NYU’s Free Medical School Tuition Sparks Debate

New York University School of Medicine (NYU) announced free tuition for all of its medical students, regardless of merit or need. The plan is effective immediately and covers all current and future students. The cost of attending NYU’s medical school, this year, was $55,018.

Rising Medical School Costs

According to the Association of American Medical Colleges, a nonprofit organization which represents United States medical schools and academic health centers, 75% of all doctors in the U.S. graduated with debt in 2017. The median annual cost of a private school medical education is now $59,605 and most medical students leave medical school with approximately $202,000 in student debt. These financial barriers to attending medical school often discourage promising students from considering a career in medicine.

Many government programs help students pay for medical school or even forgive their loans. These programs often require that students serve in the military, public health service or practice medicine in an underprivileged area.

The Department of Education has a Public Service Loan Forgiveness program that forgives outstanding loan balances after 10 years for those who work in public service careers. The National Health Service Corps offers a scholarship program and loan repayment program for medical professionals who serve areas that have a shortage of health professionals. The Health Professions Scholarship Programs covers 100% of medical school expenses in exchange for four years of active duty service with the United States Army, the United States Navy, or the United States Air Force.

NYU is not alone. Other medical schools have also begun to help medical students pay their school debts. One example is programs that let students earn their degrees in three years rather than four, which reduces the overall cost by 25%. The Consortium of Accelerated Medical Pathway Programs is an organization of medical schools that offer accelerated MD programs and study financial, regulatory, and competency matters. The Consortium was founded in 2015. The 13 medical schools who allow students to graduate medical school in three years are:

• Cooper Medical School of Rowan University, Camden, New Jersey
• Duke University School of Medicine, Durham, North Carolina
• McMaster University, Hamilton, Ontario, Canada
• Medical College of Wisconsin–Central Wisconsin, Wausau, Wisconsin
• Medical College of Wisconsin, Green Bay, Wisconsin
• Mercer University School of Medicine, Savannah, Georgia
• NYU School of Medicine, New York, New York
• Ohio State University, Columbus, Ohio
• Penn State College of Medicine, Hershey, Pennsylvania
• Texas Tech University Health Sciences Center School of Medicine, Lubbock, Texas
• University of California, Davis, School of Medicine, Sacramento, California
• University of Louisville School of Medicine, Louisville, Kentucky
• University of Kentucky School of Medicine, Lexington, Kentucky

Other medical schools have begun offering tuition-free programs. Cleveland Clinic and Case Western Reserve University offer a free five-year program that trains medical researchers, granting their graduates both a Doctor of Medicine and a special research credential master’s degree. University of California-Los Angeles (UCLA) offers merit-based scholarships that cover the entire cost of medical education to 20% of its students. Columbia University recently announced a $250 million endowment that is intended to pay all medical school expenses for students in financial need.

With its recent announcement, NYU School of Medicine became the only top-ranked medical school to offer all of its students free tuition.

NYU’s Announcement

NYU made the surprise announcement at the at the end of its annual White Coat Ceremony, where every new student is presented with a white lab coat to mark the beginning of their medical education and training. The announcement affected 442 currently enrolled students, including the 102 new students beginning their education this fall.

In its press release to mark the occasion, NYU said that its initiative was an effort to “simultaneously address the rising costs of medical education and still attract the best and brightest students to careers in medicine.” The school noted that overwhelming student debt has caused many medical school graduates to choose higher-paid specialties, which leaves less talented candidates to pursue careers in the less lucrative specialties like primary care, pediatrics, and gynecology. According to recent surveys, primary care physicians earn an average of $217,000, while orthopedic surgeons average $538,000 per year.

Kenneth G. Langone, chair of the Board of Trustees of NYU Langone Health said, “Thanks to the extraordinary generosity of our trustees, alumni, and friends, our hope—and expectation—is that by making medical school accessible to a broader range of applicants, we will be a catalyst for transforming medical education nationwide.”

Robert I. Grossman, M.D., the Saul J. Farber Dean of NYU School of Medicine and CEO of NYU Langone Health, explained, “This decision recognizes a moral imperative that must be addressed, as institutions place an increasing debt burden on young people who aspire to become physicians.” He continued, “A population as diverse as ours is best served by doctors from all walks of life, we believe, and aspiring physicians and surgeons should not be prevented from pursuing a career in medicine because of the prospect of overwhelming financial debt.”

NYU will need $600 million to fund this initiative—$450 million has already been raised.

Response to NYU’s Free Tuition Plan

NYU’s announcement was met with mixed reviews. Since the announcement, economic experts and commentators have questioned whether free tuition is the best solution to our nation’s rising student debt problem.

Anupam B. Jena, M.D., Ph.D., an economist, physician, and professor at Harvard Medical School, opined in Bloomberg, “Making medical education free for all students, then, may not be the soundest economic approach—at least from this perspective. A better tactic would be to expand means-testing beyond what medical schools already offer: to prioritize tuition coverage for applicants with low parental income, to waive their application fees, to pay travel expenses for medical school interviews, and to increase research and clinical opportunities for high-school and college students who fall in this demographic. Simply applying to medical school can cost upward of $10,000 per applicant, and relief here would yield large returns.”

Jena commented that the most likely result of NYU offering free medical school tuition is better recruitment. He noted that many of his own students have declined admissions to top-ranked schools in favor of lower-ranked school that offered them full scholarships.

Meanwhile, Deborah Sweeney, a columnist for Forbes, questioned if a tuition-free education would truly allow for a more diverse student body and whether student loan debt had an impact on which areas that physicians choose to practice. Sweeney noted that the data on this is mixed, “While some physicians may cite debt as a consideration when choosing family practice, for example, there is also ample evidence that family practitioners may take into consideration other factors—work/life balance, a desire to work in family practice, strong salaries in family practice—when making the final decision in their area of practice. It doesn’t appear that decreasing costs, or lower debt, would necessarily result in students choosing different practice areas, which was the espoused goal of the free tuition program at NYU.”

Edith Bracho-Sanchez, M.D., an NYU School of Medicine alumna and pediatrician who consults for ABC News’ medical unit, wrote that the email announcement that she received from NYU School of Medicine came as a surprise—and initially as a disappointment. Dr. Sanchez and her fiancé took on over $500,000 in combined debt to become doctors and she predicts that it will take her at least 10 years to pay off her debt. She wrote, “Once I was able to move past my initial disappointment, however, I did feel the excitement [Anthony J.] Grieco [NYU’s Associate Dean for Alumni Relations had also predicted. A tuition-free medical school has tremendous implications for future physicians, and for patients.”

OTW spoke with Rocco Monto, M.D., a Nantucket orthopedic surgeon and author who is an alumnus of NYU School of Medicine. Dr. Monto said, “This historic move by my alma mater is a bold statement that will help secure the future recruitment and training of American physicians. What makes it so compelling is that it comes at such a critical moment for medicine in the United States—a time when graduate training costs are skyrocketing even as we are debating healthcare access and delivery models. It’s a gamechanger that is going to pressure other professional schools, particularly those with extraordinary endowments and resources, to take similar action on behalf of their students. I’m really proud of NYU—even if I don’t see a tuition rebate check in the mail!”

What’s Next?

As medical school expenses increase and student debt rises, schools may have to adapt to continue to attract the best and brightest talent.

Will NYU’s bold initiative lead to other institutions following suit? Will promising low-income students who would never have considered a career in medicine be encouraged to follow this path? Will free medical school lead to free law school and eventually free college for all? Time will tell.