “The High Cost of Profiting from Student Loans,” that discusses the tens of billions of dollars in profits that the government is making from student loan borrowers. (1, 2) Among these borrowers are medical students who are literally mortgaging their lives away under millions and millions of dollars in debt.

As I entered the Russell Senate Office building several weeks ago to attend a policy briefing, I was greeted by a swarm of medical students – a sea of white coats as far as the eye could see. Why were they on the Hill?

United States Capitol Dome.
United States Capitol Dome. (Photo credit: Wikipedia)

I learned that it was Medical Student Advocacy Day on the Hill. The goal of Medical Student Advocacy Day on the Hill was to raise awareness concerning issues that mattered most to medical students, including the future of medical education, residency training, student debt, and health care reform. (3) Medical students visited House and Senate offices to petition members to preserve Medicare funding for graduate medical education (GME). Of concern is a proposed 2% cut to GME with the federal government sequester. (4)

The Problem

Students also raised awareness concerning the problem of medical student debt. Today, medical students are crushed by overwhelming educational debt. It is estimated that the average medical student owes $161,270 upon graduation. (5) This amount often includes money borrowed to finance their undergraduate education, as well.

The exorbitant financial loan weight can be a significant determinant of specialty choice. A student who would have otherwise chosen a primary care career may opt for a higher-paying specialty, regardless of whether or not the specialty is truly right for the student. This drastic shift in career choice would enable the student to expedite the resolution of the educational debt. (6)

High Student Debt Loads and Personal Sacrifices

High amounts of debt encroach upon other areas of life, as well, delaying or hindering plans for marriage, starting a family, and/or investing in major purchases, such as a home. (6)

Parents who borrow money to help pay for their child’s medical education may place their own financial futures in jeopardy. Statistics in a recent New York Times article indicate that 2.2 million parents over age 60 hold $43 billion in student loan debt. Albeit, the types of student debt (e.g. undergraduate, graduate, medical) are not distinguished in this source. However, the article discusses how those who borrow significantly for a child’s education can exhaust their retirement funds and/or risk bankruptcy. Extension of parents’ working years or a return to work to generate supplemental income are best-case scenarios. (7)

My medical school – Brown – was not a Medical Scientist Training program (MSTP)-designated institution. The MSTP is an NIH-funded program that finances medical and graduate school education for most MD-PhD students in the United States. (8) This meant that we were largely responsible for procuring funds for our education. As a result, the students in my program were at a significant disadvantage compared to students who hailed from fully funded programs. My 8-year MD-PhD at Brown was financed by a combination of loans, scholarships, small grants, parental contribution, personal savings, and a significant grant from the NIH. The National Institutes of Health (NIH) loan repayment program paid for all except a small amount of my educational debt as I worked my way through a residency program in Anatomic Pathology at the NIH Clinical Center. I was extremely fortunate, but most of my colleagues were not as fortunate.

Beyond the Debt

It’s not just about the money, but it is also about having the freedom to explore your passions and fulfill your true potential in all aspects of life. Doctors who are able to explore their passions and fulfill their potential in their dream specialties under the weight of seemingly prohibitive debt are blessed, indeed. As for the others – well, that remains to be seen.

Doctors are not just doctors. We are so much more. We are mothers, fathers, sisters, brothers, sons, daughters, teachers, consultants, writers, medical missionaries, administrators, researchers, scientists, inventors, specialists, businessmen and businesswomen, and colleagues. It’s all out there just waiting for us to explore, but the options can be limited when debt blocks the door.

References:
1. “Buried Under Mountains of Medical School Debt – ‘The High Cost of Profiting from Student Loans’.” http://blogs.law.harvard.edu/billofhealth/2013/05/19/the-high-cost-of-profiting-from-student-loans/. Twitter. Retrieved 23, 2013.
2. Abbott, Ryan. “The High Cost of Profiting from Student Loans”. Bill of Health. May 19, 2013. Blog. http://blogs.law.harvard.edu/billofhealth/2013/05/19/the-high-cost-of-profiting-from-student-loans/.  Retrieved May 21, 2013.
3. “2013 Medical Student Advocacy Day.” American Medical Association. Website. http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/news-events/advocacy-day.page. Retrieved February 11, 2013.
4. “Medical Students Advocate for Future of Medicine.” American Medical Association. Website. http://www.ama-assn.org/ama/pub/advocacy/events/national-advocacy-conference/advocacy-day.page
5. “Background: Student Debt Statistics.” American Medical Association. Website. https://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/advocacy-policy/medical-student-debt/background.page. Retrieved February 11, 2013.
6. Ludden, Jennifer. “Call Me Maybe When Your School Loan is Paid in Full.” NPR Website. July 16, 2012.
http://www.npr.org/2012/07/16/156736915/call-me-maybe-when-your-school-loan-is-paid-in-full. Retrieved March 14, 2013.
7. Lewin, Tamar. “Child’s Education, but Parents’ Crushing Loan.” New York Times. November 11, 2012. http://www.nytimes.com/2012/11/12/business/some-parents-shouldering-student-loans-fall-on-tough-times.html?pagewanted=all&_r=0. Retrieved March 14, 2013.
8. “Medical Scientist Training Program.” National Institute of General Medical Sciences. November 27, 2012. Website. http://www.nigms.nih.gov/Training/InstPredoc/PredocOverview-MSTP.htm. Retrieved May 21, 2013.

Revised May 28, 2013

The U.S. Capitol Wikipedia Image is licensed under a Creative Commons Attribution 3.0 Unreported License at http://creativecommons.org/licenses/by/3.0/deed.en.

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