The student loan deal and the primary care physician shortage: problems on the way? ~ Pen and Chisel

Tuesday, July 3, 2012

The student loan deal and the primary care physician shortage: problems on the way?

Since Congress reached the new student loan deal last week, negative effects for graduate and professional students have emerged--and the worst consequences may affect the medical field.

According to the Washington Post, the federal government "will no longer pay the interest on new graduate loans while students are in school and for six months after they finish." In short, graduate and professional students are no longer eligible for subsidized loans. The Post reports that this will increase the amount such students must pay by $18 billion.

To make matters worse, the cost of graduate and professional education has risen dramatically in the past few years. Increased cost combined with a longer compound interest period will make graduate and professional school exponentially more expensive and discourage otherwise excellent candidates from attending.

This presents a particular problem for the medical field. The US has been facing a primary care physician shortage since at least 2003, when individual states and professional organizations began to express concerns about meeting increasing medical need in a variety of specialties. "Approximately 44,000 governmental public health jobs at the state and local levels, or 19% of the 2008 workforce, were lost between 2008 and 2010 due to the economic downturn," causing even greater need. After the passage of the Affordable Care Act (ACA) and the consequent increase in insured patients, sources projected a physician shortage of 150,000 by the year 2025. With ACA's constitutionality newly affirmed, projections are sure to be revised, but will almost certainly remain large.

The medical school establishment has taken steps to address this looming shortage. However, federal funding for medical education, infrastructure, research, and residency positions continues to have a large effect on their success.

While ACA does provide additional funding for health care training, these resources were allocated when health care reform was initially passed in March 2010--well before the current student loan deal came under consideration. With the dramatic increase in the cost of medical education, it seems very likely that the provisions of the ACA will not be enough to stave off health care shortages, particularly in rural and underserved areas.

The American Medical Student Association (AMSA) recently called on Congress to protect Stafford loans for graduate and professional students, stating that "more than 86 percent of physicians-in-training rely on student loans to pay for medical school" and graduate with "an average debt of more than $160,000." However, since the final student loan deal does not protect subsidized Stafford loans for graduate and professional students, medical student debt seems certain to increase--and numbers of students willing and able to attend medical school seem certain to decrease.

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