Financing Your Medical Education

Securing a medical education can be extremely expensive. The annual tuition at the costliest school has exceeded $28,000, and the national mean for private schools is more than $16,000 per academic year.

The reason for high tuition is many-faceted. Many schools are burdened with the major expense of sustaining commitments—from tenured faculty to capital improvements. Research, which requires a physical plant and equipment, is no longer as heavily subsidized by the federal government. Medical technology has created increasingly costly instrumentation that must be updated to maintain the state-of-the-art performance.

Essentially, tuition constitutes only a very small part of the school's income. The bulk of the income comes from research grants, government funding, endowments, and medical practice fees. For most private schools the critical factor is the endowment. For public medical schools the allotment by the state legislature is the determining factor, with the state's economy and demographics being the key factors.

The only bright spot in the financial picture is that there is evidence that tuition levels may have peaked and recently, in a few cases, tuition reductions have taken place, perhaps in response to the decline in applicants during the late 1980s.

The high cost of medical education raises problems for many students. Various sources of financial assistance are presently available, so that, once accepted, a student can feel relatively assured that adequate financial support will be forthcoming, if not in scholarships, then in loans. Recent proposed cuts in the federal aid to medical schools have included mostly attempts to cut back on research and building grants. These cuts in funding would affect the research being done primarily by staff professors and would threaten the future of research and the training of research scientists. In addition, other proposals include the substitution of a loan program instead of scholarships for students. Needless to say, educators have been decrying these cuts and have been urging a reassessment of financial allocations.

How do medical students meet their expenses? Usually from multiple sources including gifts and loans from families, their own earnings, and, if married, their spouses' earnings. Scholarships and loans form another major source of financial assistance, with about 50% of all students currently being helped by either of these means. Employment during medical school is not advisable, but work during the summers is possible. In light of this situation, it is important that prospective medical students anticipating the need for financial assistance undertake long term planning early in their careers. Once the student has been accepted and has decided to attend a school, the financial aid office should be contacted for information and assistance. In most cases, financial aid is provided solely on the basis of need.

In determining how to finance your medical education, keep the following points in mind:

1. The most important sources of current financial information are the individual schools.
2. Students who are planning to apply to medical school should obtain current information as to tuition and fees (and any projected increases), room and board, and other expenses (see specific school catalog Table 6.1, Chapter 6).
3. Students who have been accepted and are considering enrolling at a school should request relevant information from the school's Financial Aid Office.
4. Students who have decided to enroll at a school should arrange to obtain specific information about a personal aid package by requesting an interview with the school's financial aid officer.
5. Some federally funded programs exist (see Scholarships and Loans section) that provide financial aid for medical school students in return for a specified number of years of service.
6. Students should realize that the financial aid picture is a changing one and that the general pattern of aid has been toward a declining level of support.
7. Financial aid awards are usually made on the basis of demonstrated need established by a financial analysis system. There are three national organizations that analyze the information provided by the students and their families. The results are sent to the individual medical schools. The schools then determine the award to be made.
8. Public medical schools are less expensive for residents and, generally, for nonresidents also than private schools. This applies to both tuition and fees as well as all other expenses.
9. In 2005–2006, the average cost of tuition and fees for freshman medical students will be about $12,399 for residents and $27,297 for nonresidents at a public school, and $32,000 at a private school.
10. The total average expenses (tuition, fees, living) for 2005–2006 for a freshman thus can be estimated as $20,800 for a resident attending a state school and $34,000 for a nonresident. For a student attending a private school, the average total expenses were about $37,000.

Note that there is a range on both sides of all the above figures.