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Taking debt out of the equation for future physicians

December 12, 2024
by Ashley Festa

At age 79, Marc Lippman no longer takes the future for granted. He’s in good health and sharp as a tack, but he quips that he has stopped buying green bananas. “It’s something people joke about in Florida,” says Lippman, whose career included a stop at the University of Miami. “Who knows what the future holds?”

At this latter stage of his career (Lippman is still a fulltime clinician and researcher, now at Georgetown University Medical Center) he is nonetheless thinking about the future — the future of medicine in particular. Just as training postgraduate physician–scientists has been one his greatest joys, he is also considering ways to influence the careers of future doctors earlier in their education, when they are medical students. Lippman would like to make it easier for them to imagine themselves in academic careers, pushing forward the science and care of patients.

To help make that possible, Lippman made a gift to the Yale School of Medicine (YSM) to establish the Class of 1968 Scholarship Fund, joined by classmates and initial donors Donald Lyman, Libby Short, William Keane, and Harmon Michelson.

“Thanks to Marc and the others, we’ve made a great start in being able to support one student each year in perpetuity with this scholarship,” says Lyman, who has led fundraising efforts for the class since the 1970s. With the cost of medical school exceeding $100,000 a year, it will take an endowment of $2 million to fund one student annually. Lippman has made it his goal to recruit others to help reach that amount before the class’s 60th reunion in 2028. As of November 2024, the fund stands at $575,000.

Lippman hopes the scholarship will enable medical students to follow a career path they are passionate about, without the fear of debt looming over them.

The Influence of a Physician-Scientist

Over Lippman’s nearly 60-year career as a practicing oncologist, basic scientist, and translational researcher, he has led the cancer centers at Miami and Georgetown and chaired the internal medicine departments at Miami and Michigan. His contributions to the understanding of breast cancer include developing the first model of estrogen regulation of breast cancer in the 1970s while at the National Cancer Institute.

Recently, he has been working to understand how the macro environment—the world we live in—affects the occurrence and recurrence of breast cancer. In addition to metabolic syndrome, diabetes, and other health factors, anxiety and depression are also known to increase the risk. Lippman’s question: “How do breast cancer cells know you’ve had a hard day?”

Research studies have shown that cognitive behavioral therapy and other treatments for mood disorders can reduce the recurrence rate of breast cancer. “It’s not hocus-pocus; this is credible science. Depression is not just feeling terrible—it’s an inflammatory disease and a pathway to multiple other common diseases,” says Lippman, the former editor of the journal Endocrine-Related Cancer. “But not everyone has access to psychotherapy.”

So, he’s studying the signaling pathways associated with depression and breast cancer to find out whether there’s a way to interfere with those messages. He’s currently conducting clinical trials with a drug that aims to block that communication.

This research follows the mantra he has taught many of his trainees: “We are here to take care of patients we will never see,” says Lippman, adding that training the next generation of breast cancer physicians has been one of the greatest joys of his career. “When a woman goes through dealing with breast cancer, we want to do things to make her journey useful to other women. I enjoy that. There’s a purpose even beyond the patient in front of me.”

Sadly, academic careers have become less popular as the economics of medicine and medical education have changed. Many learners shy away from research and certain clinical fields because of relatively low compensation and the dread of accumulating debt. Many will pursue higher-paying specialties to pay off their loans. That burden can be enormous; for the class of 2024, the highest indebtedness was $375,000, though the average was much lower.

“I believe medicine is amazingly flawed; there are many things we don’t understand, and people die miserable deaths. So, we need to continue doing research,” Lippman says. “We need to train physician leaders, and Yale School of Medicine epitomizes this. I wanted this scholarship to help Yale attract students to become leaders and not fear financial burden.”

Lippman believes that he might not have pursued academic research if he had thousands of dollars in debt hanging over his head—one reason he’s excited about the Class of 1968 Scholarship Fund. “Medical school debt might keep people from making choices they wish they could make,” Lippman says, “and I want to help alleviate that hesitation with this scholarship fund.”