What COVID Showed Us About Medical Student Finances

Yash B. Shah


June 03, 2022

The COVID pandemic has affected personal finances for nearly everyone, with disappearing jobs, increasing healthcare costs, skyrocketing inflation, and cratering stock markets. This was devastating for too many families, as it became difficult to afford food and stable housing. The pandemic's impact on medical students, however, was largely unrecognized and complex, yet it showed us that improvement is possible.

Even prior to the pandemic, medical schools posed great barriers to most students, but particularly those of underserved communities. With unbelievably high tuition and a commitment to attend school for another 4 years, during which one could not earn an income to support their family, cost was perhaps the biggest downside of pursuing medical education.

COVID has exacerbated many of these obstacles, as families may now be less equipped to support pre-medical students in MCAT preparation, volunteering, or other undergraduate educational opportunities. Instead, families ask students to seek cost-saving measures in their education or pursue concurrent employment.

In medical school itself, students may find it more difficult to purchase necessary third-party study materials — which are unbelievably expensive — or may again feel increased pressure to seek part-time employment. In fact, 16% of medical students reported incurring additional financial burden due to the pandemic.

Luckily, several expenses have also fallen. With the elimination of Step 2 CS and the conversion of Step 1 to pass-fail, costs associated with test preparation resources and exam registrations were largely reduced. Moreover, virtual interviews and limited away rotations have resulted in thousands of dollars saved in travel and lodging costs. These changes certainly help offset the new financial demands brought on by the pandemic. Recognizing the benefits, students are hoping to hold onto these temporary changes.

Unfortunately, medical schools have not lowered tuition despite the shift to virtual education, although tuition is by far the greatest burden on students. Traditionally, online higher education has been significantly cheaper than its on-campus counterpart, yet this trend did not carry over into the pandemic.

In addition, with the abrupt transition to remote learning since 2020, I have noticed firsthand that students are less satisfied with their coursework, and studies have demonstrated an inherently lower quality of education globally. Overall, virtual learning has produced notable reductions in students' financial, mental, and social wellness, along with less comfort in medical knowledge and patient care.

I have seen students question why they are paying the same amount for a lesser education, particularly because online schooling was more affordable prior to the pandemic. More than half of medical students owe more than $200,000 in medical school loans, with nearly a quarter in debt for over $300,000, according to Medscape's Residents Salary & Debt Report 2021. The challenges of virtual learning may exacerbate debt concerns and lead them to further question whether this cost is truly worth the return on investment.

Importantly, deep financial burdens for students can have grave downstream effects on society at large. Many will have substantial student loans for years after graduation. Uncontrolled tuition certainly plays a small role in the high costs passed on to patients. This burden can also influence physicians' choice of practice, with graduates often choosing a higher-paying specialty or geographic location instead of one that interests them more.

This is a primary factor in our existing primary care shortage and lack of healthcare access for rural and impoverished communities. When physicians have sizeable loans to offset, they are understandably compelled to seek opportunities for higher pay. Certainly, without change, the exacerbations on medical student finances caused by COVID will worsen these systemic healthcare problems.

Unfortunately, student loans tend to be much more common in both women and minorities, namely non-Hispanic Black adults. This inequality further impairs the lack of diversity and representation in the medical community.

In addition to being responsible for training qualified physicians who will advance the field, medical schools should ensure that these same graduates will serve the entire population, win public trust, and support healthcare equality. These goals are tremendously helped by ensuring that physicians represent the community they serve in terms of socioeconomic status, race, and background.

Medical schools are also well served by protecting their trainees' wellness and mental health, as this reduces burnout and improves productivity. These factors can be significantly enhanced by eliminating financial burdens during a journey that is already difficult due to its educational and emotional demands.

With COVID, broad economic instability has made it more difficult for students to manage their debt. Coupled with the recent skyrocketing inflation leading to rising rents and grocery bills, burdens on students have increased.

Thankfully, the federal government suspended student loan repayments and interest accumulation during the pandemic. The changes made during the pandemic demonstrate that it is possible to rethink tuition and loan mechanisms to optimize student well-being and increase accessibility in the medical field.

Ultimately, to strengthen the healthcare system, we need the most capable and brilliant professionals. However, the current financial burdens discourage many from pursuing this journey or impede the career path for those who stay on it.

By further understanding the cost burdens placed upon medical students, we can effect systemic change on healthcare itself while increasing the competency and mental health of our future physicians.

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About Yash B. Shah
Yash Shah is a first-year medical student at Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, Pennsylvania. He earned a bachelor of science in premedicine from Penn State University. Prior to attending medical school, Yash worked on clinical and translational research in hematology/oncology at the Children's Hospital of Philadelphia. Yash has long-standing interests in advancing medical education, improving healthcare policy and economics, and working with cancer patients. In his free time, he enjoys playing tennis, rooting for the Eagles, reading, and traveling.


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