Reducing educational debt among underrepresented physicians and dentists
- Collection:
- Health Policy and Services Research
- Author(s):
- Toretsky, Christopher, author Mutha, Sunita, author Coffman, Janet, author
- Contributor(s):
- University of California, San Francisco. Healthforce Center, issuing body.
- Publication:
- San Francisco, CA : University of California, San Francisco, Healthforce Center, August 2019
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Education, Dental -- economics Education, Medical -- economics Ethnic Groups -- statistics & numerical data European Continental Ancestry Group -- statistics & numerical data California United States
- Genre(s):
- Technical Report
- Abstract:
- The rising cost of higher education raises concerns about equitable access to professional education for underrepresented minorities (URMs). This is problematic since URMs play critical roles in the health care field. They often speak patients' languages and/or relate to them on both cultural and socio-economic levels, which strengthens the patient-physician relationship through higher levels of trust and satisfaction with care. Many URM students come from families of modest incomes and are often deterred from applying to health professional schools because of their costs. URMs who do attend medical or dental school, must often take on substantial educational debt to afford the escalating tuition and fees. Interest rates for student loans are higher than for most other common forms of debt such as auto, mortgage, and small business, which makes them even more difficult to repay. This issue brief presents data on educational debt among medical and dental students, summarizes the literature on the relationship between educational debt and career choices, describes policy options for reducing educational debt, and makes recommendations for reducing debt among URM health professionals. Data on educational debt among medical school graduates indicate that American Indian, Blacks, and Latino graduates are more likely to have educational debt than White graduates and more likely to have debt of $100,000 or more. Black and Latino dental school graduates are also more likely to have educational debt than White graduates. Deciding to take on this debt could encourage URM students to choose educational programs and careers that enable them to pay off debt more easily instead of ones in which they are most passionate or for which they are best suited. Review of the literature suggests that the association between educational debt and specialty choice is mixed among physicians. However, among dentists, higher levels of educational debt is associated with lower likelihood of specialization. Students with high levels of debt are more likely to enter private practice. The association between educational debt and practice location is limited and inconclusive. The rising level of educational debt disproportionately affects URM students and limits their representation in health professions, and the ability of underrepresented communities to obtain concordant, timely, and affordable care. These challenges can be overcome with focused efforts to reduce or eliminate the cost of education for URM students. There are two policy strategies for reducing the educational debt burden for URM students. The first strategy is to reduce or eliminate the level of accrued educational debt through scholarships, loan repayments and income-sharing agreements. The second strategy is to decrease educational costs by shortening the duration of education or reducing tuition. The most direct method for reducing or eliminating educational debt is to ensure low or no cost education for URM students. One way this can be accomplished is through tuition reduction or elimination programs supported by private philanthropic endeavors. Other options include targeting reductions in the cost of education for students of certain racial/ethnic backgrounds who commit to practice in certain areas (e.g., health professions shortage areas) to increase concordance (racial/ethnic, cultural and linguistic) of health professionals for these communities. The feasibility, success, and traction of these strategies is difficult to assess. Some initiatives aimed at reducing medical or dental student debt are broad and do not specifically target URM students. Some programs only offer URMs small amounts of money which does not substantially reduce their educational debt. In addition, few initiatives targeted at reducing debt among URMs have been evaluated. Further study is needed to determine which strategies are most effective.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (33 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101764336 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101764336