Analysis IN BRIEF
Association of
American Medical Colleges
2450 N Street, N.W.
Washington, D.C. 20037-1127
www.aamc.org/data/aib
across years, we used the Consumer
Price Index All Urban Consumers
(CPI-U, 1982-84=100)
5
to adjust the
data to constant 2011 dollars.
Results
Figure 1 presents the median cost and
education debt for public and private
medical school students. Across school
type, results show that while cost and
debt amounts have increased over the
last 13 years, cost still exceeds debt,
which has leveled off in recent years.
The cost of attendance across school
type has grown dramatically over this
same time span. The median four-year
COA at private schools has grown at a
rate of 1.8 times the comparable rate
for inflation while at public schools the
growth rate has been over twice the rate
for inflation (Table 1).
Over the same 13 years, the median
education debt for indebted private
medical school graduates grew from
$110,000 to $180,000, a CAGR of
4.2 percent, or 1.6 times the rate for
inflation. At public schools the same
data point grew from $80,000 to
$155,000, an annual growth rate of 5.7
percent, on average, or over twice the
rate for inflation.
Table 2 reflects both historical and
recent trends of mean education debt
amounts. In 1978 indebted graduates
across all schools had, on average, just
$13,500 ($46,500 in 2011 constant
dollars) in loans to repay. By 2011
that amount grew to $161,300. Thus,
over the last 31 years, medical student
debt has increased at twice the rate
of inflation, growing, on average, 7.8
percent per year. However, the last
three years have seen an unprecedented
slowdown in growth of mean debt
levels, with values relatively stable in
constant dollars in 2008-2011. The
percent of graduates with education
debt has remained quite stable for over
20 years.
Discussion
We posit that calculating a four-year
COA for medical school creates a more
accurate picture of the total attendance
costs faced by students compared to the
traditional focus on single-year tuition
and fees. The four-year COA data also
shows that student education debt levels
are typically lower than the four-year
COA, a fact that is not apparent when
comparing graduating medical student
debt amounts to single-year tuition and
fees amounts only.
The gap between four-year COA and
debt levels tends to be higher at private
medical schools compared to public
schools, reflecting, in part, the public
schools’ smaller gifts and endowment
funds that can be used to support
medical student grants and scholar-
ships. Indeed, in 2009-10 the 75 public
medical schools reported a combined
$1.25 billion in gifts and endowment
while the 51 private medical schools
reported $2.5 billion.
6
The recent slowdown in education
debt levels for medical students is not
completely understood, though interest
rates may play a role. In July 2006,
the interest rate on graduate student
(including medical students) Stafford
loans was fixed at 6.8 percent; previ-
ously it had been a variable rate that,
at times, was below three percent. The
graduating class of 2009 was the first
medical school class to face at least
three years of a fixed 6.8 percent interest
rate—the same time that the growth of
debt levels began to slow.
Further investigation is needed to
identify other factors beyond cost and
interest rates that might influence
the debt levels of graduating medical
students, including the role of
premedical debt. Calculating compa-
rable trends for other higher education
attendance costs, such as those at four-
year undergraduate degree-granting
institutions, is another avenue for future
research.
School Type Student Type 1998-1999
Median 4-yr
COA
2010-2011
Median 4-yr
COA
CAGR* of
COA data
CAGR* of
CPI data
Private Out-of-state $155,875 $263,964 4.5% 2.5%
Public In-state $96,796 $187,393 5.7% 2.5%
*CAGR = compound annual growth rate.
Note: During this 13-year span, some schools did not provide COA data for all four years and the total number of medical
schools increased slightly. For 2011, approximately 63% of private school students were out-of-state and 86% of public school
students were in-state.
Table 1: Changes in 4-Year Cost of Attendance (COA) at U.S. Medical Schools
Table 2: Mean Education Debt* of Indebted U.S. Medical School Graduates and Percent
of Students Indebted
Year Mean Education
Debt
(Current Dollars)
Percent Change
from Prior Year
(Current Dollars)
Mean Education Debt
(2011 Constant
Dollars)
Percent of Medical
Graduates With
Education Debt
1978 $13,500 N/A $46,500 72
1988 $38,500 8.1 $73,200 83
1998 $85,200 5.9 $117,500 84
2008 $154,600 10.8 $161,500 87
2009 $156,500 1.2 $164,000 87
2010 $157,900 1.0 $162,900 86
2011 $161,300 2.1 $161,300 86
* Values are rounded to nearest $100 for clarity and include both public and private school graduates. Data limitations in earlier
years prevent the reporting of medians.
5 Consumer Price Index. Accessed April 9, 2012 at: ftp://ftp.bls.gov/pub/special.requests/cpi/cpiai.txt.
6 For more detail on medical school revenues see: https://www.aamc.org/download/251012/data/i.revenueofu.s.medical
scholsbysourcefiscalyear2010.pdf
Authors:
James “Jay” Youngclaus, Senior Education
Analyst, Student Financial Services,
Julie Fresne, Director, Student Financial