One Class at a Texas University Dodges the Financial Burden of Med School

Last week, Fort Worth’s Texas Christian University (TCU) School of Medicine announced that the Class of 2024 received a financial gift from an anonymous donor that fully covers tuition for the next academic year, marking the second such gift for the 60-student class.

One of the lucky students, Hanna Makk, noted that this will change what she is able to do with her career in medicine.

“It frees me to be able to pursue whatever specialty I want and to be able to serve the underserved, which is something that I’ve always wanted to do,” Makk said in a video testimony provided by the school. “And now, free from the burden of those debts, I can pursue that.”

Makk’s gratitude and optimism was shared by Erin Nelson, MD, the assistant dean of admissions at the medical school.

“For our medical students, this is truly a life-changing gift,” Nelson told MedPage Today. “For every single one of them, the trajectory that this can set them on in terms of their choices and their future and their practice — it’s exponential in its magnitude.”

This class — who started medical school in July 2020 — had their second year of tuition fully supported by an anonymous couple in 2021. The new gift will cover next year’s full tuition, which is approximately $63,000, and about two-thirds of the $95,000 cost of attendance. The announcement was made during an in-person session with the students on June 16.

The response to the gift and its effect on the students serves as a reminder that medical education has become synonymous with extreme financial burden. This reality was not an afterthought for the TCU students or the school’s leadership.

“We know that medical students everywhere have a tremendous amount of debt when they leave medical school, and it is an incredible burden to bear for students,” Nelson said.

The average medical school student graduates with more than $250,000 in education-related debt, according to a TCU press release.

Daniel Barron, MD, director of the Pain Intervention and Digital Research program at Brigham and Women’s Hospital in Boston, pointed out that medical school graduates also carry this substantial debt into residency programs that don’t afford them the opportunity to quickly pay debts off. However, he noted that the real focus should be on determining the true cost of medical education.

“It’s important to draw a distinction between cost and price. The cost is how many cents and dollars it requires to educate a medical student,” Barron told MedPage Today. “In medical education — and in many other forms of higher education — the cost to educate one student is not clear.”

In 2019, Barron realized the importance of this difference while researching the topic for an article he wrote for Scientific American. He realized that identifying the real cost of educating doctors is a crucial first step to understanding why medical school debt has grown to its current levels.

“I would love to know the cost of educating a medical student,” he said. “I think it would be very difficult to learn that because the academic centers are not organized in such a way that that cost is fairly calculable.”

In the absence of transparent and measurable costs for medical education, Barron highlighted New York University’s Grossman School of Medicine as an example of an institution that applies a different approach to keep the price of medical school manageable. In 2018, the school announced that it would become a fully tuition-free program, citing the need to ease the financial burden facing its graduates.

“We wanted to take the stress off of our students,” said Rafael Rivera, MD, MBA, associate dean for admission and financial aid. “We wanted to allow them — if they wanted — to start saving money to buy a home or to start a family, [so] that they can do so on their own timeline, and not have that timeline be dictated by having to pay $200,000+ off in debt.”

Since that announcement, the Grossman School of Medicine has also started providing a debt-free program to students who need help with non-tuition costs, such as living expenses, as well as a 3-year medical program that is designed to shorten the time and cost of obtaining a medical education.

Rivera said the school had to increase its endowment from the low-$10 million range to over half a million dollars in order to establish the funding to provide that tuition relief, the result of a decade-long effort led by the Dean and CEO of the medical school, Robert Grossman, MD.

The long-term approach to building such a large endowment could be a major barrier for other programs hoping to follow in NYU’s footsteps, Rivera noted. The size of the gift given to students at TCU was approximately $3 million.

As Barron pointed out, the price of medical education is still worthwhile for many people. It is the reason most medical schools still recruit full classes each year, he said, though he believes that the financial burden would become more manageable for incoming students if they had an accurate understanding of the cost of their education. This is the first step to potentially reducing the price and the long-term debt for upcoming classes of new doctors, he added.

He noted that even the Hippocratic Oath advocates for tuition-free medical education, stating that all who take the oath should “… teach them this art, if they shall wish to learn it, without fee or contract… .”