Forgive med school loans

Editorial Board
http://daily.stanford.edu

Last month was Stanford’s School of Medicine Match Day, a celebration where soon-to-be-graduates learned with which medical residency programs they had been paired.

These graduates are faced with a difficult decision regarding which medical field to enter, and an increasing number of top medical students around the country are applying to residencies in dermatology and cosmetic surgery. These fields offer lucrative pay and regular hours. Many cosmetic procedures are not covered by insurance, allowing doctors to ask for money up-front without having to tussle with insurance companies.

Meanwhile, critical fields like geriatrics, a specialization in care for the elderly, and internal medicine, which cares for adults, are facing growing physician shortages. Much of this shortage can be blamed on less-attractive hours and salaries. Many seniors are covered by Medicare and Medicaid, which in some cases provide skimpy reimbursements for medical care. This in turn drives down the salaries of those physicians who choose to care for the nation’s poorest, weakest and most infirm citizens. And as the shortage of these primary-care physicians worsens, these doctors have to put in longer and longer work weeks to fulfill their expanding caseloads.

As Dr. Eric Parlette, a dermatologist in Massachusetts, said in an interview with The New York Times in March: “It is an unfortunate circumstance that you can spend an hour with a patient treating them for diabetes and hypertension and make $100, or you can do Botox and make $2,000 in the same [amount of] time.� He said he chose his field because he wanted to perform procedures like skin cancer surgery and cosmetic treatments while keeping regular hours and earning a rewarding salary.

Troublingly, top graduates of top medical schools are effectively discouraged from entering primary care. This worsens America’s primary-care physician shortage, and as America’s population continues to age, the demand for primary-care physicians will continue to grow.

But Stanford’s School of Medicine can do something to stop this vicious cycle — by forgiving loans for graduates who enter these crucial fields. While the School is at it, it should go even further by instituting a loan forgiveness program for those graduates entering public service and also for those serving underserved areas.

Graduates of Stanford’s School of Medicine emerge saddled in debt; as Dr. Charles Prober, an administrator at the medical school, told The Daily last week, the average indebtedness of graduating students is pegged at $78,000. While this figure is quite low compared to most medical schools, and the national average of over $150,000, it is substantial enough to sway many graduates’ career decisions. A loan forgiveness program would give Stanford School of Medicine graduates a real incentive to enter the career paths that they feel are most fulfilling, not just those that are most lucrative.

A similar, successful system is in place at Stanford’s Graduate School of Business (GSB), where for each year a student works at a non-profit (or in some circumstances, an international organization in a developing country), a portion of their outstanding loans is paid for by the GSB.

The School of Education announced this year that it is partnering with the Woodrow Wilson National Fellowship Program to provide generous $30,000 annual stipends to top students who opt to teach at needy secondary schools.

And Stanford Law School announced last month that it will be expanding its long-standing loan forgiveness program for graduates making less than $100,000 a year. As The Daily reported in April, some public defender and non-profit positions have annual salaries of as little as $50,000 a year, scanty compared to the six-figure entry-level salaries available in private law practice.

But Stanford’s School of Medicine is conspicuously absent from the list of Stanford’s professional schools offering commendable loan forgiveness initiatives. Last week, the Editorial Board commended Dean Philip Pizzo and Stanford’s School of Medicine for banning gifts from pharmaceutical companies. This week, it urges the medical school to join the trend of loan forgiveness. Stanford’s School of Medicine ought to reward its graduates who enter underserved professions and communities.

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