When I graduated from medical school, the “white coat ceremony” had not yet been established. I remember, though, the feeling of progress, anticipation, belonging and excitement of putting on my white coat as a first-year medical student.
When Dr. Cliff Leftridge, a beloved pediatric radiologist at Georgetown University, greeted new medical students like me in our short white coats, he would say, “Hey, doc!” I always stood taller.
That memory makes what happened on July 1 so heartbreaking. That day, a quiet shift took place, one that threatens not only to dash the dreams of hopeful medical students, but also damage the future of American healthcare.
Under the One Big Beautiful Bill Act, the federal government is phasing out the Graduate PLUS Loan program for new borrowers, threatening to shut out middle class, working class and first-generation students, as I once was, from careers in medicine.
This program allowed graduate and professional students to borrow up to their school’s full cost of attendance directly from the U.S. Department of Education.
Now — without any plan to help students make up the difference — the federal government will enforce strict caps on such direct borrowing, limiting most graduate students to just $20,500 annually while capping designated professional tracks, like medicine, at $50,000 per year.
Graduate PLUS loans were imperfect but bridged a gap
Credit: Oh Happy Photography
Credit: Oh Happy Photography
It is no secret that medical education is incredibly expensive. The total price tag for medical school — tuition, mandatory equipment, fees, and basic living expenses — can exceed $300,000. That could mean a deficit of $100,000 or more for a student borrower contemplating four years of medical school.
My career predates the Graduate PLUS program, but I had to take out loans to go to medical school. While repayment was always in the back of my mind, I did not worry about being able to borrow enough to cover tuition and housing.
Plus, if I ran out of money during the summer, my uncle helped pay my rent. But when I had to relocate for residency, I borrowed money for that too. I had to get an apartment and move all of my stuff. Who could I have asked to cover such costs? No one.
While an imperfect solution, Graduate PLUS loans bridged gaps like these. Last year they allowed almost two million students — approximately 40,000 of them medical students — to borrow up to the full cost of attendance with a fixed interest rate and consumer protections. Rather than doing the hard work of improving the program, however, lawmakers’ decision to simply cut back these loans could reinforce a medical career as a domain of the well-off.
The ability to access credit is more difficult for less wealthy students. A family, if they own a house at all, may not be able to get a second mortgage to cover educational expenses.
Having a family member borrow money to cover the cost of medical education is not feasible for parents who are saving for retirement and other caregiving roles, nor is it necessarily the parent’s responsibility. For example, my mother paid for my undergraduate education along with the help of grants and lower in-state tuition. Medical school was on me.
Changes to loan program put vulnerable populations at risk
We already face a nationwide shortage of physicians. Phasing out Graduate PLUS loans means rural clinics and urban community health centers could find it even harder to recruit talent because there will be fewer people in the pipeline to fill those roles.
Nearly half of all medical students rely directly on Graduate PLUS loans, and we know that doctors from minority and lower-income backgrounds are statistically more likely to practice in underserved communities. Because chopping these loans threatens decades of work to “diversify the healthcare workforce” and “promote health equity and reduce disparities,” it could also put America’s vulnerable populations at even greater risk.
The Trump administration argues cutting Graduate PLUS loans will “help curb tuition growth.” But a study by the American Association of Medical Colleges found that “in the four years after Grad PLUS loans were introduced, the average annual growth rate for medical school tuition slowed compared with the four years before the loans were introduced, after adjusting for inflation.”
Proponents of cutting these loans also say saving $4 billion a year for 10 years in a multitrillion-dollar annual federal budget restores “fiscal restraint to the federal student lending system.”
If budgetary restraint really is a goal, perhaps lawmakers could eliminate fossil fuel tax subsidies, close corporate tax loopholes, trim a bloated Immigration Customs Enforcement budget or cut wasteful Pentagon spending instead.
Eliminating the Graduate PLUS Loan program, without providing a safety net for student borrowers, is short-sighted and harmful to our nation’s healthcare needs. Hopeful doctors from middle class, working class and first-generation backgrounds who have the talent, drive, and focus to become physicians in America should be able to do so. Crushing their dreams of a career in medicine doesn’t just hurt them. It hurts all of us.
Sylvia E. Morris, M.D., MPH, is a hospitalist and co-author of “The Game Plan: A Woman’s Guide to Becoming a Doctor and Living a Life in Medicine.” Follow her on LinkedIn: @drsylviamorris. She is resident of Decatur, Georgia.
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