New program eases debt for rural medical students

Feb 22, 2012

The average medical school student graduates with close to $160,000 in debt. That heavy burden is one reason why there is a long-running shortage of primary care doctors in rural America. More and more graduating students choose higher-paying specialties over rural primary care. In this weekly update, a new pilot program helps medical students pay off loans as soon as they start residency, so it's easier to choose a lower-paying, but possibly more fulfilling career path.

The National Health Service Corps provides loan repayment to young doctors who agree to practice in rural or underserved areas after they finish residency. But this year, the Corps is trying out a new program starting that repayment at the beginning of residency.

Rebecca Spitzgo, director of the NHSC, said by making a commitment while students are still in medical school, the program takes the question of debt "off the table" when students are deciding between a residency in primary care or a higher paying specialty.

"We know as students are about to finish up school, that amount of student loan debt becomes very looming and feels very heavy. Many studies suggest that's why physicians tend to choose a specialty or tend to go to a path other than primary care, because they want to pay the loan off."

The NHSC accepted 77 students in the program for this first year. Each will get up to $120,000 to pay back loans over three years, on the condition that they agree to work in a rural or underserved area for an equal amount of time.

That wasn't a hard sell for Brady Didion, a 4th-year medical student at the University of Missouri.

"I'm from rural areas, I grew up in towns of 200 people, 500 people," said Didion. "This program was really right up my alley."

Didion said the loan repayment is a huge help, but he would probably want to work somewhere rural regardless.

"For me, the core of it is relationships with people," he said.  "You're really seen as 'the doc' and you're really part of the fabric of the community. I would relish the thought of seeing my patients at the supermarket and knowing them and knowing who they are and knowing them for beyond what they came to see me for -- knowing them for something beyond their hypertension or something like that."

The pilot program is funded through the Affordable Care Act, which allocated $1.5 billion to the National Health Service Corps through 2015. That increased funding is intended to help expand the rural health care workforce as more people gain access to insurance through health care reform.