Peter Bach, of the Memorial Sloan—Kettering Cancer Center, and Robert Kocher, of the Brookings Institution, argue that medical school should be free. In a May 2011 New York Times op-ed, the two doctors said M.D. programs could be free if they suspended stipends for students in specialty training programs. Since a specialist can earn $325,000 annually compared to a primary care doctor's $190,000, Bach and Kocher said specialists could forgo their stipends without too much pain.
"Our approach has no strings and does not require any decisions about future career be made in advance of medical school," Bach and Kocher—who have received calls from Capitol Hill staffers, current administration, and a Republican candidate's team wanting to help implement their plan—said in an E-mail.
But for now, medical school isn't free for the overwhelming majority of students in the United States, and aspiring M.D.'s can expect to pay more on average than their predecessors, according to a recent Association of American Medical Colleges report. Nonresident students at public schools—the subset with the highest tuition costs, according to the report—will pay about $188,000 over a four-year period, on average, not including room and board.
Primary care doctors earn an average annual salary of $186,582, according to a recent a study in Health Affairs, which means medical school costs remain a challenge for those who aren't destined to host Extreme Makeover or Dr. 90210. Luckily, there are some ways to earn an M.D. without taking out huge loans.
For example, Vanderbilt University's School of Medicine offers eight non-need-based scholarships, according to its website. Carla Valenzuela, a second-year student at Vanderbilt, holds one of the school's Cornelius Vanderbilt Scholarships, which covers 75 percent of her tuition.
Though an "incredible honor," Valenzuela says the scholarship didn't affect her choice of schools. "I know it sounds crazy, but I seriously wanted to go to a school that 'fit' and didn't care about the cost," she says.
According to its website, Washington University in St. Louis's School of Medicine is "among a small number of medical schools which offer merit-based scholarships," all of them full tuition, as well as a scholarship for women studying at the school. University of Virginia's School of Medicine also offers merit scholarships—some of them a full ride.
[Learn about the 10 least expensive private medical schools.]
Eve Privman, a third-year medical student at UVA, has her tuition and fees waived as part of the National Institutes of Health's Medical Scientist Training Program (MSTP), which also pays stipends to 933 budding researchers in joint M.D.-Ph.D. programs at 45 institutions. Privman, who had been torn between pursuing a research career and an M.D., says she was "ecstatic" to learn of the combined program.
But she stresses that the seven- or eight-year program isn't really a free M.D., and students who treat it that way might be getting free classes but, for the doctoral half of the program, are "essentially losing four years of doctor's salary."
Myles Akabas, who directs the MSTP at Yeshiva University's Albert Einstein College of Medicine, says Einstein's admissions committee is "very concerned" about students—generally those from lower income backgrounds who can't imagine receiving a $250,000 loan—mistaking the program for a free M.D. Einstein spends "a lot of time" trying to identify their applications and direct them elsewhere, says Akabas, who was involved in a 2010 study of 24 M.D.-Ph.D. programs nationwide.
Like MSTP in general, Case Western Reserve University's College of Medicine offers full scholarships that cover tuition and fees for "physician investigators," in response to the fact that "less than two percent of active physicians [are] pursuing careers involving research."
Aspiring M.D.'s who don't want doctorates might consider loan repayment plans such as the National Health Service Corps, which repays up to $60,000 in loans for awardees who commit to working in "Health Professional Shortage Areas" for two years. Another option is the military-sponsored Health Professions Scholarship Program (HPSP).