Some students opening acceptance letters from the School of Medicine this spring had another reason to celebrate. While their colleagues in the Class of 2008 graduated with an average debt of $115,000, a new financial aid formula should ease that burden for middle-income families.
Dean Robert J. Alpern, M.D., Ensign Professor of Medicine, announced the new policy in April. Formerly, parents with a combined income over $45,000 were expected to help pay the costs of their child’s medical education. Beginning this academic year, that threshold has been raised to $100,000. The “base loan” (the amount students are expected to borrow before receiving scholarship funds) has been raised from $17,000 to $18,000, keeping it among the lowest in the country. The new formula applies to all current students.
“What we were expecting was not realistic,” said Richard Belitsky, M.D., the Harold W. Jockers Associate Professor of Medical Education and deputy dean for education.
The change was made possible after Yale’s endowment income added $1.1 million to the medical school’s financial aid budget. The school’s financial aid committee then decided that students from middle-income families needed the extra funds most. Especially needy families did not need to borrow more than the base loan, as School of Medicine scholarships make up the difference, while affluent families were less burdened by tuition costs. The resources of students from middle-income families, though, consistently fell short of the old financial aid formula’s estimate, and these students were forced to borrow above the base loan to pay what the school required.
“They should have been borrowing $68,000—four times the unit loan—but the average debt was $115,000,” said Alpern.
Another reason for the change, said Belitsky, was that high debt often influences specialty choice. For example, primary care physicians are in critically short supply nationwide, perhaps in part because they are less well reimbursed than their colleagues in some specialties. Of the 97 Yale students who matched this year, only four entered primary care, and another three entered family medicine. The American Medical Student Association has stated that the current American model of financing medical education harms efforts to improve physician diversity and patients’ access to care.
Richard Silverman, director of admissions, speculates that the change may also affect the diversity of the applicant pool. “If another school is widely perceived to be generous or liberal in its financial aid policy, it might get more applications from candidates who assume that Yale, because of the name, is only for the wealthy,” he said. Tuition, fees and expenses at the School of Medicine this year are expected to range from $62,000 to $69,000.
Other medical schools are also changing their financial aid policies. In March, citing concerns about debt and specialty choice, Harvard Medical School raised its parental-income threshold to $120,000.
“If a student wants to be a neurosurgeon instead of going into primary care,” said Alpern, “I’d hate for them to do it just because of the loans they had.”