I chose pri­mary care. Will NYU pay my debt?

USA TODAY International Edition - - NEWS - Cary Blum

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.

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