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High Price of Medical Education a Barrier for Many
Kendra Campbell -- Last week, the Association of American Colleges (AAMC) announced a new campaign to increase diversity in medicine. The disparity between the racial background of the U.S. population and the nation’s doctors is profound. According to the U.S. Census Bureau, 98 million, or 33 percent, of the country’s total population belongs to a minority race. Yet, according to the AAMC, only 6 percent of all practicing physicians in the U.S. are minorities.
The AAMC has been concerned about this issue for a long time. They’ve developed many programs to try to attract minority applicants to medical schools. Unfortunately, they haven’t been very successful. For a while, the number of minority applicants was increasing, but the numbers have again begun to decline.
As part of their new campaign, the AAMC has also launched a Web site, AspiringDocs.org, which is an attempt to make the idea of going to medical school more appealing to minority groups. One of the premises of the new campaign is that while more and more minorities have been graduating with biology degrees, the number of medical school applicants from this group has remained steady. The AAMC is hoping to change that.
Although I applaud the AAMC for their efforts over the years to increase the diversity of our nation’s doctor pool, I think there are a number of factors working against them. Probably the most important factor is cost. Medical school is horrifically expensive. If you are from a low-income family, the thought of spending $200,000+ to go to school can be mind-boggling. How could you possibly undertake something that will cost more than your entire family makes in ten years? While it’s true that there are many types of financial assistance programs, the vast majority of students will end up having to pay the money back eventually. Unless you plan on being a cosmetic surgeon in Beverly Hills, making $2,000 loan payments every month, on top of medical malpractice insurance and many other costs, can be a frightening prospect. Since I plan on working with underserved populations, I’m quite scared about how I’m going to manage paying back my student loans.
Not only is the cost of actually attending medical school intimidating, but the cost of just applying can be equally daunting. If you add up the expense of getting an undergraduate degree, taking the MCAT, applying to medical schools, traveling for interviews, and paying many other fees, the number is astounding.
When I was applying to medical school, I had a decent job, yet I still could not afford everything. I spent money on an MCAT prep class, and then had barely any money left to pay for all the applications and travel costs. If I had trouble affording it, imagine how someone making minimum wage might feel. If you can’t even pay to apply to medical school, how could you begin to entertain the thought of actually going to medical school?
There are plenty of other reasons why many minorities are not applying to medical school, such as the lack of minority role models. In addition, many elementary and secondary schools are so busy making sure that “No Child is Left Behind,” that they don’t have the time and resources to effectively teach the sciences. If we don’t foster an interest in the sciences at an early age, how can we expect our children to want to pursue medicine later in life?
To me, it seems like the issue always comes back to money. I think the question that we should be asking ourselves is, “how can we make medical school more accessible to everyone?” Right now, we’re facing a shortage of physicians, and the problem is most severe in the rural and impoverished areas of the country. Considering that many of our patients are from diverse backgrounds, we need to ensure that our doctor supply is equally as diverse.
December 12, 2006 in Kendra Campbell | Permalink
Comments
It's true that there isn't enough diversity in medical school. It is also true that medical school costs alot of money. It is absolutely false that this is a barrier to becoming a doctor for minorities and or low income/no income qualified individuals!! There are endless monies out there for anyone and everyone. Starting from the beginning... up through high school education is free... applying to college and college itself is also free with academic scholorships... and as we know there aren't enough of those to go around.... so... there are tens of thousands of private scholorships and foundations out there and less than half of those monies are claimed due to the lack of effort and or research on the parts of would be students.... the application fee for AMCAS is waived for those meeting financial requirements, and the fee for the MCAT is waived for those in need. Medical school is also free for those who want to serve the underserved.... I'm sure most who look into it are familiar with the primary care loan program... your tuition is free if you sign a commitment to work in an underserved primary care role. Pretty sweet deal huh? Further... you can join the military... yup... free med school again and none of that messy match stuff for the most part.... If you're like most and think "Don't want to commit to a no pay Family Practice , peds, etc. specialty" (confirmed by stats) You, once again, can hit the internet or the local library and apply for the billions of dollars of foundation money out there (I know over a dozen people in my school who apply and get between 2 and 4 different scholarships each year just because they are from a paticular state or go to a church or write an essay or just need the money! And more importantly ... because no one else tried to get it!) If you're still not convinced... there is always that 200,000 bucks you can borrow from uncle sam... and yes you have to pay it back (OH NO>>>nothing for free :() Well, I did the 200,000 thing and am not worried at all about having to pay it back.... the truth is that you won't have to pay $2000 a month as was previously implied... but for $200,000 on a graduated plan it's more like $500-800 a month (less than the majorities of rents) Further, if you qualify, as most do... you can defer in residency and pay reduced monthly payments if your income is low. Long story short.... money is not the reason there are less minorities in medical school! There are many reasons for the lack of diversity... and they should be addressed... money isn't one of them... it is an excuse... if you want to be a doctor and you work hard enough (short of having an evil stepmother/father that locks you away from the books) then the resources are out there and are more than reasonable. It sucks that it costs so much... but for those of us who would wear a burlp sack to rounds if need be to realize our dream... it's really nothing... it's not the person who dies with the most money tucked in her mattress who wins.....
Posted by: Faustus | Dec 13, 2006 5:29:39 PM
Although it's true that money may not be a true barrier, I do agree that it's a definite psychological barrier for a lot of folks. A lot of the stuff about the MCAT being free etc. isn't really advertised and the general population knows that medical school is very expensive. If the public was more aware of the financial aid available, more people in unfavorable financial positions might apply.
Posted by: Little veg | Dec 15, 2006 5:21:57 AM
I really have to say that Faustus is living in a dream world. As a minority and as a graduate student in the health sciences I can say that private and public scholarships are difficult to get, even if you are an a+ student with a terriffic MCAT score! They aren't there for the taking... and spending hours each week applying for different sources of funding takes away from other things that must get done!
Anyway, what I meant to say is that I would agree with Kendra's post except for the statement - "there is a shortage of physicians" - the fact is, we live on a continent that is not understaffed. We simply have an incredible disparity in the availability in physicians over geographic areas and specialties. Finding a GP in a rural or small town is almost impossible, and finding certain kinds of specialists is incredibly difficult... but they are there. In Uganda, there is (on average) one physician for more than 200,000 people. That's the equivalent of a whole city with only one doctor.
I agree completely that we should examine the barriers that keep our medical classes from representing the ethnic, ability and gender diversity that truly exists in each population. But as long as medical school is the path to status in a society, the biggest barrier to true diversity will be money.
Posted by: jocelyn | Dec 17, 2006 3:10:48 AM
"Considering that many of our patients are from diverse backgrounds, we need to ensure that our doctor supply is equally as diverse."
This is not true.
We need to recruit physicians willing to work in these underserved areas by offering better incentives for them to do so. I don't care what racial or socioeconomic background my doctor comes from as long as they come up with the right test, the right treatment, and are available for me to see them.
It's racist to say we need black doctors to treat people in black neighborhoods or hispanic doctors in hispanic neighborhoods. Like I said, increase the incentives and more doctors of all backgrounds will be more likely to work in underserved areas.
Posted by: | Dec 19, 2006 9:42:03 AM
It is clearly jocelyn who is living in a dream world... to post a comment as naive as "I can say that private and public scholarships are difficult to get, even if you are an a+ student with a terriffic MCAT score!" is uninformed and baseless coming from someone who isn't even a medical student! Second your discouraging words about how hard it is to get funds from scholorships and foundations is detrimental to those who need them but won't try because they think it is hard... the fact is ... IT ISN'T... in the vast majority of cases all you have to do is fill out a form or write an essay... that's it!!! Here are two out of hundreds of links...
http://collegeuniversityscholarships.com/
http://scholarships.fatomei.com/health.html
The second being a link to minority scholorships...
Next... The statement that there isn't a shortage of physicians in the USA is also absolutely FALSE!! If you're going to pursue a medical career you better get use to evidence based opinions and you shouldn't make statements without knowing the facts... there are several articles in JAMA and other journals clearly demonstrating the lack of physicians in this country... further Uganda is a very poor comparison.... with a population of just over 25,000,000 it has less than 1/10th the population and a vastly smaller area....As for medical school being the path to status... time to wake up and smell the coffee!!!!! If you hadn't noticed that notion went away about 30 years ago... hence the relative drop off in the numbers of new physicians... now we are sued, suspected, and slandered at every turn... and lastly... I find it rediculous that there are more important things to do or get done than finding funding for your education!!!!!!!!!!!!!!!!!! If you can't put together an hour a day for a week or even less to apply to a dozen or so funds.... you should seriously rethink your career choice... there are tons of much more dedicated people out there who take becoming a doctor seriously!
Posted by: Faustus | Dec 22, 2006 10:40:13 PM
Thanks to everyone for the comments. After reading all of your responses, I felt compelled to follow up on one point. I am very, very aware of all the scholarships available to low-income and minority applicants, as well as the fee assistance programs for things like the MCAT and AMCAS. However, there are two problems with using this as a basis to say that money is not a barrier to getting a medical education. First of all, the biggest problem has to do with "hidden costs." For example, while one can have the MCAT fee waived if they qualify, no one will pay for a low-income individual to take an MCAT prep course. While this is not a necessary prerequisite, it could certainly help level the playing field for someone who went to a not-so-ivy-league school and who might need that extra bit of help to obtain a high enough score to even be considered. This is just one example of a hidden cost associated with attending medical school. I could list hundreds more. And I am not the first person to recognize this. It's something the AAMC and others have been studying for years. The second problem is that while fee assistance programs can be very helpful for extrememly low-income individuals, there are many middle-to-low income individuals who don't qualify. I was actually in the middle-income bracket when I was applying to medical school, and I still had problems paying for everything. However, I was not eligible for any of the fee assistance programs because I was not poor enough. Basically, there are lots of people who fall through the cracks. I think that the lack of information is also key to this equation. Many lower-income folks just don't know about all of the resources that are available to them. Many of them might not even have an easy way to access the internet, or even know where to begin looking. I think that one of the most important things we can do is work to educate everyone about the options available to them.
Posted by: Kendra Campbell | Dec 23, 2006 9:30:07 AM
the middle class gets screwed again and again...cant qualify for much aid but not deep enough pockets to pay it straight.
how come the doctors who graduated 20 yrs ago paid so much less tuition than we do, even when adjusted for inflation? thats insane.
Posted by: | Dec 26, 2006 11:11:56 PM
i live in turkey..most of medical schools belong to the government and they are not so much expensive.the medical schools which belong to a foundation or a person are expensive so much..having too much money is not enough to enter a medical faculty in our country, we have a silly examination after high school.everybody is ambitious, want to enter a good university.taking a very high mark is required to be able to enter a good medical school..if you can enter, you may find a scholarship from a foundation.as you guess, the price is not a barrier in front of medical education, the examination for entering university is a barrier for many of us.thank God, i could enter..God saves us..
come come, whatever whoever you are..our door is open for everybody:)) (from Mevlana)
Posted by: erkan sabri ertas | Dec 29, 2006 1:52:21 PM
i live in turkey..most of medical schools belong to the government and they are not so much expensive.the medical schools which belong to a foundation or a person are expensive so much..having too much money is not enough to enter a medical faculty in our country, we have a silly examination after high school.everybody is ambitious, want to enter a good university.taking a very high mark is required to be able to enter a good medical school..if you can enter, you may find a scholarship from a foundation.as you guess, the price is not a barrier in front of medical education, the examination for entering university is a barrier for many of us.thank God, i could enter..God saves us..
come come, whatever whoever you are..our door is open for everybody:)) (from Mevlana)
Posted by: erkan sabri ertas | Dec 29, 2006 1:54:29 PM
Hello, while reading your post I thought about my undergrad experience while I was a student. I started my education at a university in Chicago(CSU) that was for the most part all minority. I passed all of the science classes that I took there but I will say I had the hardest time.
I must say that the chemistry professors were very helpful and taught for concrete understanding of the subject but the biology professors were the exact opposite, they didn't teach for understanding and spent entire semesters covering subjects that we never even tested on and tested on things that were never even covered. I felt that we were worked harder because we were minorities
After 3 semesters at that university I transfered to another school that had a different demographic (U of C) and I must say I had a better academic experience there. The professors actually taught in a way that one would easily understand. The test were revelant and the professors were very approachable. I felt no pressure to prove that as a minority i'm better than the rest of the school population.
I say all of this because aside from the reasons you stated, in my opinion the reason that more minorities do not apply or attempt to go to medical despite having an interest is because of the pressures of "if we don't perform at the top level of everything we will not make it in medical school".
Yes medical school is hard and we are supposed to perform at the highest level but at the same time a person can make it in medical school without the best or highest scores (I've seen many non-minorities that were average at best go through med school and become great doctors).
So while we as minorities are often left to go to colleges or universities that offer low and affordable tuition we are also stuck with underpaid and overworked professors whose only job is to make our lives miserable. Yes I kow this is part of a professors job but it just seem a little bit more at minority universities.
Yes I could be a angry student who is upset because I worked so much harder than other people to get the same opportunity or I could also be totally or even partially right, either way what's your opinion??
Posted by: Minoirity | Nov 24, 2007 2:03:09 AM
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