A ‘SAFE’ Proposal for Cutting Med School Tuition Debt

With states across the nation facing physician shortages and new docs dealing with mounting education-based debt, a new proposal may offer some relief.

Drs. Louis Weinstein and Honor Wolfe presented their idea in the July edition of the American Journal of Obstetrics & Gynecology with the simple premise of new docs paying for their education after the completion of their studies and not during. Under their plan, grads of public medical schools would give 5 percent of their yearly compensation back to their school for a decade and private med school attendees would pay 10 percent over the same period after completing their studies and residency/fellowship.

The duo’s Strategic Alternative for Funding Education (SAFE) proposal also would allow med schools to shorten the length of medical education, hence saving tuition for new docs and reducing the debt they incur. This would also reduce a major obstacle in not attending med school - cost - many face, especially minority students, the authors say.

According to the article, 87 percent of medical students graduating in 2008 carried debt. Those attending public schools owed an average of $145,000 and private school students $180,000 with another 25 percent carrying debt of $200,000 or greater.

Weinstein and Wolfe’s piece also notes that while the percentage of medical students carrying debt has remained “relatively stable” over the past decade, the level of that debt has dramatically increased. Match that with the data that primary care physicians have only seen average salary increases of 2.6 percent and specialists a 4.3 percent hike, and debt is continuing to exceed income.

So enter the authors’ proposal: No longer will new doctors need to choose specialties based on the debt they face, but instead, the type of medicine they truly want to practice.

This still means that doctors can choose lucrative specialties – and in turn, under the SAFE plan, pay more financial support to their schools – but at the same time, “those in primary care specialties, public health professions or charity work will pay less,” according to the authors.

The SAFE proposal also has the interesting caveat that “those students who never enter a medical field will not be responsible for their tuition payments,” which Weinstein and Wolfe claim “represents a very small percentage of the current medical school graduates.”

So as a new crop of doctors enter a post-Affordable Care Act world, is this a good idea to increase the number of new physicians in the most needed areas of care? Or instead, could this have a negative effect with, for example, med schools hiking tuition knowing that they have a guaranteed repayment stream upon graduation?