Tuition-free medical school a big step but not enough, experts say

To diversify the physician workforce, the nation needs more affordable and equitable pathways to a medical education for students from groups underrepresented in medicine, experts tell Inside Higher Ed. In 2022, Black and Latine Americans made up 14.4% and 19% of the U.S. population, respectively. Yet, among active physicians, 5.7% identified as Black or African American and 6.9% as Latine, according to the American Association of Medical Colleges (AAMC). Native Americans make up 3% of the U.S. population but just 0.4% of physicians, says Inside Higher Ed.

Related: End of affirmative action not an excuse to end diversity efforts, Biden Administration says >

With the Supreme Court ruling ending race-conscious admissions, schools are taking aim at barriers to medical education. Some have focused on lowering tuition costs in hopes of attracting more diverse applicants, but experts say that a holistic admissions process and diversity, equity, and inclusion (DEI) programs—efforts that are being dismantled in certain regions—are also essential to ensuring that students from underrepresented backgrounds apply to medical schools, enroll, and persist.

“Unless there’s other programmatic changes that would increase the total pool of students, the numbers won’t change,” Billy Thomas, a neonatologist who served as the first vice-chancellor for diversity and inclusion at the University of Arkansas for Medical Sciences, tells Inside Higher Ed. “And if all of these DEI efforts are dissolved, then the number of minority students who can even apply to medical school is going to go down.”

Related: To increase diversity in medicine, schools must confront structural barriers, new studies say >

Are tuition-free programs enough?

Earlier this year, Albert Einstein College of Medicine received a $1 billion donation from a faculty member—the largest gift made to any medical school—that eliminates tuition for every student accepted to the college starting this fall. “This transformational gift is intended to attract a talented and diverse pool of individuals who may not otherwise have the means to pursue a medical education,” officials said in a press release

Einstein joined other tuition-free medical programs, such as New York University Grossman College of Medicine, the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, and the Kaiser Permanente Bernard J. Tyson School of Medicine.

While these efforts make medical education more affordable at individual schools, they may have a limited overall impact. Most medical schools are not receiving large, transformative donations to fund tuition-free programs, and those that do are typically highly selective.

After NYU’s School of Medicine went tuition-free in 2018, applications rose nearly 47% overall, and 102% for underrepresented students, including Black, Latine, and Native students, according to STAT News. The school’s 2023 acceptance rate, however, was just 2.7%. Among the students offered spots in 2023, 24% were from underrepresented backgrounds, and 7% were first-generation students. On average, Black students made up 11% of NYU’s medical school classes between 2019 and 2022, down from 14% in 2017. The share of low-income students attending NYU medical school fell as well, from 12% in 2017 to 3% in 2019; it has remained between 3% and 7% ever since.

Addressing bias

While tuition-free medical education can attract applicants and eliminate student debt, moving to a more holistic admissions process and increasing DEI programs can help schools admit and graduate more underrepresented students, experts say.

“Simply going tuition-free cannot address entrenched issues of racial and socioeconomic disparities in medical school admissions,” says STAT News. “[A]bsent any additional interventions it is unlikely to substantially improve the racial, ethnic, and financial diversity of our physician workforce.”

Georgetown University School of Medicine: Building a more inclusive physician workforce
Through a suite of medical education pathway programs, Georgetown’s School of Medicine is engaging future physicians from diverse backgrounds, supporting their success, and setting the stage for better health outcomes. Several initiatives, the Gateway Exploration Program and the Summer Medical Institute and Medical Immersion Programs, strengthen high school students’ ability to pursue their passions through early exposure to the sciences. Others, like the Georgetown Experimental Medical Studies Program (GEMS) and Academy for Research, Clinical, and Health Equity Scholarship (ARCHES) bring undergraduate and post-baccalaureate students into research and clinical settings, empowering them to thrive in their future careers and preparing them for the medical school application process.

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