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The Catalyst

MUSC Opening Doors campaign aims to provide needed medical school scholarships

By Mikie Hayes
Public Relations

Opening Doors is the College of Medicine’s first-ever scholarship campaign. For information visit www.musc.edu/openingdoors.

When Paul Underwood, Jr. M.D., graduated from the College of Medicine in 1959, the cost of tuition was $2,000 for four years. That number held steady through 1970. Today, however, college students who plan to pursue a career in medicine should brace themselves for sticker shock as they can expect to pay an average of 6,500 percent more in tuition than students paid in 1970.

To put that in perspective, the cost of a medical education has skyrocketed to more than $36,000 a year, not including books, fees, room or board, according to Underwood, associate dean of admissions and professor in the Department of Obstetrics and Gynecology.  

Currently, base tuition for a first-year student is $35,665 in–state and $62,129 out–of–state. That puts the cost of an in-state, four year medical degree, including living expenses, fees and books, at nearly $200,000.

This reality leaves far too many medical students carrying untenable debt as they struggle to pay back loans with exorbitant interest payments. At a time when there is a dearth of primary care providers in small and rural towns and low reimbursements for their services, students carrying significant debt are sometimes forced to forego areas like family medicine and pediatrics to choose a higher paying specialty in order to satisfy their debts while providing for families and making a decent wage.

This situation weighed heavily on the college’s dean’s office as it halted increases in tuition costs for the past three years. It was also mentioned as an area of concern during a 2014 reaccreditation site visit by the Liaison Committee on Medical Education — the body responsible for the accreditation of medical education programs.  While the college scored high marks in all other areas during the visit, the committee cited its concerns related to the high level of debt MUSC’s medical students were graduating with — a trend that is plaguing medical schools across the country.

Opening doors
The college responded with an ambitious campaign — the first in its 190–year history — to raise $20 million specifically for medical scholarships. The “Opening Doors” campaign is designed to help to those who have the deepest desire to become a doctor and the strongest abilities to do so, but perhaps not the financial means.

Deborah Deas, M.D., interim dean of the College of Medicine, is spearheading the campaign. "Scholarships make a huge impact on the lives of our students — tuition, books, food, travel to scholarly meetings, to name a few. The costs of medical school attendance and living expenses have skyrocketed over the past decade, and medical students find themselves with loans averaging more than $190,000 at graduation. We have to change this scenario to encourage students to choose a specialty for which they have passion, not one which makes sense because of medical school debt. The Opening Doors scholarship campaign will make a difference for our students and allow us to continue to attract the best and brightest students to MUSC. An increase in our scholarship endowment by $20 million would yield enough money to provide partial tuition scholarships for more than 50 additional students, thus opening doors to great opportunities and decreasing medical school debt."

Time and time again, students who have worked hard and sacrificed greatly all through high school and college have had their dreams derailed due to today’s financial realities. In many cases, financial factors alone are keeping qualified students from being able to pursue a medical career and escalating costs aren’t helping the situation.  State support of higher education over the past 15 years has shifted more of the financial burden onto students.

Merit versus needs-based aid
State appropriations now account for only 5 percent of the college’s annual budget. To make matters worse, states have shifted away from allocating dollars toward financial aid for students who need it toward those whose grade point averages merit it. According to the Journal of Public Economics, merit–based state aid has nearly tripled in the last two decades, to almost 30 percent. The prevailing attitude has been that if you give merit scholarships to students with top GPAs, you are motivating talented students to remain in state — reducing the possibility of brain drain: well–educated students leaving the state for greener pastures.

The actual consequence, however, is that precious dollars are helping students who need it less or in many cases, don’t need it at all.

Often, students with tremendous potential are not able to qualify for the merit–based scholarships that academic high–achievers from advantaged backgrounds are able to easily qualify for.

Their academic performances have earned them these scholarships even though finances were not a barrier to attending medical school.  

Many states are grappling with issues related to the allocation of need–based versus merit–based funding. As the argument goes, families of means are able to position their children to reach their potential and navigate the competitive track to getting into medical school. On the other hand, students who have to work 25 to 40 hours a week through college to pay for their education normally don’t have as much time to study, don’t get as much rest, and often aren’t able to achieve a resume that includes studies abroad, Greek affiliations, or academic extracurricular activities. Typically, they don’t have access to tutors or expensive prep courses or even the most up–to–date computers and equipment. Even if a less advantaged student is as smart or capable as his more affluent counterpart, he is still at a distinct disadvantage when competing for merit–based scholarships.

Private scholarships can level the playing field.

Medical student Robert Williams after receiving his master’s degree from Indiana University’s School of Medicine. photo provided

Terry Stanley, director of development for the College of Medicine, knows that for capable students, economic challenges can often be overcome with the help of scholarships. “We have to be able to help more students,” he said.  “If we could, we’d offer every student a full ride. Until that time, I want to make sure we can offer as many scholarships as possible to deserving students. Robert Williams is a perfect example of a truly gifted student we were so fortunate to be able to recruit.”

The youngest of five children, Williams came to his MUSC interview not confident he could afford a medical education. First of all, it was an out–of–state school. Secondly, his father had serious heart problems and had undergone a quadruple bypass and his mother had her own set of health issues. Williams never expected his parents to underwrite the cost. In fact, he was accustomed to finding ways to fund his own education. In the two years it took him to earn his master’s degree in biomedical science from the Indiana University School of Medicine, he had already amassed $90,000 worth of debt. Even though he knew medicine was his calling, he questioned whether he could continue on his journey into medicine.  

“For a long time I didn’t think that attaining acceptance to medical school was possible, being where I’m from Wilcox County in rural Alabama, and also being one of the first individuals to actually take this journey to go into medicine.”

But after his interview at MUSC, he knew he had to make it work. “I just knew this was the place for me,” he said. “From stepping on campus, from day one, I knew it was the place I wanted to be. Honestly, I felt I was at home; I felt like it was a family environment. It definitely did not feel like an interview. It was just like, ‘Come, we want you here.’ It actually allowed me to see I was not going to be just another number, I was actually going to be an asset to this institution.”

Williams was offered the Mary D. Rich scholarship and in–state tuition, and while he still builds quite a bit of debt each year, the financial assistance from the college has helped a great deal. “It was fortunate that I was awarded a scholarship through MUSC, where I was granted in-state tuition through my scholarship fund. I am forever in debt to this award. I definitely agree that the amount of debt one is in has an impact on what profession one chooses to go into.”

Williams, like most medical students, had a tough decision to make about which path to follow. Some choose specialties like ophthalmology, urology or cardiothoracic surgery knowing they will likely start out making a healthy salary. But even though the stress of debt haunted Williams, he made a decision based on his heart, not his wallet.

After his first two years in medical school, he realized he was in a lot of debt. At first, he thought he would pursue a field that would enable him to pay off his debt quickly. Then he remembered what his true purpose for going to medical school was. “I kind of forgot about that and the whole idea of money was just lingering over my head,” he said. “So I stepped back and allowed myself to look at the bigger picture, to realize why I came into medicine. It was never about me, it was more about my community and giving back. It doesn’t matter how much debt I’ll be in, I’m just going to do what I set out to do which is my calling to practice preventative care medicine/primary care.”

Williams is a member of the class of 2016. He’s worked hard and overcome a lot. He credits his father for instilling in him the qualities that have helped him make it through. “My father has a second grade education. At a very early age he left school to help out his mother. He lived on a farm. So my father doesn’t have a higher education, but to me, he is one the greatest people alive. I gain so much strength from him. He was a quadruple–bypass survivor: His perseverance and tenacity give me hope.

There’s something deep within me that keeps me going when it gets tough, when it gets rough. When I feel like it’s time to just give up and throw in the towel, there’s a voice inside me that says ‘Keep going, keep going.’ I know that I wouldn’t be happy doing anything else.”

Robert Williams was a successful student and high school athlete at Wilcox Central High School in rural Alabama. photo provided

Williams was the valedictorian at Wilcox Central High School, captain of his 5A state championship basketball team, a drum major, in FBLA, and a Bryant Jordan student athlete scholar.

At MUSC, he’s served as vice president of his class for two years and was president of the Multicultural Student Advisory Board. He is a prime example of why the Opening Doors campaign is so important. A student with unlimited potential and an abundance of heart and drive who just needed a little help to become all he could be.

“I grew up in rural Alabama, one of five children,” he said. “I have had to overcome a number of financial and resource-related barriers. The generous and kind spirit of the late Mrs. Mary D. Rich, who endowed my scholarship through her estate, has provided support and encouragement for both my family and me. This scholarship has afforded me the opportunity to continue on my journey of obtaining my medical degree and for that, I will be forever grateful.”

Underwood sees firsthand the financial angst MUSC students deal with every day. He said, “We believe our profession belongs to the most gifted, hardest–working individuals among us, and that tuition should never be the reason qualified and willing candidates turn away from a career in medicine. Our goal is to raise $20 million to open our doors to those who have the strongest ability and desire to study medicine — those who have worked the hardest to be here — rather than just to those who have the greatest financial means.”

Layton McCurdy, M.D., Distinguished University Professor, served as dean of the MUSC College of Medicine from 1990 to 2001. Raising funds for scholarship support was an important initiative to him then, and as an alumnus of the college, it continues to be important to him now.

“I’ve watched the field of medical education change, especially having been a student here myself. The problem students face now is that it is a huge cost to come to medical school. My tuition was $300 twice a year, today it’s up close to $40,000 a year and the paying back becomes burdensome and it guides graduates in their career choice. If someone is going to be a pediatrician, not one of the particularly overly–compensated medical practices, is that person going to go to a rural area and do pediatrics in an under-served area if they are $250,000 in debt, and they have to pay it back? I think it adds a significant obstacle to choose desireable places that are needed and choose specialties that are needed. Scholarship support for doctors is crucial in their pathway to success and their pathway to providing help to their patients. I believe that is a fact,” McCurdy said.

Jerry Reves, M.D., dean emeritus of the College of Medicine, wants to ensure that, regardless of cost, the next generation of doctors has an opportunity to study at MUSC. He is concerned that as tuition for medical school goes up, it will select against very capable students who are actually needed in the profession.

“There’s no question that today’s students on average are graduating with debt that would have been inconceivable when we were medical students. This has a profound effect on today’s students in that they have to take a look at their debt and they have to consider what fields they can afford to go into. Can they afford to go in lesser–reimbursed fields and be able to pay their debts and take care of their family obligations? Assisting today’s students by giving scholarship aid is one of the wonderful things that today’s doctors can do for the next generation of physicians. It ends up freeing them to enjoy medical school and get the most of out of it. It would relieve some of the stress that is always present in medical school. It will make them better doctors and ultimately, it will help them learn because their minds are less cluttered with worry. It is my sincerest hope that we are successful with this scholarship campaign because it will allow us to open the doors to the different people who otherwise can’t get it — not because of their ability, not because of their potential but because they simply don’t have the money. It’s a wonderful gesture on today’s doctors’ part to help the next generation, just as we were helped in one way or the other.”

More than 90 percent of MUSC’s medical students finance their education with loans. If a student is not able to begin making full interest payments on loans immediately after graduation, interest on most medical school loans continues to accrue on at least a portion of the balance during a student’s multi–year residency training. That means a higher debt balance at the end of training.  

The college has a long history of awarding scholarship support to its students. In the 2013–2014 academic year, $1,333,040 was awarded to 191 students. Most of these awards, however, were for $5,000 or less and while helpful, they are still merely a drop in the bucket. Unlike private institutions that have endowments in the billions, the college’s endowments can only award 11 full–tuition scholarships and seven half–tuition scholarships per year.

Never before has a medical education cost as much as a new home. No longer is it simply a matter of simply working hard, keeping your nose to the grindstone and being willing to make making sacrifices. While some capable, smart and hard-working students are financing their futures to care for their fellow man, sadly, others see the price tag and give up before they even get out of the gate. Stanley added, “The fruits of this campaign will hopefully provide hope for these students and let them know they belong at MUSC.”

October 23, 2014

 

 
 
 

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