Medical Student Debt: Have We Reached the Tipping Point?

Leroy: There are certain students that would have looked at medicine as a viable career and then they say, "No, I can't do that because I can't even imagine owing someone $200,000. You might as well say its $200 million." I'm Gary LeRoy from Dayton, Ohio, Wright State University, Boonshoft School of Medicine, where I'm the Associate Dean of Student Affairs and Admissions.

Announcer: Asking questions, seeking perspectives, searching for answers, algorithms for innovation. Live from Philadelphia at the AAMC 2013.

Byington: Hi, my name is Carrie Byington. I'm from the University of Utah. I'm the Vice Dean for Academic Affairs and Faculty Development in the School of Medicine. Could you give us an idea of what you think the biggest issues are right now, for medical education?

Leroy: First of all the increasing student indebtedness. At our school, the average indebtedness for graduates this past year was over $170,000, and they're are going to have to spend nearly two decades paying that back. So this can't just go on indefinitely because if it's going to increase anywhere from 2-5% in tuition costs every year, at some point you reach that tipping point. I believe that we as a country have reached that tipping point where we have to bend that curve so that it doesn't continue on. So that's one of the big things.

The other one includes the increasing number of students that are going into medicine, which is a good thing for the increasing needs that our society has but you have more students that are going into medicine and needing additional residency specialty programs after they graduate, and those residency programs, the numbers are not actually increasing proportionate with the number of students.

Byington: Has your institution tackled this problem with any methods to help defray some of the debt for your students?

Leroy: What we are trying to do is inform our students about debt management and not borrowing up to their limits in the amount of money that they can borrow, but again, you can only go so far with that.

Byington: Have you made any effort to implement programs on loan forgiveness?

Leroy: Yes, as a matter of fact at our institution in Ohio, we have what we call, "Choose Ohio First Initiative", and that is for individuals that have indicated a commitment to go into primary care specialties, and so we have at each school about seven students that actually will receive a $30,000 a year scholarship when they commit to go into primary care specialties and stay in Ohio and practice in Ohio for three years beyond their residency training.

Byington: Is that an alternative for the people that they are actually choosing, and do you feel that helps with your recruitment?

Leroy: There is a great deal of interest on the part of our medical students, but this is only the second year that we've done this.

Byington: I have a big concern about indebtedness and our ability to recruit diverse students. Do you share that concern?

Leroy: Absolutely. Diversity is another one of our major challenges of the US medical school system because, again, when you increase the indebtedness of our students, there are certain students that would have looked at medicine as a viable career and then they say, "No, I can't do that because I can't even imagine owing someone $200,000. You might as well say it's $200 million."

I, as African American family physician, felt that same kind of struggle when I was thinking about going into medicine. It kind of puts us in this precarious situation where you have are a lot of children, young people that come from affluent backgrounds going into medicine because they don't feel as much of the strain of owing that money.

Byington: One of the things that we are doing at the University of Utah is actually starting our own institutional education loan repayment program and we are about to launch it in January of 2014. We are excited to see if this will help us in our recruiting of diverse candidates and helping us graduate students and have faculty that can concentrate on their careers and their specialties.

Leroy: That's a fantastic program and I wish you the best. I know that other states will look at these programs and hopefully model some of these programs in their own respective states.

Announcer: Impossible problems in academic medicine. Here how others are solving their impossible problems at algorithmsforinnovation.org.