Here's the reason med students are drowning in debt

[Obnoxious Dad]

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All medical students need to read this piece concerning the economics of medical education.

Why Doctors Are Drowning in Medical School Debt

A resident physician investigates the causes of skyrocketing tuition

blogs.scientificamerican.com

Tuition at many medical schools vastly exceeds the actual cost of educating medical students. There is an enlightening dialog in the piece between the author and the Dean of the NYU medical school. Dean Grossman tells it like it is.

“I always saw myself as an underdog,” he says with a charming, toothy grin, “because I was an underdog.”
After medical school, Grossman and his wife (also a physician) raised two children while paying off $12,000 in student debt—a large amount at that time, but a far cry from the $55,000 that the N.Y.U. medical students used to pay each year in tuition.
Tuition has increased exponentially since Grossman was a medical student—more than twice as fast as inflation. Now, physicians graduate with a median $194,000 in student debt. I mention that each year, N.Y.U.’s 450 medical students paid a total of $25 million in tuition.
“So where does this money go?” I ask Grossman.
“Well, where do you think?” he asks, smiling, raising his hands and shrugging shoulders. I think I know what he’s about to say, but I’m surprised when he says it so bluntly.
“It supports unproductive faculty,” he states coolly.
Unproductive faculty, Grossman explains, are people who draw a monthly paycheck, but don’t write grants, teach, or see patients. Tuition also funds other expenses, but the vast majority of tuition is not spent educating students. (My emphasis.)
“Think about it,” Grossman continues, “How many full-time faculty does it take to teach a group of medical students? Twelve or 13?”
I think back to my own medical education and tally up the faculty instructors. Thirteen sounds about right.
Grossman continues: “You only need say 12 or 13 FTEs [FTE is a full-time employee] because there’s one teacher at a time for 150 medical students.”
“Well, you could easily pay that salary with 25 million dollars,” I state the obvious. “N.Y.U.’s annual budget is nine point seven billion—"
“Almost 10 billion,” Grossman corrects me with a grin. He tracks every dollar N.Y.U. makes—from clinical revenue, to research grants, to tuition.
“OK,” I say, rolling my hand in the air, “Let’s call it ten billion–ish. So then 24–25 million of that is what? A quarter of a percent?”
“A rounding error.”
“A rounding error.”
We both nod.
It’s easy to get lost in the numbers. Rounding error or not, before Grossman’s endowment, N.Y.U.’s medical students paid $25 million in tuition each year, only a small fraction of which was needed to support their education. I want to know whether tuition is equally divorced from educational costs at other schools.

 

[7331poas]

That excerpt does leave out the most costly part of medical education, placement of medical students on their clerkships.

Even with that being said, no way it costs 7 billion dollars.

Great piece overall, thanks for sharing.

 

[theKingLT]

All medical students need to read this piece concerning the economics of medical education.

Why Doctors Are Drowning in Medical School Debt

A resident physician investigates the causes of skyrocketing tuition

blogs.scientificamerican.com

Tuition at many medical schools vastly exceeds the actual cost of educating medical students. There is an enlightening dialog in the piece between the author and the Dean of the NYU medical school. Dean Grossman tells it like it is.

“I always saw myself as an underdog,” he says with a charming, toothy grin, “because I was an underdog.”
After medical school, Grossman and his wife (also a physician) raised two children while paying off $12,000 in student debt—a large amount at that time, but a far cry from the $55,000 that the N.Y.U. medical students used to pay each year in tuition.
Tuition has increased exponentially since Grossman was a medical student—more than twice as fast as inflation. Now, physicians graduate with a median $194,000 in student debt. I mention that each year, N.Y.U.’s 450 medical students paid a total of $25 million in tuition.
“So where does this money go?” I ask Grossman.
“Well, where do you think?” he asks, smiling, raising his hands and shrugging shoulders. I think I know what he’s about to say, but I’m surprised when he says it so bluntly.
“It supports unproductive faculty,” he states coolly.
Unproductive faculty, Grossman explains, are people who draw a monthly paycheck, but don’t write grants, teach, or see patients. Tuition also funds other expenses, but the vast majority of tuition is not spent educating students. (My emphasis.)
“Think about it,” Grossman continues, “How many full-time faculty does it take to teach a group of medical students? Twelve or 13?”
I think back to my own medical education and tally up the faculty instructors. Thirteen sounds about right.
Grossman continues: “You only need say 12 or 13 FTEs [FTE is a full-time employee] because there’s one teacher at a time for 150 medical students.”
“Well, you could easily pay that salary with 25 million dollars,” I state the obvious. “N.Y.U.’s annual budget is nine point seven billion—"
“Almost 10 billion,” Grossman corrects me with a grin. He tracks every dollar N.Y.U. makes—from clinical revenue, to research grants, to tuition.
“OK,” I say, rolling my hand in the air, “Let’s call it ten billion–ish. So then 24–25 million of that is what? A quarter of a percent?”
“A rounding error.”
“A rounding error.”
We both nod.
It’s easy to get lost in the numbers. Rounding error or not, before Grossman’s endowment, N.Y.U.’s medical students paid $25 million in tuition each year, only a small fraction of which was needed to support their education. I want to know whether tuition is equally divorced from educational costs at other schools.

I completely agree that budgets need to be more transparent and accountable, but the article also oversimplifies med education a bit. The need for 12 or 13 full time faculty may apply to preclinical years but it's been mentioned on SDN previously that the bulk of costs generally come from clinical education. I imagine this is one of those points that varies drastically between schools, especially those that have their own hospitals vs those contracting out rotations. Definitely a reason for more transparency.

 

[Obnoxious Dad]

I completely agree that budgets need to be more transparent and accountable, but the article also oversimplifies med education a bit. The need for 12 or 13 full time faculty may apply to preclinical years but it's been mentioned on SDN previously that the bulk of costs generally come from clinical education. I imagine this is one of those points that varies drastically between schools, especially those that have their own hospitals vs those contracting out rotations. Definitely a reason for more transparency.

This is the party line based on zero evidence. How does LECOM educate medical students at a cost of $22,000 per student per year, have the highest board pass rates among DO schools, and keep growing? Please answer that question. Show me the cost accounting of an efficient medical education by an independent third party.

Medical students are being charged based on "what the traffic will bear" and not actual cost. Face it.

 

[7331poas]

This is the party line based on zero evidence. How does LECOM educate medical students at a cost of $22,000 per student per year, have the highest board pass rates among DO schools, and keep growing? Please answer that question. Show me the cost accounting of an efficient medical education by an independent third party.

Medical students are being charged based on "what the traffic will bear" and not actual cost. Face it.

I don't think anyone is questioning that.

 

[Angus Avagadro]

This is the party line based on zero evidence. How does LECOM educate medical students at a cost of $22,000 per student per year, have the highest board pass rates among DO schools, and keep growing? Please answer that question. Show me the cost accounting of an efficient medical education by an independent third party.

Medical students are being charged based on "what the traffic will bear" and not actual cost. Face it.

The answer to your question lies in the Monolithic traditional medical school models. My wife's former school now encompasses a full city block in a major US city. Taxes, employees, maintaining buildings, heating/ac, labs, libraries, etc., all extremely expensive. Supporting faculty and research that is not fully funded by grants. This is incredibly expensive. Schools with lower tuition often have fewer buildings, different curricula, i.e., PBL, Ind Study, etc. Both which require far fewer faculty. They also have research budgets that dont run in the red.

 

[Obnoxious Dad]

The answer to your question lies in the Monolithic traditional medical school models. My wife's former school now encompasses a full city block in a major US city. Taxes, employees, maintaining buildings, heating/ac, labs, libraries, etc., all extremely expensive. Supporting faculty and research that is not fully funded by grants. This is incredibly expensive. Schools with lower tuition often have fewer buildings, different curricula, i.e., PBL, Ind Study, etc. Both which require far fewer faculty. They also have research budgets that dont run in the red.

There is absolutely no reason that medical students should have to subsidize any of the costs you cite. If researchers can't get funded, show them the door. If a new building can't make the enterprise more efficient, don't build it. If an old building is a money pit, get rid of it. Don't pay 10 bozos to read personal statements that are pure fluff.

If some schools are more efficient, make them the model for everyone else. It's time to stop saddling people with $600,000 of debt at the end of residency.

 

[theKingLT]

This is the party line based on zero evidence. How does LECOM educate medical students at a cost of $22,000 per student per year, have the highest board pass rates among DO schools, and keep growing? Please answer that question. Show me the cost accounting of an efficient medical education by an independent third party.

Medical students are being charged based on "what the traffic will bear" and not actual cost. Face it.

I don't think anyone is questioning that.

Yup, not questioning it, hence why I'm calling for more transparency. Everyone seems to have different ideas of where the major costs come from which is why we need budget transparency. I was simply pointing out that the article jumps the gun saying unproductive faculty are the problem, when that is entirely unproven. That may have been the case at NYU, but that's just one school.

 

[electropartyogram]

Do many academic medical centers also provide safety-net services and provide medical care at lower cost or subsidize the cost for patients that are low income compared to private hospitals? Is there numbers on how much the budget is based on supporting the cost of the academic hospital, or does tuition seem proportionate to the size and patient population the hospital takes in? Then there are state differences to consider. Many states heavily subsidize education spending, some even have relatively low tuition for OOS students.

 

[Angus Avagadro]

There is absolutely no reason that medical students should have to subsidize any of the costs you cite. If researchers can't get funded, show them the door. If a new building can't make the enterprise more efficient, don't build it. If an old building is a money pit, get rid of it. Don't pay 10 bozos to read personal statements that are pure fluff.

If some schools are more efficient, make them the model for everyone else. It's time to stop saddling people with $600,000 of debt at the end of residency.

No argument from me.i was just providing some answers to your question. People dont do the math. Same as in undergrad. 300k of loans for private liberal arts school with a degree in art therapy paying 28k a year. Heard this example on Dave Ramsey a few years back. Where the hell were the parents? I dont think it ends till students quit applying due to costs. If you get accepted at such a school, look for alternative ways to finance. NHSD, military, some towns offer loan forgiveness. Tuition will rise as long as the market will bear it.

 

[7331poas]

No argument from me.i was just providing some answers to your question. People dont do the math. Same as in undergrad. 300k of loans for private liberal arts school with a degree in art therapy paying 28k a year. Heard this example on Dave Ramsey a few years back. Where the hell were the parents? I dont think it ends till students quit applying due to costs. If you get accepted at such a school, look for alternative ways to finance. NHSD, military, some towns offer loan forgiveness. Tuition will rise as long as the market will bear it.

Well, at the current moment even the most expensive medical schools are affordable on a physician's salary

 

[Med Ed]

How does LECOM educate medical students at a cost of $22,000 per student per year, have the highest board pass rates among DO schools, and keep growing? Please answer that question.

Because COCA has no real standards. Next question?

 

[mistafab]

That’s just like big pharma talking about their drug prices saying “at this price, the drug is still cost-effective.”

Well, at the current moment even the most expensive medical schools are affordable on a physician's salary

 

[Med Ed]

All medical students need to read this piece concerning the economics of medical education.

Why Doctors Are Drowning in Medical School Debt

A resident physician investigates the causes of skyrocketing tuition

blogs.scientificamerican.com

Tuition at many medical schools vastly exceeds the actual cost of educating medical students. There is an enlightening dialog in the piece between the author and the Dean of the NYU medical school. Dean Grossman tells it like it is.

“I always saw myself as an underdog,” he says with a charming, toothy grin, “because I was an underdog.”
After medical school, Grossman and his wife (also a physician) raised two children while paying off $12,000 in student debt—a large amount at that time, but a far cry from the $55,000 that the N.Y.U. medical students used to pay each year in tuition.
Tuition has increased exponentially since Grossman was a medical student—more than twice as fast as inflation. Now, physicians graduate with a median $194,000 in student debt. I mention that each year, N.Y.U.’s 450 medical students paid a total of $25 million in tuition.
“So where does this money go?” I ask Grossman.
“Well, where do you think?” he asks, smiling, raising his hands and shrugging shoulders. I think I know what he’s about to say, but I’m surprised when he says it so bluntly.
“It supports unproductive faculty,” he states coolly.
Unproductive faculty, Grossman explains, are people who draw a monthly paycheck, but don’t write grants, teach, or see patients. Tuition also funds other expenses, but the vast majority of tuition is not spent educating students. (My emphasis.)
“Think about it,” Grossman continues, “How many full-time faculty does it take to teach a group of medical students? Twelve or 13?”
I think back to my own medical education and tally up the faculty instructors. Thirteen sounds about right.
Grossman continues: “You only need say 12 or 13 FTEs [FTE is a full-time employee] because there’s one teacher at a time for 150 medical students.”
“Well, you could easily pay that salary with 25 million dollars,” I state the obvious. “N.Y.U.’s annual budget is nine point seven billion—"
“Almost 10 billion,” Grossman corrects me with a grin. He tracks every dollar N.Y.U. makes—from clinical revenue, to research grants, to tuition.
“OK,” I say, rolling my hand in the air, “Let’s call it ten billion–ish. So then 24–25 million of that is what? A quarter of a percent?”
“A rounding error.”
“A rounding error.”
We both nod.
It’s easy to get lost in the numbers. Rounding error or not, before Grossman’s endowment, N.Y.U.’s medical students paid $25 million in tuition each year, only a small fraction of which was needed to support their education. I want to know whether tuition is equally divorced from educational costs at other schools.

Interesting piece. I applaud Dr. Grossman's efforts, but if he think that current M1/M2 students at NYU just sit in a lecture hall with one faculty member at a time he needs to have a conversation with his academic affairs dean.

At any rate, the baseline cost of running an allopathic medical school is not really a mystery. A number of private, community-based medical schools have opened over the years. With no clinical operation to muddy the finances, and no desire on the part of the parent institution to provide subsidies, the math comes out to about $26-28 million/year. This translates into a class size of about 120 with tuition in the high 50K range. This assumes that the facilities have already been constructed, and that the parent institution has already established adequate financial reserves for the school.

Of course, few schools will actually run this lean. Most have additional lines of revenue.

 

[7331poas]

That’s just like big pharma talking about their drug prices saying “at this price, the drug is still cost-effective.”

Meh, one is life and death. The other is getting a MD

 

[Obnoxious Dad]

Because COCA has no real standards. Next question?

you call them standards. I call them entry barriers.

 

[Obnoxious Dad]

Interesting piece. I applaud Dr. Grossman's efforts, but if he think that current M1/M2 students at NYU just sit in a lecture hall with one faculty member at a time he needs to have a conversation with his academic affairs dean.

At any rate, the baseline cost of running an allopathic medical school is not really a mystery. A number of private, community-based medical schools have opened over the years. With no clinical operation to muddy the finances, and no desire on the part of the parent institution to provide subsidies, the math comes out to about $26-28 million/year. This translates into a class size of about 120 with tuition in the high 50K range. This assumes that the facilities have already been constructed, and that the parent institution has already established adequate financial reserves for the school.

Of course, few schools will actually run this lean. Most have additional lines of revenue.

You are confusing total expenses with the actual costs of running an efficient medical school.

 

[Dave1980]

You are confusing total expenses with the actual costs of running an efficient medical school.

OP username checks out.

Education is a business. Medicine is a business. Medical school costs so much because even at those inflated prices people are still clamoring to get in.

You wouldn't go to a clothing store and say "Why does this shirt cost $30?! It only costs $6 to make it!" It costs what the market will bear.

 

[Med Ed]

you call them standards. I call them entry barriers.

Either way it answers your question. Large enrollment + Lord of the Flies clerkship year = relatively low tuition.

 

[Med Ed]

You are confusing total expenses with the actual costs of running an efficient medical school.

No, I'm not, and I'm willing to bet that I have seen a lot more medical school budgets than you have.

Most of the money is allocated to salaries. You sit down with an org chart and go person-by-person and ask if each employee is (1) necessary to the daily function of the institution and/or (2) necessary for maintenance of LCME accreditation. Then you tally up the recurring non-negotiable expenditures. With 120 students paying high 50's you'll end up in the neighborhood of $27 million.

For an osteopathic school you can increase the class size dramatically and cut a lot of expenditure.

 

[Obnoxious Dad]

No, I'm not, and I'm willing to bet that I have seen a lot more medical school budgets than you have.

Most of the money is allocated to salaries. You sit down with an org chart and go person-by-person and ask if each employee is (1) necessary to the daily function of the institution and/or (2) necessary for maintenance of LCME accreditation. Then you tally up the recurring non-negotiable expenditures. With 120 students paying high 50's you'll end up in the neighborhood of $27 million.

For an osteopathic school you can increase the class size dramatically and cut a lot of expenditure.

The issue is the extent to which those employees are even necessary and whether the salaries they are paid are market based. Much of the first two years of medical school, aside from the anatomy lab and the introduction to clinical medicine, could be taught on line. In fact that is what most medical students would prefer. There is simply no reason that on line lectures in the basic sciences have to be reinvented every year at 175 different medical schools. Two or three for profit companies could perform the task at a fraction of the current price.

The LCME shouldn't even be in business. There is no reason to regulate the inputs of a medical school. All that matters is the outputs. If you could smack a medical student upside the head with a bag of flour and produce the next Jonas Salk that should suffice. Please justify for all of us the probation of the George Washington U medical school which was based in part on having an inadequate student lounge.

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[Obnoxious Dad]

No, I'm not, and I'm willing to bet that I have seen a lot more medical school budgets than you have.

Most of the money is allocated to salaries. You sit down with an org chart and go person-by-person and ask if each employee is (1) necessary to the daily function of the institution and/or (2) necessary for maintenance of LCME accreditation. Then you tally up the recurring non-negotiable expenditures. With 120 students paying high 50's you'll end up in the neighborhood of $27 million.

For an osteopathic school you can increase the class size dramatically and cut a lot of expenditure.

If DO students are getting an inadequate clinical education how did 5,000 match in the last National Resident Match Program?

https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2019/04/NRMP-Results-and-Data-2019_04112019_final.pdf

 

[Obnoxious Dad]

OP username checks out.

Education is a business. Medicine is a business. Medical school costs so much because even at those inflated prices people are still clamoring to get in.

You wouldn't go to a clothing store and say "Why does this shirt cost $30?! It only costs $6 to make it!" It costs what the market will bear.

You've just confirmed my position. The price of medical school is driven by demand and not underlying cost. Thanks. I owe you one.

When you buy clothing there isn't some governmental body regulating supply to hold up prices. That is why in the long run in competitive markets, the marginal cost of something equals its price.

 

[Angus Avagadro]

The issue is the extent to which those employees are even necessary and whether the salaries they are paid are market based. Much of the first two years of medical school, aside from the anatomy lab and the introduction to clinical medicine, could be taught on line. In fact that is what most medical students would prefer. There is simply no reason that on line lectures in the basic sciences have to be reinvented every year at 175 different medical schools. Two or three for profit companies could perform the task at a fraction of the current price.

The LCME shouldn't even be in business. There is no reason to regulate the inputs of a medical school. All that matters is the outputs. If you could smack a medical student upside the head with a bag of flour and produce the next Jonas Salk that should suffice. Please justify for all of us the probation of the George Washington U medical school which was based in part on having an inadequate student lounge.

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Digital newsstand featuring 7000+ of the world’s most popular newspapers & magazines. Enjoy unlimited reading on up to 5 devices with 7-day free trial.

www.pressreader.com

Smack 'em upside the head with a sack of flour? HHmmm? Hadn't thought of that one. Maybe that's what we need to do to get the bottom third up to speed! LOL, just kidding.
having said that, I think Free Tuition being offered by some schools is brilliant. First it will attract the best and brightest because of the incentive. It should cause other schools to lower their tuition,(unless they are For Profit), if they want to continue to attract the high caliber students. That leaves the others left to see what kind of student they can attract at those kinds of prices. Students, if they are smart, will do the math. At some point, and I believe we are close, students will choose alternate career paths. As we produce more Doctors and Mid Levels, salary packages will go down. The math just won't support that kind of time commitment or debt load. If not, we will have predatory Caribbean style schools in the US, preying on pre meds who think they can do it, despite not having the academic chops to succeed.

 

[Medic741]

If DO students are getting an inadequate clinical education how did 5,000 match in the last National Resident Match Program?

https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2019/04/NRMP-Results-and-Data-2019_04112019_final.pdf

Because of UFAPS teaching us 90% of what we learned

 

[Obnoxious Dad]

Because of UFAPS teaching us 90% of what we learned

Yep. You have just reinforced my spiel. Thanks.

 

[Obnoxious Dad]

Well, at the current moment even the most expensive medical schools are affordable on a physician's salary

That is perfectly irrelevant and in some cases untrue. A primary care doc in New York City saddled with a debt of $600,000 and debt service payments of $50,000 per year for 30 years, federal income taxes, New York City and State income taxes is going to have a very difficult time making ends meet given New York's high cost of living.

 

[7331poas]

That is perfectly irrelevant and in some cases untrue. A primary care doc in New York City saddled with a debt of $600,000 and debt service payments of $50,000 per year for 30 years, federal income taxes, New York City and State income taxes is going to have a very difficult time making ends meet given New York's high cost of living.

600k is excessive debt, even for a doctor. The median is 260k.

 

[Medic741]

Yep. You have just reinforced my spiel. Thanks.

Yeah it’s extremeely frustrating to be ripped off this badly by the process

 

[Dantes]

600k is excessive debt, even for a doctor. The median is 260k.

Source? I've always seen numbers hovering around 180k, though I think that takes into account people who don't take out loans.

 

[libertyyne]

The real cost of educating medical students is probably in the range of 15k-30 k per year, this obviously varies by cost of living adjustments for staff and services. This includes the overhead and regulatory burden of complying with the lcme. Whether or not you think the lcme should exist or regulations should occur is a separate question.state school tuitions in Texas and all over the country have somewhat reasonable tuition rates.


If you do not believe lcme should exist then you should also have no philosophical qualms with paying the market rate for private schools which can charge whatever they want.

 

[7331poas]

Source? I've always seen numbers hovering around 180k, though I think that takes into account people who don't take out loans.

I believe the 180k is for all med students. 260k is for students who have any debt at all.

(remember than 1/3rd of students have rich doctor parents)

 

[BorderlineQueen]

I believe the 180k is for all med students. 260k is for students who have any debt at all.

(remember than 1/3rd of students have rich doctor parents)

I can't find the link to the article but somewhere of 23% of students have no debt. While around 23-33% have over 300k in debt. I can't find the article will link it when I find it.

 

[BorderlineQueen]

Also here is a breakdown of medical school debt. PubMed Central, Figure. : JAMA Intern Med. 2017 Oct; 177(10): 1–3. Published online 2017 Sep 5. doi: 10.1001/jamainternmed.2017.4023

 

[Franzd'Epinay]

The LCME shouldn't even be in business. There is no reason to regulate the inputs of a medical school. All that matters is the outputs.

Medical education in North America has been standardized for over 100 years. The standardization is not the reason for the runaway tuition prices we've seen in the last 20-30 years.

 

[Osminog]

People are willing to pay a lot of money to gain access to a job where they can work reasonable hours, make at least $200K/year, and enable their tiger parents to brag to neighbors, coworkers, and random strangers at the bus stop that the heir of their bloodline is going to become a doctor.

Assuming current job market trends continue, the high price tag of medical school is probably worth it from a purely financial perspective for a lot of people.

 

[7331poas]

People are willing to pay a lot of money to gain access to a job where they can work reasonable hours, make at least $200K/year, and enable their tiger parents to brag to neighbors, coworkers, and random strangers at the bus stop that the heir of their bloodline is going to become a doctor.

Assuming current job market trends continue, the high price tag of medical school is probably worth it from a purely financial perspective for a lot of people.

Exactly, everyone here is complaining about the debt. I agree it is a lot of money.

But the public simply would not tolerate doctors making 400k+ a year if the average debt was something like 50k. I certainly wouldnt tolerate that.

 

[nimbus]

Exactly, everyone here is complaining about the debt. I agree it is a lot of money.

But the public simply would not tolerate doctors making 400k+ a year if the average debt was something like 50k. I certainly wouldnt tolerate that.

Why? Not sure how they are related. Lots of people exit medical school with no debt and make tons of money. Nobody cares.

 

[nimbus]

Interesting piece. I applaud Dr. Grossman's efforts, but if he think that current M1/M2 students at NYU just sit in a lecture hall with one faculty member at a time he needs to have a conversation with his academic affairs dean.

At any rate, the baseline cost of running an allopathic medical school is not really a mystery. A number of private, community-based medical schools have opened over the years. With no clinical operation to muddy the finances, and no desire on the part of the parent institution to provide subsidies, the math comes out to about $26-28 million/year. This translates into a class size of about 120 with tuition in the high 50K range. This assumes that the facilities have already been constructed, and that the parent institution has already established adequate financial reserves for the school.

Of course, few schools will actually run this lean. Most have additional lines of revenue.

Speaking from 1st hand experience, that’s exactly how the preclinical years were and there is nothing wrong with that. Got a great education sitting in lecture halls with 1 professor lecturing to all 140 of my classmates.

And clinical faculty are paid from clinical revenues, not med school tuition. And a freestanding medical school will have much different challenges than a medical school that is part of a $10 billion clinical and research enterprise. As Grossman states, the medical school tuition is a rounding error.

Grossman is the dean. He knows how and where the money flows better than anybody on the Internet.

 

[nimbus]

Also here is a breakdown of medical school debt. PubMed Central, Figure. : JAMA Intern Med. 2017 Oct; 177(10): 1–3. Published online 2017 Sep 5. doi: 10.1001/jamainternmed.2017.4023

It’s interesting that the least indebted students choose ophtho and derm. There seems to be no correlation between debt and specialty income. I’ve always felt that was the case. Specialty choice is much better correlated with board scores than debt.

 

[watermelon master]

It’s interesting that the least indebted students choose ophtho and derm. There seems to be no correlation between debt and specialty income. I’ve always felt that was the case. Specialty choice is much better correlated with board scores than debt.

which is why it will be very interesting to see what the match list of NYU's first class to have full tuition will end up being. something tells me it isn't going to be full of family medicine matches, but rather the same if not more matches into high paying sub-specialties since students now have less pressure, meaning they can succeed in all other aspects of medical school

 

[Med Ed]

Speaking from 1st hand experience, that’s exactly how the preclinical years were and there is nothing wrong with that. Got a great education sitting in lecture halls with 1 professor lecturing to all 140 of my classmates.

Did you learn clinical skills during the first two years? Or do anything in small group?

 

[JoaoMoutinho]

Exactly, everyone here is complaining about the debt. I agree it is a lot of money.

But the public simply would not tolerate doctors making 400k+ a year if the average debt was something like 50k. I certainly wouldnt tolerate that.

So those of us who have scholarships should get paid less? Lol

 

[Angus Avagadro]

I can't find the link to the article but somewhere of 23% of students have no debt. While around 23-33% have over 300k in debt. I can't find the article will link it when I find it.

This has been my experience when I ask students who don't drive late model imports. They typically tell me 300 to 300k debt for undergrad and med school. Not a study, but is generally accurate according to the studies @BorderlineQueen has provided

 

[Angus Avagadro]

People are willing to pay a lot of money to gain access to a job where they can work reasonable hours, make at least $200K/year, and enable their tiger parents to brag to neighbors, coworkers, and random strangers at the bus stop that the heir of their bloodline is going to become a doctor.

Assuming current job market trends continue, the high price tag of medical school is probably worth it from a purely financial perspective for a lot of people.

I dont believe the high price tag will be worth in in about 10 yrs. Just my opinion.

 

[libertyyne]

It’s interesting that the least indebted students choose ophtho and derm. There seems to be no correlation between debt and specialty income. I’ve always felt that was the case. Specialty choice is much better correlated with board scores than debt.

People taking out loans may be different compared to people not taking out loans. Rich parents probably make medical school less stressful financially, you can spend a research year without concern for snowballing debt etc. Also poorer students tend to have more academic difficulties ultimately leading to lower board scores.

 

[libertyyne]

Did you learn clinical skills during the first two years? Or do anything in small group?

I will say that any of the skills i learned in the first two years or small groups were entirely inconsequential. Clinical skills are much easier to pickup on the wards when you take care of real patients.

 

[Med Ed]

I will say that any of the skills i learned in the first two years or small groups were entirely inconsequential. Clinical skills are much easier to pickup on the wards when you take care of real patients.

That's not the point of my question.

 

[libertyyne]

That's not the point of my question.

if the value of the small groups and clinical skills provided by the first two years is negligible, it kind of defeats the purpose of wasting everyone's time and resources on those activities. So i do think it is pertinent to the discussion.

 

[Obnoxious Dad]

600k is excessive debt, even for a doctor. The median is 260k.

The debt service would be about $50,000 per year for 30 years.

About 12% of allopathic med students attend state owned medical schools as out of state residents. Tuition at places like Michigan State and the University of Illinois for those students average about $90,000 per year and their living expenses and fees amount to another $25,000 per year. If you let that $460,000 mess accrue interest for eight years (yes, i know that the debt during med school is built in stages) the student will end up after the end of a four year residency with a debt of $600,000.

This is my last post on this thread. I think I've made my point rather clearly.