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Reducing student loan debt and increasing diversity in medical school. Two physician leaders at the University of Chicago Pritzker School of Medicine: Vineet Arora, MD, dean of medical education, and Keme Carter, MD, associate dean of admissions, discuss a redesigned curriculum that includes full-tuition scholarships for medical students. AMA Chief Experience Officer Todd Unger hosts.
- Vineet Arora, MD, dean of medical education, University of Chicago Pritzker School of Medicine
- Keme Carter, MD, associate dean of admissions, University of Chicago Pritzker School of Medicine
Unger: Hello and welcome to the AMA Update video and podcast series. Today, we're talking about how one medical school redesigned its curriculum to increase diversity among its students and to find out whether this is indicative of a larger trend in medicine.
Here to discuss this are two physician leaders at the University of Chicago Pritzker School of Medicine—Dr. Vineet Arora, dean of medical education, and Dr. Keme Carter, associate dean of admissions. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Arora, Dr. Carter, welcome.
Dr. Arora: Thank you. Great to be here.
Dr. Carter: Thank you for having us.
Unger: Well, before we dive into the specifics of your new program, I want to take a step back because lack of diversity in medicine, which is at least partially driven by the huge cost of medical education, not just a University of Chicago problem. This is a medicine problem. So let's start by talking about what the debt statistics are telling us and how this has influenced the current makeup of the physician workforce. Dr. Arora.
Dr. Arora: Thanks, Todd. As many people know, a career in medicine is becoming really inaccessible to all but the wealthiest Americans. And in fact, 80% of U.S. medical students hail from the top two quantiles of family wealth. So, really, it's very difficult for an average wealth or lower than average wealth family to produce a physician.
And that's really important because we know that doctors who actually go into practice are more likely to serve their communities if they are from those underrepresented in medicine groups, either minorities or groups that are from lower income. And so this is actually a real problem for the U.S. health care workforce. There's actually a dose-response relationship between your family wealth that you grew up with and your ability to enter medicine. So it's a real problem.
Unger: That is an alarming stat that you gave. So your program now is working to remove some of these barriers. So tell us a little bit about your redesigned curriculum and the changes that you're making there.
Dr. Arora: Yeah, absolutely. So we are launching a new curriculum this fall called the Pritzker Phoenix, which symbolizes things that we learned from the pandemic but also our alignment with the University of Chicago campus that we're colocated with. And, really, it's a return to the focus of inquiry small group learning and really highlighting that our medical students, something that we learned through the pandemic, can make contributions to the team as part of value-added roles, even as early as first year.
So we're very excited about the new curriculum and then also providing a robust transition for them to go on to graduate medical education residency and fellowships.
Unger: Now, Dr. Carter, in addition to the changes in curriculum, a big piece of news and aspect of this redesign is around increased scholarship funds. Tell us more about what that looks like.
Dr. Carter: Absolutely. Well, at the Pritzker School of Medicine, we are very fortunate to be able to offer the vast majority of our student scholarship support. So, actually, about 90% of our students will receive some form of scholarship support.
However, with this new investment, we are able to offer up to half of the matriculants coming to the Pritzker School of Medicine a full tuition scholarship. And this is big. This is huge. This is making a medical education more accessible, as Dr. Arora just mentioned. And this model is a need-informed model. So this investment is directed primarily to students with the highest need.
We want students to be able to move through the curriculum not worrying about debt on a day-to-day basis and certainly not worrying about their future practice setting or their future specialty choice based on their debt burden. So we are excited to be able to make this investment in the future of physician workforce.
Unger: Dr. Carter, that's huge because it's not uncommon for a med student to leave school with $200,000 or more in debt. So I've got to ask you, how is a full-ride scholarship like that funded? And is it difficult to get buy-in to something that is so significant?
Dr. Carter: We are, again, very fortunate to have the investment of the leaders at the University of Chicago. So the funding is coming in part by investment of the Biological Sciences Division at the University of Chicago in these students and also philanthropy.
Dr. Arora: Yeah, and I want to chime in that we're grateful to all of our donors as well as our institutional leadership, including our dean, Dr. Mark Anderson, for really believing in this vision, and that this is a real problem that we need to actually do something about to help our medical students, especially in an era where we also know that there are health equity gaps. And we need to diversify our workforce.
Unger: Dr. Arora, I'm curious, does this have anything to do with the experience, the pandemic itself? Is there any influence there.
Dr. Arora: Absolutely. That's a great question. And as I mentioned before, the pandemic really underscored the value—the students that are graduating this week actually were first years when the pandemic hit, and they mobilized.
They were helping with testing and telehealth. And there's six student-run free clinics. They were supporting literature reviews, helping clinicians on the COVID units with infection control.
So what we found is that as opposed to a deficit model where it's, well, you can't do anything, because you're a med student, it was actually, what can you do? And that really influenced our team and our curriculum. And, actually, as a school, that's been also funded by the AMA consortium really to think about, how do we institutionalize some of the innovations that were funded by the AMA around value-added roles so that students, as early as first year, were making impact in the clinic, in the emergency room, or in the OR and the community with patients?
Unger: And, Dr. Arora, in recognition of the unique journey that those graduates experienced during the pandemic, we did just air our AMA Tribute to the Medical School Class of 2023. Make sure to check that out on AMA's YouTube channel. Now, I know this latest effort is but one step in a very, very long journey. Dr. Carter, I'm curious, what successes have you seen already?
Dr. Carter: We've seen significant successes. We have been able, over the last several years, to continue to decrease the average debt amount that our graduates are graduating with. We have also, over the last several years, been able to almost double the number of students who are matriculating at the Pritzker School of Medicine and who identify as coming from a low-income background.
Again, what we're doing is representing the broader community in this country within our school of medical students. So this is exciting. This is needed. And we look forward to the great impact that these students will have within this country and beyond in medicine.
Unger: Dr. Arora, do you think this is a trend and something you hope to see happen more broadly across medicine?
Dr. Arora: Absolutely. I mean, the debt load is tremendous. And we need to do something about it. And, certainly, we aren't the first school to have done this. But we are proud to be joining our peer schools in this commitment to lowering debt as well as providing tuition support. But the need is great.
And as Dr. Carter pointed out, we're really thrilled to be able to recruit the best and brightest students but also then lower their stress levels when they're here about the debt so that they can choose their careers, choose where they want to practice without that staggering debt load. And that really will help us train the most excellent doctors that are going to help us really take us into the next century for Americans. And we're really privileged to be part of that.
Unger: What a great move and very inspiring. Dr. Arora, Dr. Carter, thanks so much for joining us and telling us about the new program. That's it for today's AMA Update. We'll be back soon with another segment soon. You can find all our videos and podcasts at ama-assn.org/podcasts. Thanks again for joining us today. Please take care.
Dr. Arora: Thank you.
Dr. Carter: Thank you.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.