The following was passed down from RuralMed in Canada. We know in this country that those from lower socioeconomics tend to choose underserved practices. We also know that these same students struggle with poorer schools and education and career preparation. A higher proportion take 5 or 6 years to complete medical school, compounding their debt and obligations. There is no reason to believe that in the US, the debt situation impairs selection of the right kind of students. We also know that students from professional parents are more likely to specialize, leading away from primary care and rural practice.
TORONTO STAR EDITORIAL, Apr. 9, 2001
A study of first-year medical students at the University of Western Ontario shows that the average income of the students' parents is 50 per cent higher than three years ago. Students whose parents earn less than $60,000 are down from 36 per cent to 15 per cent.
You'll have to go a long way to find a better measure of what the Mike Harris government's sky's-the-limit tuition policy is doing to Ontario.The central message of this study couldn't be clearer. Soaring tuition ismaking medical schools ‹ and medicine ‹ a preserve of those who are wealthy or able to take on an average debt of $100,000.
But the implications go deeper than destruction of the equal access to education that once was Ontario's hallmark. This is effectively an offloading of the province's education debt onto the middle class. Families with deep pockets can finance the costs with little debt. Lower income families can't get in the door.
Since limits on student loans haven't kept pace with tuition, there's little help from the government. Ontario has also arranged things so that the federal millennium scholarships go first, not to help students, but to payoff provincial loans.
The second major implication is that it hits students from rural and small-town communities harder than students who live in or near the cities where medical schools are located. Not only do these students have to pay higher tuition but also the higher costs of living away from home.
So the soaring tuition aggravates an already serious financial barrier to rural and small-town students going to medical school and becoming doctors.
But there is a longer-term impact on communities as well. Some 109 communities are short 1,000 doctors. The government says it is a problem of "distribution." But it's been sitting on a report arguing for a new medical school in the north, because doctors tend to set up practice where they go to school. The kids who can afford to go away to school, in brief, usually stay away.
Without government action on a northern school, small towns and cities stand to lose their best hope for future doctors ‹ their own kids.
Finally, the government's abandonment of medical education is a surrogate for its broader disinvestment in human capital. Ontario is now near the bottom in North America in terms of per capita investment in higher education.
Four years ago, university and college operating budgets were cut by $400 million a year. Little has been put back, leaving tuition as the main source of new funds.
At Western, medical students already in class have generously voted to increase their own fees so that first-year fees can be held to $11,000 instead of increasing to $14,000. The Ontario Medical Association has started a bursary fund to help out.
But, as they say in the doctor business, these are Band-Aids. The real problem is a policy that has stripped cash from education and left us running down the investments past governments made in human capital.
This must end. If it doesn't, we'll all pay dearly and soon for trying to educate doctors and just about everyone else on the cheap
Toronto Star Newspapers Limited
Studies in the US reveal major income differences across certain groups. Comparisons of who gets admitted compared to who is not, reveal income as a major factor.