The Icahn School of Medicine at Mount Sinai will begin capping debt at $75,000 for students with a demonstrated financial need during the next academic year, making it the latest institution to address the massive debt burden that often accompanies medical education.
Students who qualify will take out no more than $18,750 per year in loans to cover costs such as tuition, housing, food and books.
The initiative follows NYU School of Medicine's decision to offer free tuition for all medical students and a move by Columbia University's Vagelos College of Physician and Surgeons in 2017 to offer scholarships that cover 100% of students' financial needs.
Mount Sinai's strategy is unique in that it applies not just to tuition but to living expenses. Tuition for the current academic year is nearly $53,000, but the school estimates the cost of attendance, which includes expenses such as rent and health insurance, will run students an additional $25,000 to $35,000 a year. Three-quarters of medical students nationwide finance their education with some debt, and the median amount for the class of 2018 was $194,000, according to the Association of American Medical Colleges.
"Doing just tuition would still leave students with $110,000 to $120,000 of debt. That's an unacceptable level," said Dr. David Muller, the medical school's dean for medical education. "We need to whittle away at the real number, and the real number is cost of attendance."
Muller said the institution has been working on a plan to lower students' debt burden for the past five years. It has received $25 million to $30 million in pledges from donors to jump-start a fund that will support the scholarships, which it expects to provide at least some aid to 40% of students. He said the school's strategy is most similar to that of Yale School of Medicine, which set an annual debt limit of $15,000 for the next school year.
The program won't benefit all students. It will award money based on a student's expected family contribution, which is determined through federal and private financial aid applications. A first-year student with an expected family contribution of $79,000, which is above the cost of attendance, wouldn't receive any aid, for example.
The news was shared with students via email Wednesday and wasn't met with unanimous praise. One student, who doesn't expect to qualify but will graduate with about $200,000 in debt, said it was "honestly a little bit of a disappointment" because many middle-class students won't be eligible.
"This is good for low-income students, and it will help Sinai stay competitive with those students and underrepresented minority students. This is not a fundamental reimagining of the financing of medical education," said the student, who asked not to be identified to avoid damaging relationships with the school's administrators. "It is just a glorified scholarship. I don't think it really helps a lot of the middle-class kids that are here."
Accounting for need is a way for medical schools to make their programs accessible to low-income students, Muller said.
"For us, that's just a way of distributing what we all know is limited resources," Muller said. "There has to be justice in any initiative that takes on student debt. Some students have accumulated all sorts of privileges over their lives, and some students have accumulated none of those advantages."
The program does not, as some do, compel students to enter specialties such as family medicine and pediatrics or to work in underserved areas. Muller said it hopes that encouraging more people with limited means to apply might draw students from underserved areas, who may be inclined to return home to provide care. Surveys show students' debt does not influence the specialty they choose to practice.
"That's the key for these programs: to get people who otherwise wouldn't to go ahead and apply," said Julie Fresne, senior director of student financial and career advising services at the Association of American Medical Colleges. "That is the main benefit that could come out of this."
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