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Last summer New York University's medical school, where the sticker price on tuition was more than $55,000 a year, announced that all current and new students would henceforth receive full-tuition scholarships.
One question raised by the move was whether top medical schools would match NYU's new policy.
On Tuesday, another leading medical school -- at Washington University in St. Louis -- announced that it was going to spend $100 million so that more than half of its new students from now on will not pay tuition. Currently, only about 20 of the students in an M.D. class of 120 receive full-tuition scholarships. Those not receiving full scholarships in the future will be able to receive partial scholarships. (Under a tuition plan that assures students the same rates for four years, Wash U currently charges $65,044 a year for tuition, with total costs of more than $85,000.)
The awards will be made both on the basis of financial need and measures of academic merit.
Washington University officials said that they have been making progress at limiting student debt, but that efforts to date have not been enough. The average debt of Washington University School of Medicine graduates over the past five years has been $99,088, compared to a national median of $166,239. Many have argued that high debt levels -- coupled with relatively low pay new M.D.s receive during their residencies -- discourage new doctors from jobs in which they may treat the disadvantaged or work in rural or other locations lacking enough medical care.
According to statistics from the Association of American Medical Colleges, three-quarters of the Class of 2018 had debt. Among those who had borrowed, median indebtedness rose 4 percent, to $200,000. About half of students, 51 percent, borrowed $200,000 or more -- and 46 percent planned to enter a loan forgiveness or repayment program.
Completely tuition-free medical education isn't unheard-of. Sometimes new medical colleges adopt such policies to attract students, but this is typically for a limited time period. Other institutions have made pushes for some designated share of the class to receive full-tuition scholarships.
About 20 percent of students at the David Geffen School of Medicine of the University of California, Los Angeles, are awarded scholarships that cover all expenses -- tuition, room and board, books and supplies, and more. The scholarships are awarded based on measures of academic merit, not financial need.
When NYU announced its plans last year, some critics questioned whether all medical students needed the same levels of help. An essay in Slate called the move "at best, a well-intentioned waste -- an expensive, unnecessary subsidy for elite medical grads who already stand to make a killing one day as anesthesiologists and orthopedic surgeons."
Eva Aagaard, senior associate dean for education at Washington University, said via email that the university does hope to encourage medical students to look for a range of careers and that curricular changes will spotlight the value of such careers.
But she also said it may not be realistic to target aid to new medical students based on later career goals. "Students rarely know their career plans at the time of entry into medical school, and many students change their minds," she said. "We do look at interest and potential in academics, including interest in teaching, research and community engagement/advocacy, as part of the selection process both for the school and for the non-need-based aid."
NYU officials said it was too early to know how the new class of students will be different from prior classes. Many medical education experts have speculated that NYU may attract some students who in prior years might have gone to other medical schools.
But NYU saw major gains in its applicant pool, and in particular from groups that have not been flocking the medical schools. NYU Med saw a 102 percent increase, to 2,020, in applications from those who are a member of a group that is underrepresented in medicine (including black, Latino and Native American students). The largest percentage increase was among those who identify as African American, black or Afro-Caribbean. Applications from this group went up 142 percent, to 1,062.
