Is Merit-Based Financial Aid Detrimental to the Future of American Medicine?

In a commentary published on the website of the New England Journal of Medicine, scholars from Johns Hopkins University, Harvard University, and Stanford University warn that the increase use of merit-based financial aid to attract candidates to medical school may be detrimental to the future of medicine in the United States.

Typically, four years of medical school can cost $250,000 or more. Many medical schools offer merit-based aid to attract candidates with the highest undergraduate grade point averages and scores on the Medical College Admission Test.

Roy Ziegelstein, vice dean for education at the Johns Hopkins University School of Medicine, points out that “assuming all institutions have a finite pool of money for aid, the more dollars used for merit means fewer dollars are left for those with financial need.” A smaller pool of need-based aid will make it difficult to “train a diverse group of physicians who reflect the populations they serve and serve the needs of those populations,” Dr. Ziegelstein adds.

The commentary reports that the number of students who graduate with no medical school debt has nearly doubled in the past five years. This suggests the increased use of merit-based aid. In contrast, the number of students who graduate with more than $300,000 in debt has also doubled. This shows that those with financial need are increasing having difficulty obtaining need-based aid.

Dr. Ziegelstein explains that “medicine is a public trust, and we are seeing increasing need for primary care physicians and geriatricians to care for our aging population. If merit aid creates a situation, even if unintended, that makes it more difficult for students to choose these lower-paying specialties, then this affects our ability as a profession to meet our responsibility as a public trust.”

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