How are medical school tuition dollars actually spent? One resident tried to find an answer.
Daniel Barron, MD, a resident at Yale, detailed his quest in a , the idea for which originated with a visit to his accountant. He and his wife Kristin Budde, who is also a physician, have nearly $300,000 in student debt to pay down.
Barron talked to Robert Grossman, MD, dean of NYU School of Medicine and CEO of NYU Langone Health, who famously last year. Grossman said the $25 million in tuition that students used to pay largely went to supporting "unproductive faculty" -- those who don't get grants, teach, or see patients. Grossman also said this amount could effectively be considered a "rounding error" in the university's $10 billion annual budget.
"What's frustrating is the idea that even though we've sacrificed so much already, our debt is an amount of money that schools might not actually need," Budde said in the post.
In this video, Barron talks about tuition and debt with 51˶, calling for medical schools to calculate and publish the marginal cost of educating one student, so aspiring med students can make informed decisions about which school to choose.
Following is a transcript of his remarks:
Each year, thousands of new physicians graduate with an average of $195,000 in debt. The question I wanted to answer in writing this essay and talking to people was not whether this was a good investment, because multiple studies have shown that it is a good investment. What I wanted to find out was where all that money goes and how it's spent. It turns out that no one really bothers to sort out where it goes.
I really enjoyed going to NYU to meet Dr. Robert Grossman, who, since 2007, has been the dean and CEO of the Langone Health System. The reason I went is because I wanted to understand where medical student tuition went, and we decided that A) the NYU medical students were paying around $25 million a year in tuition, and first of all, on the overall budget of $10 billion, that's less than 1%. Also, Dr. Grossman, because of this large IT system that he had built, could track where that money was going. He could tell that it was not going to the resources or faculty that were teaching those medical students. In fact, the vast majority of it was going to support what he called "unproductive faculty" -- tenured professors who no longer bother to write grants or had any clinical responsibilities.
To the question of whether or not medical schools should understand the marginal costs of educating one medical student: I feel that absolutely yes, they should. Not only would this be a good business practice for them to understand where their money was coming from and where it was going, but the medical students themselves -- if they had access to this information -- could then make a more informed decision. For instance, a college kid who wanted to go to medical school could look at all the medical schools out there and see what the marginal cost was of educating that medical student and how much they were charging in tuition and make a decision on where to go. I wager this would decrease the price of tuition because then the average consumer would have more information about where to go.
We have a combined student debt of $300,000. What did that money pay for? When I learned that the amount of money we had paid in tuition was only a rounding error in the school's overall budget, and in fact, didn't even support the educational experience -- or the vast majority of it didn't support the educational experience -- this was very frustrating because not only is there the principal, which is the amount of money that we paid for those actual tuition dollars, then there's the amount of interest. Then there's the opportunity cost. Then there's the stress and how that amount of debt guides your decision.
This isn't just for my wife and I. This is for every medical student in the U.S. who pays a lot of money in tuition. I wager that the same principles are happening at all levels of education, whether law school or graduate school of any sort, and even at the undergraduate level. We ought to be able to know where our tuition dollars are going and what we're buying with our money.