Medical Education and the Public Service Loan Forgiveness Program: Unnecessary Uncertainties
Authors: Justin A. Grischkan, Benjamin P. George, E. Ray Dorsey, David A. Asch
Journal: Annals of Internal Medicine (2018)

Ideas and Opinions16 October 2018Medical Education and the Public Service Loan Forgiveness Program: Unnecessary UncertaintiesJustin A. Grischkan, MD, Benjamin P. George, MD, MPH, E. Ray Dorsey, MD, MBA, and David A. Asch, MD, MBAJustin A. Grischkan, MDMassachusetts General Hospital, Boston, Massachusetts, and University of Rochester School of Medicine & Dentistry, Rochester, New York (J.A.G.), Benjamin P. George, MD, MPHYale New Haven Hospital, New Haven, Connecticut, and University of Rochester School of Medicine & Dentistry, Rochester, New York (B.P.G.), E. Ray Dorsey, MD, MBAUniversity of Rochester School of Medicine & Dentistry, Rochester, New York (E.R.D.), and David A. Asch, MD, MBAUniversity of Pennsylvania and Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania (D.A.A.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-1511 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Medical students graduating in 2017 faced average costs of $240 000 to attend U.S. public medical schools and $314 000 to attend private schools (1). Nearly three quarters of them borrowed money to finance these costs, amassing student loan debt averaging almost $200 000. A third of 2017 graduates with debt reported planning to use the Public Service Loan Forgiveness (PSLF) program to help defray that debt (2). The PSLF program requires participants to make 10 years of loan repayments while employed at nonprofit or governmental institutions, after which all remaining educational debt sponsored by the federal government is forgiven. The program's structure ...References1. Association of Ameican Medical Colleges. Medical student education: debt, costs, and loan repayment fact card. Accessed at https://members.aamc.org/iweb/upload/2017%20Debt%20Fact%20Card.pdf on 7 August 2018. Google Scholar2. Association of American Medical Colleges. Graduation questionnare. Accessed at www.aamc.org/data/gq on 7 August 2018. Google Scholar3. Lieber R. Panicked borrowers and the education department's unsettling silence. The New York Times. 7 April 2017. Accessed at www.nytimes.com/2017/04/07/your-money/student-loans/panicked-borrowers-and-the-education-departments-unsettling-silence.html on 7 August 2018. Google Scholar4. Asch DA, Nicholson S, Vujicic M. Are we in a medical education bubble market? N Engl J Med. 2013;369:1973-5. [PMID: 24171508] doi:10.1056/NEJMp1310778 CrossrefMedlineGoogle Scholar5. Jolly, P. Diversity of U.S. medical students by parental income. Association of American Medical Colleges Analysis in Brief. Accessed at www.aamc.org/download/102338/data/aibvol8no1.pdf on 8 August 2018. Google Scholar6. Grischkan J, George BP, Chaiyachati K, Friedman AB, Dorsey ER, Asch DA. Distribution of medical education debt by specialty, 2010-2016. JAMA Intern Med. 2017;177:1532-5. [PMID: 28873133] doi:10.1001/jamainternmed.2017.4023 CrossrefMedlineGoogle Scholar7. PROSPER Act, H.R. 4508, 115th Cong. (2017). Google Scholar8. McCaskill C, Gillibrand K, Nelson B, Murray P, Schumer CE, Leahy PJ, et al. Letter to Betsy DeVos. 6 April 2017. Accessed at www.help.senate.gov/imo/media/doc/040617%20Dem%20Caucus-DeVos%20PSLF%20Final.PDF on 8 August 2018. Google Scholar9. Simpkin AL, Schwartzstein RM. Tolerating uncertainty—the next medical revolution? N Engl J Med. 2016;375:1713-5. [PMID: 27806221] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Massachusetts General Hospital, Boston, Massachusetts, and University of Rochester School of Medicine & Dentistry, Rochester, New York (J.A.G.)Yale New Haven Hospital, New Haven, Connecticut, and University of Rochester School of Medicine & Dentistry, Rochester, New York (B.P.G.)University of Rochester School of Medicine & Dentistry, Rochester, New York (E.R.D.)University of Pennsylvania and Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania (D.A.A.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-1511.Corresponding Author: David A. Asch, MD, Center for Health Care Innovation, Perelman Center for Advanced Medicine 14-171, 3400 Civic Center Boulevard, Philadelphia, PA 19104; e-mail, [email protected]upenn.edu.Current Author Addresses: Dr. Grischkan: Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114.Dr. George: Yale School of Medicine, Division of Neurocritical Care, PO Box 208018, New Haven, CT 06520.Dr. Dorsey: University of Rochester Medical Center, Center for Health and Technology, 265 Crittenden Boulevard, CU 420694, Rochester, NY 14642.Dr. Asch: Center for Health Care Innovation, Perelman Center for Advanced Medicine 14-171, 3400 Civic Center Boulevard, Philadelphia, PA 19104.Author Contributions: Conception and design: J.A. Grischkan, B.P. George, E.R. Dorsey, D.A. Asch.Analysis and interpretation of the data: J.A. Grischkan, B.P. George, E.R. Dorsey, D.A. Asch.Drafting of the article: J.A. Grischkan, D.A. Asch.Critical revision of the article for important intellectual content: J.A. Grischkan, B.P. George, E.R. Dorsey, D.A. Asch.Final approval of the article: J.A. Grischkan, B.P. George, E.R. Dorsey, D.A. Asch.Administrative, technical, or logistic support: J.A. Grischkan.Collection and assembly of data: J.A. Grischkan, B.P. George.This article was published at Annals.org on 28 August 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byA Burnout Reduction and Wellness Strategy: Personal Financial Health for the Medical Trainee and Early Career Radiation Oncologist 16 October 2018Volume 169, Issue 8Page: 566-567KeywordsFellowshipsForecastingGraduate medical educationHealth careMedical educationMedical servicesNeurosurgeryPrimary care physiciansProblem solvingResidency ePublished: 28 August 2018 Issue Published: 16 October 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...