Publications

Reducing Educational Debt Among Underrepresented Physicians and Dentists

Author(s): 

Christopher Toretsky, Sunita Mutha and Janet Coffman

Date: 
Aug. 27, 2019

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.  

Key Findings

  • In the 2016-2017 academic year, the average debt was highest for Black students ($286,540), followed in descending order by Latino students ($265,413), White students ($240,903), and Asian students ($216,194).
  • Similar to medical students, Black dental students have the highest rates of educational debt (97.6 percent), followed by Latino students (89.9 percent), White students (85.6 percent), Asian students (82.0 percent) and lastly, American Indian students (77.8 percent). Nearly half of all Black students had $300,000 or more in educational debt, which is much higher than all other racial/ethnic groups.
  • Among physicians, the association between educational debt and specialty choice is mixed, but among dentists higher levels of dental education debt are associated with a lower likelihood of specialization.
  • Students with higher levels of debt are more likely to enter private practice.
  • Literature assessing the association between educational debt and practice location is limited and inconclusive.

 Policy Recommendations

  • Design state programs to meet gaps not addressed by other local and federal scholarship or loan repayment programs and that meet a state’s unique needs for care for underserved populations, geographic regions, and communities.
  • Collapse the myriad funding channels of scholarships and loan repayments into fewer funds directed towards URM students. 
  • Make the borrowing terms of all student loans more transparent and easy to compare. First-generation students, who are predominantly URMs, are less likely to have complete knowledge about available loans.