Medical School Debt Disproportionately Affects African-American Students

More than three-quarters of African-American medical students said they expected debt above $150,000.

A new report says more African-American medical school students anticipate higher levels of debt than students of other races and ethnicities.
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African-American medical school students have significantly higher amounts of anticipated debt than students of other races and ethnicities, according to a report from Columbia University's Mailman School of Public Health published in the journal PLOS One on Monday.

The researchers surveyed more than 2,300 medical students enrolled in 111 accredited medical schools during the 2010-11 academic year.Overall, 62 percent of medical students said they anticipated more than $150,000 in debt upon completing medical school. But a much higher percentage of African-American students reported anticipated debt above $150,000, at 77.3, compared to white students, at 65 percent. Meanwhile, a lower rate of Hispanic or Latino and Asian students anticipated debt in excess of $150,000, at 57.2 percent and 50.2 percent respectively.

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"The cost of American medical education has increased substantially over the past decade," the report says. "Given racial/ethnic inequalities in access to financial resources, it is plausible that increases in student debt burden resulting from these increases in cost may not be borne equally."

One explanation for lower anticipated debt among Hispanic students, according to the report, is that group of students are likely coming from immigrant households, despite the fact that group has among the lowest median incomes in the United States. Likewise, Asian students are more likely to come from immigrant families, which could explain their lower levels of debt, as "immigrant families may be less comfortable with the American norm of educational loan utilization than non-immigrant families," said co-author Abdulrahman El-Sayed, in a statement.

"At the same time, they may be more willing to offset the costs of their children's graduate education," El-Sayed said.

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But the findings also underscore the belief that the high cost of medical school deters qualified minority students from applying and enrolling, especially among African-American students. Since 2004, the report says, the percentage of African-American students enrolled in medical schools has fallen, while enrollment for Hispanic and Asian students continues to rise. In 2004, African-American students represented 7.4 percent of students enrolled in Allopathic schools (the traditional route resulting in an M.D.), compared to 7 percent in 2011.

The report found that compared to the overall population in America, Asian students are overrepresented in the medical student population by 75 percent, whereas African-American students are underrepresented by 100 percent.

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"With black students reporting higher debt burdens than their counterparts from other racial and ethnic backgrounds, it is plausible that this disproportionate debt burden may play a role in the relative decline in medical school attendance among black students," said senior author Sandro Galea, in a statement.

Future research, the authors said, should evaluate how the cost of a medical education influences the supply of physicians overall, as well as how it affects students of different races.

The findings suggest "that the burden of medical student debt is substantial, and that the distribution of debt across race and ethnicity is disproportionate," the report says. "Importantly, this disproportionate burden may be influencing the diversity of the physician workforce."