NYU Medical School recently announced it will waive tuition for all medical students, now and going forward. NYU has raised $450M of the needed $600M to fund this gift in perpetuity. Kenneth Langone (one of the Home Depot founders) and his wife donated $100M.  

One reason NYU made this commitment was because many medical students are saddled with crushing debt when they graduate. Basic economics pushes them to choose higher paying specialties to help service their debts. Basic economics argues against choosing lower paying specialties. NYU wanted graduating students to select their specialty based more on passion than on need. 

One ER physician wrote that he struggles to may his monthly loan payment.  

“The crisis of paying for education has finally caught up with the one percent…. 

I am far from alone. A mentor in residency, several years my senior and making over $200,000 per year, once revealed that she had moved back in with her mother just to get a handle on her student loans. Another colleague had a marriage proposal rejected because of his mortgage-size debt…. 

If student debt is a problem for doctors, imagine what it is like for nurses, teachers and other graduates whose incomes are far lower. Indeed, an entire generation is being squeezed by the high cost of tuition at the graduate and undergraduate level. Without expendable income to buy homes, millennials are living with their parents in record numbers, stunting the housing market. Unable to save, my generation is neither contributing to nor benefiting from the stock market. Most doctors will someday earn enough to pay off their school loans. But many thousands in less lucrative professions will carry their loans into middle age and beyond. The burden that is bowing medical students has truly been crushing lower- and middle-income graduates.” 

Not surprisingly, many people have opinions on whether NYU’s policy is the best way to help medical students. Some have argued that tuition should be waived if and only if the students ultimately choose a lower paying specialty or work in underserved areas. Others have argued that tuition should be waived only for families of limited means.  

NYU is free to do what it wants. I believe one main motivation was to differentiate the school from others and attract the most talented students. Free tuition will achieve that end. One two-year “college”, Deep Springs, embraces a similar tactic.  

Founded in 1917, Deep Springs College is a unique institution of higher learning. The educational program is built upon three pillars: academics, self-government, and manual labor. The school is located 40 miles from Bishop, California on an isolated cattle ranch in Deep Springs Valley. 

Between 12 and 15 students are admitted each year. A scholarship covers the costs of tuition, room, and board for every student offered admission. In exchange, Deep Springs students are expected to dedicate themselves to lives of service to humanity. Alumni have gone on to exemplify this ideal in a wide variety of fields, including politics, science, journalism, academics, agriculture, medicine, law, business and design…. 

In addition to academics and self-governance, students are expected to participate in labor for at least 20 hours each week. Labor includes farm and ranch work, but also other daily tasks such as cooking, cleaning, and maintaining facilities and vehicles. Not only practical, the labor done by students is considered to be essential to the educational program. 

Deep Springs gets the cream of the crop. Its graduates frequently finish university at an Ivy League college. Unlike NYU, Deep Springs bundles in room and board. Of course, its students are working on the farm, cattle ranch, bakery, and kitchen. So, there is no free lunch. (Deep Springs was a male-only institution until recently. Women are now admitted. The trustees filed a lawsuit to overturn the funding trust document to harmonize the founder’s guiding principles for funding with 21st century sensibilities. This case was appealed all the way up to the California Supreme Court) 

I do not believe NYU should tie its tuition waiver to choice of specialty or location of practice. If the gift comes with strings, students could just as easily join the military and have the armed forces write the check. Or participate in the Indian Health Service Loan Repayment Program. Or any other number of programs.  

NYU is embarking on an experiment to see if eliminating one variable (crushing loan repayment) moves the needle on specialty choice. This experiment will play out over time. Regardless, NYU should see an uptick in highly qualified applicants. 

What do you think?

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About the Author

Jeffrey Segal, MD, JD

Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.

Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.

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