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The Price We Pay for an MD

Miranda Ntorinkansah · Florez Lab

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October 04, 2022

It is no secret that medical school is expensive. Depending on where in the world you live, the cost of a medical degree varies. In the United States, it is well known that medical students end up with an average of $241,600 in debt after at least 8 years of education; attending a public, private, Ivy League or non–Ivy League school may cause this to differ among students.

In the UK, however, the true cost of medical training isn't as obvious. All students pay the same amount of tuition, which is usually paid for by a government loan for the entirety of their course. For those who need it, a maintenance loan is also available for living expenses. Naturally, those from lower income households receive higher maintence loans and therefore, have a higher debt burden by the end of their studies — debt you don't think about until your first real paycheck post–medical school. (It is also important to note that these loans are completely optional — throughout my time in medical school, I've encountered students who didn't need all or any of their student loans to pay for their medical school tuition or living expenses.)

The real cost, however, the one we have to live with everday as students, comes from expenses that we were not warned about when embarking on our journey through medical school — for example, the cost a stethoscope, revision resources, transport, and housing. In addition, as the commitment of a medical degree intensifies, there is less and less time for students to work-part time outside of their studies, meaning less income coming in while expenses increase and student loans accumulate interest.

Furthermore, it is common knowledge that a higher proportion of students from affluent backgrounds are accepted into medical school and that socioeconomic status and one's finances create a huge disparity in achievement and general well-being during medical school. Indeed, studies show that higher levels of debt are negatively correlated with mental well-being and academic performance; students from lower socioeconomic backgrounds have higher debts and as a result, worry more about money.

Four years into my medical education, I have experienced and now understand the financial strain of a medical degree. The path to becoming a doctor truly is one of life-long sacrifice, so why doesn't our society look after those who make it their life's work to look after them? It is incredibly unfortunate that there is a lack of financial support and assistance for medical trainees, especially those from lower socioeconomic backgrounds. In fact, according to a The BMJ study, about 5% of students were considering dropping out of medical school due to financial hardship alone and have cut back on simple living essentials such as heating and food.

Unfortunately, these are the students that are more representative of the patient population; the average patient that we see is not one had that a private school education or had affluent parents. Although more people from diverse backgrounds are enrolling in medical school, finances act as yet another barrier preventing them from completing this degree; such factors are why we see such limited diversity in medicine.

Talking about finances appears to be a taboo in the medical field, but doing so is important, for it not only raises awareness and creates a voice for those 5% of students who are struggling financially but also helps premed students have a realistic understanding of the financial sacrifice of pursuing medicine, allowing them to make more informed choices about their future careers. In the meantime, as we create this new culture, it will be important for institutions to consider supporting students financially through bursaries and scholarships (and reducing tuition prices) throughout their time at university. In this way, we can create a more equitable and encouraging environments for all medical trainees.

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About Miranda Ntorinkansah
Miranda Ntorinkansah is a medical student studying at the University of Nottingham in the United Kingdom. As a first-generation medic, Miranda is passionate about helping other students from similar backgrounds achieve their dream of becoming a doctor. She's the co-founder and director of Med2Be Consultants, a consultancy focused on helping students through the vigorous medical application process in the United Kingdom. Her other interests include medical education and helping underserved communities in medicine. She is dedicated to championing equality through her business, and in the future, through her work as a doctor. In 2022 she joined the Florez Lab.

The Florez Lab, formerly known as the Duma Lab and the Social Justice League, was founded in August 2019 and focuses on social justice issues in medicine, including discrimination and gender bias in academic and clinical medicine, cancer health disparities, and medical education.

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