I chose primary care. Will NYU pay my debt?
This summer, officials at New York University’s school of medicine made a splash when they announced they are covering the cost of tuition for all current and future medical students. As Dean and CEO Robert Grossman stated, this move satisfies NYU’s “moral imperative” to educate students who will not be hampered by “the prospect of overwhelming financial debt.” In particular, it liberates students to pursue lower paying primary care specialties.
After the announcement, there was a buzz within our hospitals. Medical students walked with a spring in their step. Faculty chatted in the halls excitedly. Even the patients seemed to know what was going on. As an internal medicine resident and an alumnus of NYU’s medical school, I didn’t exactly fit into any of the above groups. But the splash got me wet. It felt like a bucket of water was dumped on my head.
At the end of medical school, I had to pick a specialty. As a newlywed with $200,000 in student debt, my future income was important. But I also wanted a good work-life balance, intellectual fulfillment and long-term relationships with my patients. So I chose a career as a general internist.
For the past two years, I’ve lived my dream. I am the primary care doctor for socioeconomically vulnerable patients with a high burden of chronic disease and enormous potential to benefit from primary care. In short, I am practicing the medicine that tuition-free medical school hopes to incentivize, and so far I love it. But once a month, when I pay my loans, I wonder why I didn’t go into orthopedic surgery.
If my alma mater heard my story, would they pay off my debt? The decision made by NYU prioritizes a budding plastic surgeon from the class of 2022 over a struggling primary care doctor from the class of 2017.
Over the past near-decade, NYU has made me the physician I am, and for that I am grateful. During this time, as we have climbed in national rankings, I have noticed NYU obsessing over its reputation nearly as much as quality of care. Many of NYU’s decisions, such as shrinking the size of the medical school class, reflect this priority. A smaller class means a higher average GPA, which improves the school’s prestige. Unfortunately, this also results in fewer physicians entering society.
Efforts to produce more primary care physicians at NYU should begin with higher salaries and scholarships tied to those fields, not with free tuition for all, and should address nonfinancial barriers to primary care careers.
At NYU, specialty medicine is considered more prestigious than primary care. Any long-term solution must involve a massive culture shift, and NYU should take the lead.
Cary Blum, a 2016 NYU School of Medicine graduate, is a resident in internal medicine/primary care at NYU Medical Center and Bellevue Hospital.