A free M.D. is an opportunity too good to give up.
That’s one lesson from New York University School of Medicine’s new policy to offer a medical school education tuition-free to all of its students.
The school made the announcement to much fanfare last year during the white-coat ceremony -— the symbolic start to a doctor’s educational journey — for the class of 2022. Applications for the class of 2023, the first cycle since the new policy was announced, jumped 47% to 8,932, up from 6,069, last year, according to NYU officials.
Applications to medical school overall increased 2.1% between the 2017 and 2018 application cycles, according to the Association of American Medical Colleges. Application data for this year’s cycle isn’t yet available.
This year’s applicant pool at NYU is also more diverse; the school received 2,020 applications from students who identify as minorities under-represented in medicine, up from 1,000 last year, Rafael Rivera, associate dean for admissions and financial aid, wrote in an email statement. More specifically, the number of applicants who identify as black, African-American or Afro-Caribbean, increased to 1,062 up from 438 last year.
This year’s applicant pool is also more diverse. The school received 2,020 applications from students who identify as minorities under-represented in medicine, up from 1,000 last year.
The increase in diversity is promising, particularly given how woefully underrepresented people of color remain in medicine. In 2016, nearly 59% of medical school graduates were white. That has implications for a profession that’s expected to treat a diverse array of patients who come to the doctor’s office with varying cultural and medical concerns.
But it’s still too early to tell how the new policy will shape NYU’s future classes and the medical profession as a whole, said Ronald Ehrenberg, the director of Cornell’s Higher Education Research Institute.
“Has this achieved the long run goals of the program?” Ehrenberg said. “It’s going to take time for this to shake out.”
What is clear: The tuition-free offer makes NYU a very attractive option for aspiring doctors who under other circumstances may have never considered NYU or chosen a more prestigious school.
And the offer is one other schools will have trouble matching. The policy is funded by a $650 million endowment — a sum bigger than the endowment of many universities — $100 million of which is from Kenneth Langone, a co-founder of Home Depot.
“Will this allow an already very highly ranked medical college to improve its ranking because the test scores of the accepted students will go up more?” Ehrenberg mused.
The idea behind the policy, according to officials at the time of the announcement, is to make medical school possible for more and different types of students who may be worried about the cost. Another goal is to free up future doctors, who would have to worry less about the weight of their student debt, to choose less-lucrative specialties or regions in favor of helping the under-served.
Roughly three-quarters of medical students graduate with debt, according to AAMC. The median debt in 2018 was $192,000. NYU’s policy will certainly put a major dent in that number for its students — it covers the roughly $55,000 tuition, though students will still need to finance their living expenses.
‘Has this achieved the long run goals of the program? It’s going to take time for this to shake out.’
The application numbers indicate that the offer did appear to make NYU a more attractive option for students of color, who borrow more for higher education on average and struggle more to pay it back. But it’s hard to say whether that increase will actually translate into a medical profession that looks more like the patients it serves, Ehrenberg said.
The students in NYU’s more diverse applicant pool may have just applied to other medical schools if the free tuition offer wasn’t available. “It may just be a shifting of the seats,” he said.
It’s also hard to say whether future NYU graduates will be swayed by a lighter debt load to choose primary care or to become a specialist in a rural region where they’d earn less. Whether a medical-school graduate becomes a pediatrician or an orthopedic surgeon is result of a complex set of factors, such as their interests and skills that includes, but isn’t limited to their debt load.
A more direct approach to ensuring student debt isn’t a factor in a doctor’s specialty choice, critics say, is to subsidize those who decide to go into primary care or to fund students who otherwise wouldn’t be able to afford medical school, instead of paying the tuition of all students — even those who could otherwise pay for it themselves. Other medical schools have adopted some version of this approach.
Still, the boost in applications, particularly from under-represented groups, illustrates the power very clear messaging surrounding the word “free,” can have, said Mark Huelsman, associate director of policy and research at Demos, a left-leaning think tank.
That insight comes as policymakers and higher-education leaders across the country debate the best way to increase opportunities for students who may struggle to afford college and make sure more students are aware of those opportunities.
“There’s definitely something about free college that is galvanizing in a way that previous messages about it being more affordable or accessible have not been successful,” Huelsman said.
Huelsman added that he was heartened to see the message of free medical school resonated in particular with groups of students that have been under-served by graduate education. But how NYU responds to this increasingly diverse talent pool still remains to be seen. The school said it would not be increasing the class size despite the uptick in applications.
“If this does succeed you have more doctors of color going to prestigious medical schools,” Huelsman said. “That’s part of the promise of the program, but that will require them to enroll these students and keep the affordability promise.”
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