From: Issue 36 Categories: Society

The Indebted Medical Student

27 September, 2011

Why rising tuition may be leaving family doctors at a loss

Written by Dr. Brian Goldman , Contributor

Illustration: Jack Dylan

I’ve been fortunate enough to enjoy two high-adrenaline careers as an ER physician and a medical journalist and author. Both careers have come together on my CBC Radio show, White Coat, Black Art, in which I pull back the curtain to explore the culture of health care.

What never ceases to amaze me on the show is the utter devotion of all the health care providers who make up our Canadian health care system. It makes it clear that a sustainable society’s need for competent and passionate health practitioners is as perpetual as the seasons – new generations of high-quality doctors must be encouraged to come out in droves.

And thankfully, they are out there. In my role as radio host, I am often awarded the privilege of hearing from such committed and motivated students embarking on the early years of their medical journey. Recently, Nicole Perkes of Port Coquitlam, B.C., sent me a note announcing her acceptance into medical school, and thanking me for the show’s contribution to her success in making her vision for a future in health care a reality.

In my congratulatory note to Nicole, I reminded her that she did all the work getting past the interview and into medical school—and that she will need a lot of dedication and perseverance to survive her undergraduate years and beyond.

But there is another obstacle in Nicole’s way, lurking in front of all medical students, and whittling away at the numbers of Canada’s future family care providers: debt.

As it turns out, students like Nicole will also need quite a lot of money to graduate. Medical school tuition is rising as though the schools themselves were filled with helium. According to a survey published in Maclean’s magazine last fall, first-year tuition for the previous academic year ranged from a low of $7,499 at the University of Manitoba’s faculty of medicine to a whopping $20,831 at McMaster University. Québec medical schools offer lower tuition costs to Québec residents. University of British Columbia, the school Nicole Perkes enters this September, charged $15,457 tuition to first-year students.

And tuition is only the beginning. Add in books and equipment, plus the cost of living, and the total price becomes daunting.

When I left residency back in the 1980s, I owed the bank $9,700 in student loans. That’s small beer compared to the debt racked up by today’s medical students. According to the 2007 National Physician Survey, more than one-third of respondent students said they expected their medical school-related debts to top out at more than $83,000. Among third- and fourth-year med students, a little more than five per cent said they expected to have total debts of over $160,000.

Yet believe it or not, it could be worse. Three years ago, I travelled to Ireland to visit Geoffrey Stevens, one of several thousand Canadians studying medicine abroad at the time. Stevens, a native of Ontario, attended medical school at Dublin’s Royal College of Surgeons in Ireland. Stevens admitted he didn't get into a Canadian medical school because he favoured partying over studying during his undergraduate years and his grade-point average suffered as a result. Medical schools in Ireland aggressively recruit students from North America, but at a cost.

At the time, Stevens’ first-year tuition alone cost €34,000. Annual tuition increases, living expenses and the then-weak Canadian dollar drove his total costs to close to half a million Canadian dollars. The debt was always on his mind.

“It influences how my future will unfold,” he said during an interview on White Coat, Black Art. “No matter where I go, I will always be thinking about how to pay this back.”

And why should the dwindling bank account of a medical student matter to you?

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