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Joey Johnson, National President
American Medical Student Association
Preliminary proposals for the Trump Administration Department of Education budget warrant strong concern, awareness, and potential action for physicians-in-training, the physician workforce, and all people who receive health care in the United States.
STERLING, Virginia – May 21, 2017 –Leaked documentation that outlines details of the Trump Administration’s Education budget reported earlier last week by the Washington Post should leave future doctors and their patients bewildered. If approved, the tidal wave of funding elimination would yank the rug out from under both the general public and the innumerable people who provide medical attention to them.
The official report is not slated to be released until next week; however, several programs potentially could receive deep cuts. Perkins loans have alleged reductions by up to $700 million. These federal low-interest rate loans are made available to disadvantaged undergraduate and professional students like medical students who demonstrate exceptional financial need.
Other proposed points are to extinguish the four income-driven student loan repayment programs—substituting them with a poorly crafted single program—and to abolish the public service loan forgiveness program. Average indebtedness for a domestic medical student post-graduation once accrued student loan interest capitalizes is currently approximately $220,000.
The unconfirmed proposal for a single income driven repayment plan would raise maximum loan payments to be 12.5 percent of income and a 30 year payoff period, up from 10 percent and 20-25 years in current programs. Likewise, many physicians make graduated loan payments while working 10 years as public servants for nonprofits, teaching hospitals, and other 501(c)3 organizations to qualify for public service loan forgiveness. For these recently graduated young physicians living on meager resident salaries for another three to eight years after already completing at least eight years in school, these plans would break the bank.
The American Medical Student Association (AMSA) advocates for continued support and development of low interest loan programs, which offer students a fair and practical solution to the funding of medical education. AMSA recognizes that equitable access to medical education is essential to guarantee diversity of the physician workforce. Medicine will not be able to provide for the health needs of our complex society if it does not reflect society’s demographics. AMSA further believes that access to higher education is a right and should only depend on a student’s performance, not on ability to pay tuition.
The negative impact this proposal could have on underrepresented minorities cannot be overstated. “Student loan debt understandably hits minority students the hardest,” states Joey Johnson, AMSA’s national president. “According to a report published by the U.S. News and World Report in 2013, blacks with a student loan debt of greater than $30,000 outnumbered whites 27 percent to 16 percent.”
The devastation would be similarly far reaching in rural and underserved areas, as well as academic medicine. “As a physician who trained in rural Appalachia and who wants to practice as a clinical professor, I am concerned if this proposed budget becomes reality that one day soon we may lack the medical educators to train new doctors to care for our loved ones who already struggle with access to physicians,” says Dr. Daniel H. Gouger, AMSA’s education and advocacy fellow.
AMSA believes that “Aid-for-Service” programs not only increase access to medical education, but also directly address issues of disparities in access to health care. We likewise support graduated repayment programs on an income contingent basis, and have concerns that striking these options for medical students, residents, and young physicians will pose insurmountable financial burdens. AMSA condemns federal government cuts to programs such as these aimed at increasing access to medical education.
Most alarming is that these cuts may simultaneously de-incentivize many undergraduates from pursuing careers as physicians, or only encourage pursuit of higher-earning subspecialties and abandonment of primary care in the crossfire. Smothering the nation’s supply of physicians with student and trainee debt to the point of eliminating pipelines into the profession will leave millions of Americans without doctors to care for them.
AMSA is the oldest and largest independent association of physicians-in-training in the United States. Founded in 1950, AMSA is a student-governed, non-profit organization committed to representing the concerns of physicians-in-training. To learn more about AMSA, our strategic priorities, or joining the organization, please visit us online at http://www.amsa.org.