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Debt-Free Education Helps Increase Diversity in Medical Workforce by Leveling the Playing Field

students at an event celebrating the while confetti flies around the room

Providing medical school education free of debt not only relieves a significant financial burden, it may also help increase the diversity of the medical workforce, according to Weill Cornell Medicine leadership who studied the institution’s own experience.

After Weill Cornell Medicine launched a groundbreaking program in 2019 to eliminate debt of all medical students with demonstrated financial need, the percentage of applicants from underrepresented racial and ethnic groups and those who qualify for financial assistance increased significantly, according to a JAMA Health Forum commentary published Dec. 7.

“This debt initiative was a firm, public stance to level the playing field and create equal opportunity for students to dare to dream to come to medical school,” said author Dr. Yoon Kang, senior associate dean for education at Weill Cornell Medicine.

“Making medical school debt free is likely to improve the diversity of a class without undermining the quality of the student body. And it will contribute to a diverse healthcare workforce, which is essential to providing the best possible care,” added co-author Dr. Said Ibrahim, senior associate dean for diversity and inclusion at Weill Cornell Medicine.

Drs. Kang and Ibrahim compared students who entered in 2020, the first class that applied after the debt-free initiative, to those in the four preceding years, 2016-19. Underrepresented minority applicants rose from 20 to 29 percent. Applications from public college graduates increased from 24 to 35 percent, and from 13 to 24 percent from those who qualified for fee assistance with their medical application materials, an indication of financial need. Among this class, 73.5 percent of students qualified for the program. Applications to Weill Cornell Medicine increased overall by 11 percent.

The new class had comparable MCAT scores and GPAs to those from the previous years. “We didn’t sacrifice traditional metrics of academic excellence,” Dr. Kang said.

While underrepresented race and ethnic groups are about one quarter of the United States population, they represent only 15 percent of medical school classes, and even less of the medical and scientific workforce.

Cost can be a barrier to attending institutions like Weill Cornell Medicine, especially for those from underrepresented and socioeconomically disadvantaged groups. A higher proportion of Black students, 91 percent, graduate with debt, compared to 73 percent of all students, and their median debt is $230,000, compared to $200, 000 overall, according to a 2020 Association of American Medical Colleges report.

Increasing diversity ensures more than fairness, according to Dr. Ibrahim. Physicians from underrepresented groups often go on to practice in those same communities, where there is need to expand access to healthcare.

“When communities see that we have a diverse workforce, they’re more likely to trust the system and come to us,” Dr. Ibrahim said. “Additionally, science is becoming a team sport, and diversity of the team adds to the innovation and the creativity of the team.”

The debt-free initiative stands alongside many other programs that target diversity and inclusion at Weill Cornell Medicine, ranging from faculty recruitment to a pre-medical student summer program. The institution has received the Health Professions Higher Education Excellence in Diversity (HEED) Award for these efforts for the last three years.

The debt-free program is funded by philanthropic donations, one possible blueprint for other medical schools. Other ways to ease the financial burden of medical school include paying for study resources.

“I firmly believe providing debt-free education, or other financial relief, is the way forward as we think about strategies to diversify the healthcare workforce,” Dr. Kang said.

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