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Borrow or Serve? An Economic Analysis of Options for Financing a Medical School Education.
Acad Med
July 2017
M.I. Marcu is an economist, U.S. Office of Personnel Management, Washington, DC. A.L. Kellermann is professor and dean, Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland. C. Hunter is chief medical officer, U.S. Office of Personnel Management, Washington, DC. J. Curtis is associate professor and associate dean for graduate medical education, Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland. C. Rice is professor and former president, Uniformed Services University of the Health Sciences, Bethesda, Maryland. G.R. Wilensky is economist and senior fellow, Project HOPE, Bethesda, Maryland. She also serves, unpaid, as a member of the Board of Regents of the Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Purpose: To understand the long-term economic implications of key pathways for financing a medical school education.
Method: The authors calculated the net present value (NPV) of cash flow over a 30-year career for a 2013 matriculant associated with (1) self-financing, (2) federally guaranteed loans, (3) the Public Service Loan Forgiveness program, (4) the National Health Service Corps, (5) the Armed Forces Health Professions Scholarship Program, and (6) matriculation at the Uniformed Services University of the Health Sciences. They calculated the NPV for students pursuing one of four specialties in two cities with divergent tax policies.
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