August 27, 2018

Don't 'pity physicians' who are in debt, critics say: Why NYU's plan to waive med school tuition is attracting pushback

Daily Briefing

    NYU's School of Medicine made the big decision to waive tuition last week—drawing elated reactions from medical students, but leading some critics to argue that there are better ways to diversify the student body and address student loan debt, Kaiser Health News (KHN) reports.

    September 17 webconference: Win physician buy-in in 15 minutes or less

    About NYU School of Medicine's free-tuition plan

    NYU School of Medicine on Aug. 16 announced that it would waive tuition for all of its current and incoming students, calling the move "a huge game-changer for us, for our students, and for our patients."

    The decision was met with "cheers" from students, according to KHN. According to the Journal, tuition for the upcoming academic year had been set at $55,018. The Journal reports 62% of NYU School of Medicine's most recent graduating class had an average of $171,908 student loan debt for medical school and $184,000 in overall student loan debt.

    While the institution will offer full-tuition scholarships, medical students will still be responsible for other expenses, such as books, room, and board.

    But will the plan actually achieve its goals?

    In announcing their plan to waive tuition, NYU leaders said they hoped to address the rising student loan debt among recently graduate physicians, which they argued can deter college students from pursuing medical careers and discourage medical students from pursuing lower-paying specialties.

    But some critics argue that eliminating tuition for all students—including those who could afford to pay in full—isn't the right approach, according to KHN.

    "As I start rank-ordering the various charities I want to give to, the people who can pay for medical school in cash aren't at the top of my list," said Craig Garthwaite, a health economist at Northwestern University's Kellogg School of Management.

    When the decision was announced, NYU officials said that student loan debt causes medical students to elect higher-paying fields like cardiology—and that eliminating that debt might draw students toward lower-paying fields.

    But data from the Association of American Medical Colleges (AAMC) suggests that strategy might not work, according to KHN. "Debt doesn't vary much across the specialties," said Julie Fresne, AAMC's director of student financial services and debt management.

    In the announcement, NYU school officials also said they expect the prospect of free tuition to attract a more diverse applicant pool. "A population as diverse as ours is best served by doctors from all walks of life," said Robert Grossman, the dean of NYU School of Medicine and CEO of NYU Langone Health. "[Medical students] should not be prevented from pursuing a career in medicine because of the prospect of overwhelming financial debt."

    But Garthwaite argued that offering covering students' tuition is "not the most target-efficient way" to encourage economic diversity or to influence students to take interest in lower-paying primary care specialties.

    Aaron Carroll, a pediatrician and researcher at Indiana University, questioned the significance of medical school debt for people who make, at the very least, six figures per year. "Doctors in general do just fine," Carroll said. "The idea we should pity physicians or worry about them strikes me as odd" (Korn, Wall Street Journal, 8/16; Rovner, Kaiser Health News/NPR, 8/23).

    September 17 webconference: Win physician buy-in in 15 minutes or less

    To win true buy-in for change initiatives, clinical leaders must move beyond purely intellectual arguments and proactively address physician's underlying emotional reactions.

    Join this webconference to learn an effective tactic for building buy-in: facilitating a targeted number of one-on-one "Pre-Wire Check-Ins" with key physician stakeholders.

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