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Med school tuition proposal: Take percentage of paycheck

Students would commit to paying part of their future income rather than pay as they attend school.

By Carolyne Krupa — Posted July 28, 2010

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A new plan for solving the problem of skyrocketing medical student debt would do away with traditional tuition altogether.

Instead, prospective physicians would commit to paying a portion of their income back to their medical school during their first 10 years of practice, after completing residency and fellowship training.

The proposal was published in the July issue of the American Journal of Obstetrics & Gynecology. It is the latest of many suggestions in the ongoing discussion over how to stem students' rising medical school debts.

The goal is to make medical school accessible to people of all income levels, said Louis Weinstein, MD, professor of obstetrics and gynecology at Jefferson Medical College of Thomas Jefferson University in Philadelphia.

In 2008, the median debt was $145,000 for public medical school graduates and $180,000 for private school graduates. Declining financial aid and growing medical school class sizes further compound the problem, Dr. Weinstein said.

"Students today are coming out with extraordinary debt," he said.

High costs keep many bright students from pursuing medical school and drive many young physicians to choose careers based on income potential rather than personal appeal, Dr. Weinstein said. He co-authored the article with Honor Wolfe, MD, associate professor of obstetrics and gynecology at the University of North Carolina School of Medicine.

Under their Strategic Alternative for Funding Education, or SAFE, program, graduates of public medical schools would pay 5% of their income for 10 years after completing graduate medical education, and private medical school graduates would pay 10%.

Using 2007-08 Assn. of American Medical Colleges data, the study found that public school graduates would pay $125,000 over 10 years, equal to 6.25% interest. Private school graduates would pay $175,000, equal to 7.5% interest.

It would take seven to 14 years for medical schools to start collecting the money. In the interim, schools could use funds currently set aside for financial aid and scholarships, and low-interest federal loans to cover costs, according to the proposal (link).

Other proposals for reducing medical school student debt include shortening the length of training for combined residency or dual-degree programs, easing loan repayment obligations, ensuring equitable tuition increases, and reducing undergraduate medical education to three years.

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