Where does your medical school tuition go?

[likeaboss]

This is a debate I have had with my friends over and over again. Does anybody know where our medical school tuition goes? I calculate that my medical school, which has 180 students per class at 48k per year gets about $35 million from med school tuition. Does that all go toward medical education, keeping the lights on in the library, and day to day management? Or are we paying physician salaries or for rotations?

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[SpecterGT260]

is that number your tuition or the total loan package/year? That is quite a bit more than I am paying.

 

[dadaism]

http://www.amsa.org/AMSA/Homepage/About/Committees/StudentLife/TuitionFAQ.aspx

Looking at that article, tuition only covers about 3-8% of medical school revenue. Out of that percentage, the actual money can be dispersed among a number of things including administration, maintenance, instructional costs, etc. In the end, it seems that "tuition does NOT cover all costs to fund your medical education" and that schools take a loss.

 

[TAWS]

It's usually profit from the hospitals that fund most of the medical school's expenses. At the end of each fiscal year, hospitals transfer a certain amount of money to the medical school.

 

[likeaboss]

is that number your tuition or the total loan package/year? That is quite a bit more than I am paying.

im at a mid tier private school, so that's just tuition. total loans each year for us add up to about 70k, all in...

 

[Whiskeypunch]

If you are really curious, a good place to look is at the filings of one of the free-standing non-profit D.O. schools. Those financial statements are clean enough to actually figure out what is going on.

Then you can figure in the fact that D.O. schools probably spend more than is necessary because OMM is expensive to teach. D.O. schools also tend to spend slightly more on stipends to hospitals for hosting students during clinical rotations.

From what I figured from a while ago for one of those schools it costs 15-20k/yr per student to teach med students. LECOM is bathing in money despite only charging 30k/year in tuition. There is an example of how little it can cost to educate medical students--you don't have to take my word for it. LECOM is growing like gangbusters and if you look up their financials they could set up rooms plated in gold.

Keep in mind that finance and accounting is rarely completely objective (even if the parties who have control over it are trying to be honest). Where you allocate overhead, how much administration you really need etc is all pretty arbitrary. Especially in situations where you have an integrated hospital system, a veritable army of researchers etc. it can be hard to say how much it really costs.

That's how you can get silly math like 3% of the cost of educating a student is funded from 30k/year of tuition. It DOES NOT cost 1,000,000 per year to educate a student. We need more med students/physicians who enjoy math/accounting because that number should make you laugh at whoever is trying to sell you that line of BS. (for those that don't get it, if 30k = 3%, 100% = 1mil)

Yes, your school's total revenue from all sources divided by the number of students it educates might be 1,000,000 but that doesn't have anything to do with the actual cost. Yes when you only have 80 medical students start school per year, their tuition is like pissing in the wind in comparison to your 1 billion dollar revenue university medical center, 250 million in research funding from the NIH, etc, but that doesn't mean it actually costs 1.25 billion dollars to educate 320 medical students (across 4 years).

That AMSA thing is hilarious.

If it makes you feel any better, this isn't a phenomenon unique to medicine. All education in the country has been skyrocketing in cost over the last 20 years. This exponential growth rate is in spite of the fact that it's actually more efficient to educate students now with the developments in technology.

Giant mess, and not easy to fix. Education is basically in a huge bubble right now.

 

[Marcus Brody]

Gotta make up for all those medicare/medicaid patients somehow.

 

[aerodoc]

That's how you can get silly math like 3% of the cost of educating a student is funded from 30k/year of tuition. It DOES NOT cost 1,000,000 per year to educate a student. We need more med students/physicians who enjoy math/accounting because that number should make you laugh at whoever is trying to sell you that line of BS. (for those that don't get it, if 30k = 3%, 100% = 1mil)

I don't think the AMSA article is saying that 3% of the cost of educating a student comes from tuition. It says tuition is 3% of TOTAL SCHOOL REVENUE, which does amount to millions of dollars.

If you want to know about cost of educating a student, right in the article it says:

"Furthermore, expenditure levels do not clearly indicate where these additional revenues are going; for example, instructional costs have gone from about $47,000 per student per year in 1974 to $51,000 (7) per student per year in 1997 (8) (adjusted to constant 2002 dollars)."

 

[Whiskeypunch]

I don't think the AMSA article is saying that 3% of the cost of educating a student comes from tuition. It says tuition is 3% of TOTAL SCHOOL REVENUE, which does amount to millions of dollars.

If you want to know about cost of educating a student, right in the article it says:

"Furthermore, expenditure levels do not clearly indicate where these additional revenues are going; for example, instructional costs have gone from about $47,000 per student per year in 1974 to $51,000 (7) per student per year in 1997 (8) (adjusted to constant 2002 dollars)."

As I mentioned, there are many ways to come up with those numbers. Overhead is a tricky tricky thing. There are private schools educating people for a fraction of that and pocketing the difference. The point was that number as a percentage of revenue is completely meaningless in terms of costs.

 

[JackShephard MD]

I don't think the AMSA article is saying that 3% of the cost of educating a student comes from tuition. It says tuition is 3% of TOTAL SCHOOL REVENUE, which does amount to millions of dollars.

If you want to know about cost of educating a student, right in the article it says:

"Furthermore, expenditure levels do not clearly indicate where these additional revenues are going; for example, instructional costs have gone from about $47,000 per student per year in 1974 to $51,000 (7) per student per year in 1997 (8) (adjusted to constant 2002 dollars)."

Yeah, don't believe that article.

Instructional costs are primarily comprised of professor salaries and costs that relate directly to the teaching program, while total educational resources include all activities of teaching, research, scholarship, patient care, and maintenance of facilities.(5) Therefore, tuition does NOT cover all costs to fund your medical education. This inherently means that medical schools must derive funds from other sources.

Medical schools are cleaning up. The tuition more than covers the cost of all the students.

 

[RestoreSight]

This is a debate I have had with my friends over and over again. Does anybody know where our medical school tuition goes? I calculate that my medical school, which has 180 students per class at 48k per year gets about $35 million from med school tuition. Does that all go toward medical education, keeping the lights on in the library, and day to day management? Or are we paying physician salaries or for rotations?

Salaries, infrastrucure, endowment.

On a related note, 4th year is a rip off. You get a ton of electives, many that you can just take as vacation, but your tuition is the same as 3rd year. I say if you should only pay for rotations you get instruction on, otherwise your just a paying volunteer.

 

[45408]

Nobody knows...

 

[bomgd3]

Man, the whole tuition/student loan thing has really soured me on higher education. Our profs preach empathy while they rob us blind. When I see profs who make a healthy six figures show up to work at 11, lecture for an hour, and go home...

 

[theseeker4]

Man, the whole tuition/student loan thing has really soured me on higher education. Our profs preach empathy while they rob us blind. When I see profs who make a healthy six figures show up to work at 11, lecture for an hour, and go home...

LOL, this is very true. Had this conversation earlier at work. It used to be, people chose to go into academia (not just in medicine, academia in general) because the perks of not working in the corporate world were worth the lower starting salary than could be earned in the private sector. Today, often an academic job pays more to start than a private-sector job. Add in the perks of academia, the ability to take a discovery you made in the University lab and create a private company to profit from it (with nominal royalties to the school, of course) and there is no wonder the academic jobs are in such high demand. In the private sector, if you make a discovery that could earn your company a billion dollars, you will get a bonus and a promotion if you are lucky, you certainly can't decide to leave and create your own company based on your work. Pretty much a racket, and the reason I have no respect for the preaching by anyone in academia.

 

[engineeredout]

Considering my school doesn't pay rotation sites to take us, I'd love to know where third and fourth year tuition goes.

 

[VenusinFurs]

Man, the whole tuition/student loan thing has really soured me on higher education. Our profs preach empathy while they rob us blind. When I see profs who make a healthy six figures show up to work at 11, lecture for an hour, and go home...

I'm sure that's all they're doing. Their job could not possibly entail such ridiculous things as research and teaching other professional students or undergrads.

 

[VenusinFurs]

I get a bit annoyed that they still make us pay for things such as CPR certification, lab coats for micro lab, etc.

 

[LoveMyRam]

It gets pissed away with conferences, social events, and dare I say professor salaries, among many other useless ish that your administration deems necessary and required for students.

 

[Midwestern Blot]

A lot of schools use part of tuition to subsidize other students' education that can't afford it.

 

[cowme]

It goes to the Cover the losses in productivity that occur when teaching students.

 

[link2swim06]

http://www.amsa.org/AMSA/Homepage/About/Committees/StudentLife/TuitionFAQ.aspx

Looking at that article, tuition only covers about 3-8% of medical school revenue. Out of that percentage, the actual money can be dispersed among a number of things including administration, maintenance, instructional costs, etc. In the end, it seems that "tuition does NOT cover all costs to fund your medical education" and that schools take a loss.

Ughh sorry "grants" for research have nothing to do with my education.

Med schools are just terrible at managing money becuase they have zero accountability. Its kinda like the government, they can spend 5 million dollars on a simple webpage because it isn't their money to waste.

 

[link2swim06]

A lot of schools use part of tuition to subsidize other students' education that can't afford it.

Can anyone "afford" med school? I dont think this is at all true at the professional school level...

 

[likeaboss]

Part of the problem is the availability of student loans subsidized by the government. If students paid out of pocket or actually had to pay the loans before getting out of residency the market would price medical education efficiently. Instead we have financial aid offices getting huge sums of money direct from the government and giving us a tiny piece of it.

I always wondered why our money is funneled thru a financial aid office... Medical schools are smart

 

[bomgd3]

I'm sure that's all they're doing. Their job could not possibly entail such ridiculous things as research and teaching other professional students or undergrads.

Nah, there are a bunch of people who I literally see come into their offices for a few hours a day, and mostly just to shoot the breeze with other profs or to give a disjointed lecture or two. They don't have grants or labs anymore so they aren't doing research. Also, I'm pretty sure we have like eight deans. I never know which to email so I just pick one at random and assume the correct person will get forwarded.

There are some really good people in academia, particularly many clinicians who have given up a big private practice salary in order to teach. But the lack of accountability at med schools enables a lot of fiscal shenanigans to go on. My school is fully unionized which allows further shenanigans to occur.

One day I'll build some kind of business to cash in on those fat professional student loans.. maybe buy a nice apartment complex or something. Until then, I'll just grin and bear it until graduation.

 

[link2swim06]

Part of the problem is the availability of student loans subsidized by the government. If students paid out of pocket or actually had to pay the loans before getting out of residency the market would price medical education efficiently. Instead we have financial aid offices getting huge sums of money direct from the government and giving us a tiny piece of it.

I always wondered why our money is funneled thru a financial aid office... Medical schools are smart

I think this would be true if there wasn't a surplus of pre-meds....but when only 50% of pre-med are getting in, there are plenty of people with wealthy parents who would foot the bill.

In other words it would turn into a situation where only those with wealth have the chance of med school. Our student loans system is suppose to give everyone the "chance" at education.

It short it is very dependent on the laws of supply and demand. The supply of med school spots is very limited compared to endless number of people wanting to get in. Simple economics at work.

 

[bomgd3]

I think this would be true if there wasn't a surplus of pre-meds....but when only 50% of pre-med are getting in, there are plenty of people with wealthy parents who would foot the bill.

In other words it would turn into a situation where only those with wealth have the chance of med school. Our student loans system is suppose to give everyone the "chance" at education.

It short it is very dependent on the laws of supply and demand. The supply of med school spots is very limited compared to endless number of people wanting to get in. Simple economics at work.

That's true, but medicine isn't a regular marketplace. There is a public interest in having strong access to medical education for all socioeconomic groups, not just the wealthy. There is also a public interest in producing primary care doctors, and as long as people are graduating from public school with 200k in debt @ 6.8% with capitalization, many aren't gonna work for $150k as a family doc or pediatrician.

 

[link2swim06]

That's true, but medicine isn't a regular marketplace. There is a public interest in having strong access to medical education for all socioeconomic groups, not just the wealthy. There is also a public interest in producing primary care doctors, and as long as people are graduating from public school with 200k in debt @ 6.8% with capitalization, many aren't gonna work for $150k as a family doc or pediatrician.

Its far less about what people "want" to do and much more about what residencies are available. Most people go to med school clueless about the financial aspect/availability of residencies. Its only after you have gone in too much debt most realize what is going on...(and by that point the only way out is to go forward).

Due to a boatload of foreign grads (pun intended), we still get 95% fill rates for family med residencies. Therefore, I would argue the number of specialist vs primary care is entire due to where residency fund has been placed by the government.

If nearly every residency spot is filled, then people will work for any six-figure salary in family med because they have no other options. Its not like they can just take their medical degree and work in a different career field.