Elaine Frederick

Since the New York University School of Medicine announced on Aug. 16 that the school would offer tuition-free education to all current and future students, the decision has been hailed as a game changer that will help alleviate the financial burdens of medical education.

At Yale, where medical students still grapple with this debt, the announcement has inspired lively discussions about the policy change and the future of medical education. On Tuesday, Robert Alpern, the dean of the School of Medicine, sent an email to the medical school community explaining the school’s philosophy of financial aid.

“There has been much discussion recently around the issue of financial aid and decreasing and eliminating tuition for medical students. Because of this, I thought it would be timely to review our need-based financial aid philosophy at Yale, our accomplishments to date, and our goals for the future,” he wrote. “Our ultimate goal is to provide sufficient need-based financial aid, such that all students attending Yale School of Medicine have the ability to graduate debt-free.”

One of the largest changes this year, according to Alpern, has been reduction of the unit loan — the minimum amount students are expected to borrow each year — from the projected $30,000 to $23,000.

Eventually, Yale hopes to raise sufficient scholarship funds to cover all demonstrated need and eliminate the unit loan so that no student will have to take on any debt.

Medical schools nationwide, not just Yale, are grappling with increasing amounts of student debt. In 2017, the average medical school debt for graduates was $192,000, according to the Association of American Medical Colleges.

NYU aims to nip debt in the bud by paying the tuition of all its students, regardless of merit or financial need. It will be the first major American medical school to do so.

“This tuition-free initiative is the next big milestone in NYU School of Medicine’s effort to transform medical education,” said Steven Abramson, NYU’s senior vice dean for education, faculty and academic affairs. “The model of medical education needs to address changing scientific, social and economic circumstances as well as dramatic changes in the health care delivery system.”

According to NYU, the initiative aims to increase diversity in medicine and address the shortage of primary care physicians. Crushed by debt, medical students are often drawn toward higher-paying specialties and away from less lucrative fields such as primary care and pediatrics.

Still, several students at the School of Medicine do not think that the initiative will address minority underrepresentation in medicine or physician shortages.

“I don’t think it’s going to make a huge difference. It’s not like having free medical school is going to fix 22 years of having less opportunities to pursue an education,” said Pavithra Vijayakumar MED ’20, who served as communications officer of the medical student council last year. “I think there’s this idea among administrators that that’s kind of a bigger problem than they can handle.”

According to Max Tiako MED ’20, fixing the primary care deficit will require a structural overhaul. For example, he said, NYU doesn’t have a department of family medicine, one of the core specialties that delivers primary care.

Moreover, Tiako said, there may be more effective ways of producing more primary care physicians than making tuition free. One such solution is loan forgiveness programs, which would require that the beneficiaries commit a certain number of years to practicing primary care.

Other Yale students agreed that the initiative is more likely to function as a recruitment tool for NYU than to make societal differences in the health care field.

“The program isn’t likely to catapult someone who otherwise would not be a viable candidate in the medical school application game and allow them to apply,” said a student at the medical school who requested anonymity to avoid compromising residency applications. “It just helps them ‘steal’ a student from another prestigious institution.”

Still, the move is a step in the right direction, according to students interviewed. The average medical school debt is $192,000, so having tuition waived can relieve a great deal of anxiety around financing one’s education, said Stephen Ghazikhanian MED ’21, a financial aid representative on the medical student council.

“I think we’re still quite far away from having tuition-free medical schools across the nation, but I do think there is an awareness of the student debt crisis and shift towards trying to alleviate that burden, and that should be the ultimate goal,” Ghazikhanian said.

Mehida Rojas-Alexandre MED ’18 pointed out that many countries outside the U.S. offer free medical education and suggested that more schools in the country may follow NYU.

But for Yale medical school students, free tuition is unlikely to become a reality anytime soon. Rather than conducting a massive overhaul, the school’s first priority is need-based financial aid, increasing scholarships to reduce student debt, Alpern told the News.

“[Bringing student debt to zero] in essence makes us tuition-free for those who do not have the financial resources to pay tuition,” Alpern said. “Once we have accomplished this, we might consider lowering tuition for those that can afford to pay it.”

All students interviewed said that Yale is in the middle of the pack among its peer institutions in terms of affordability and financial aid packages.

Although the recent improvement in financial aid policy has helped many students, it isn’t a perfect solution, according to Ghazikhanian.

“A great number of my friends are taking out more than the unit loan because whatever calculus is used to determine parental contribution is unrealistic in certain cases,” he said.

The total 2018–19 academic year cost for first-year students at the School of Medicine is $86,647.

Amy Xiong | amy.xiong@yale.edu