AMA's Moving Medicine video series amplifies physician voices and highlights developments and achievements throughout medicine.

In today’s episode of Moving Medicine, AMA Chief Experience Officer Todd Unger discusses loan repayment and scholarship programs that provide financial incentives to recruit and retain primary care medical students and working health professionals in exchange for their service in communities in need with Luis Padilla, MD, associate administrator of the Bureau of Health Workforce.

Learn more about National Health Service Corps (NHSC).

Speaker

  • Luis Padilla, MD, associate administrator, Bureau of Health Workforce

Moving Medicine video series

AMA's Moving Medicine video series amplifies physician voices and highlights developments and achievements throughout medicine.

Unger: Hello, this is the American Medical Association's Moving Medicine video and podcast. Today I'm joined by Dr. Luis Padilla, associate administrator of the Bureau of Health Workforce in Rockville, Maryland, and he's going to discuss loan repayment and scholarship programs that provide financial incentives for medical students in exchange for their service in communities of need. I'm Todd Unger, AMA's chief experience officer in Chicago.

Dr. Padilla, thanks so much for joining us. I want to talk about the special program, the National Health Service Corps. Can you give us a little background on what it is?

Dr. Padilla: Thank you, Todd. Thank you for having me. I appreciate the opportunity to discuss the National Service Corps and always excited about this very important program that's been very impactful in my life, both personally and professionally.

So the National Service Corps is a part of the Health Resources and Services Administration's, HRSA's, broader effort to address health equity and expand care to vulnerable communities across the nation. And the program is celebrating its 50th year anniversary next year and we're really excited about that. And at its core, the program is a loan scholarship program that supports clinicians and health professional students in exchange for their commitment to serve in areas where they're needed the most. And the National Service Corps supports medical, dental and behavioral health clinicians to pay off their student debt through loan payment and scholarship programs in exchange for working in underserved areas.

Unger: And we know that's a huge problem, medical students coming out of med school in over $200,000 worth of student loans, so that's enormous. You mentioned in your introductory kind of discussion there that this was personally important to you in terms of your own experience. Can you talk a little bit about how that impacts your work?

Dr. Padilla: Well, it impacts my work every day as a former National Service Corps scholar, as a medical student that was struggling to pay for my education. My family couldn't afford that. I'm the first in my family to attend college and it really was a life changer for me. And that scholarship afforded me the opportunity to serve at Unity Healthcare Upper Cardozo Health Center to fill my obligation in 2004 before I became that center's medical director. And I saw firsthand, Todd, how the program is impacting both not just the debt relief for these clinicians but their opportunity to provide quality competent care to these communities.

Unger: Where does the funding for this program come from?

Dr. Padilla: Well, as you know, as a federal program, that agency is funded by Congress as part of its appropriate budget. And we're happy to note that in addition to our base funding, we received $800 million from the Biden-Harris administration's American Rescue Plan. And those additional funds allowed us to award the largest class of clinicians in the program history, with now over 20,000 National Service Corps members, nearly 20,000 National Service Corps members serving in communities in need across the country. And that funding is also going to allow us to award those clinicians currently working at those NHSC approved sites. So it comes in from Congress, we appropriate those awards and support these clinicians in these communities.

Unger: And let's get a little bit more into the programs themselves. Talk a little bit more about the details around the programs that are offered.

Dr. Padilla: Sure. So we have an array of programs that are offered but primarily these are loan scholarship opportunities that support clinicians by paying off their debt or providing scholarship to pay for their health professions training program. Our longest established program is the National Service Corps scholarship program, the one that I was involved in, and that covers tuition, full tuition fees, including a stipend to medical, dental, nursing students and physician assistants in order for them to complete their education and then go work in areas where they're needed the most for at least two years of service and commitment.

But I also want to highlight, Todd, that we support fourth year medical students through our Students to Service learning payment program that provides up to $120,000 for medical, dental, nursing students and physician assistants in their final year of training in school. And these awardees would then be obligated to provide two years in an underserved community.

Unger: That's a huge amount of money, and again, back to that statistic we talked about, a big portion of what a typical student would emerge from medical school with. What about programs for health professionals who want to stay and work in these communities?

Dr. Padilla: Right, so those programs I mentioned earlier, those scholarship programs and our S to S program but we offer opportunities for loan repayment. That is those clinicians that are currently working in underserved rural areas, in those communities where we need to provide some support for loan debt and the struggles that they have. And for that, we have our longstanding traditional loan repayment program that provides up to $50,000 for qualified working health professionals' student loan debt. It has an obligation of two years, minimum. Participants that complete those two years can come on and they get priority for an additional year and they can continue in the program until they're free of their educational debt.

But along with our traditional program, we also offer support through our substance use disorder workforce loan repayment program that provides up to $75,000 to qualified members of the substance use disorder treatment team and expanded previously our disciplines to include pharmacists, registered nurses and substance use disorder counselors. This is very important, as you know, right now at a time where we're struggling with substance use disorder, opioid use disorder. We reached a peak of 90,000 deaths last year as a result of substance use disorder and overdoses. And these programs are intended to provide those services. And as a further aspect of our loan repayment program, we offer what we call our rural community loan repayment program that provides up to $100,000, again, for substance use disorder treatment team members in those rural areas. And these folks both have a three year commitment.

Unger: And who can apply for programs like this?

Dr. Padilla: Well, we offer opportunities to various disciplines, are eligible through our various programs. But remember, the focus of the corps is really focused on primary medical, dental and behavioral health. So we support professionals like physicians, nurse practitioners, certified nurse midwives, physician assistants, dentists, dental, hygienist, licensed clinical social workers and health service psychologists to name a few. But that entire list can be found on nhsc.hrsa.gov.

Unger: In terms of timing, when would students or applicants apply for these programs?

Dr. Padilla: So we typically open our online application, everything is done online, we typically open that online application once a year and we anticipate opening that up in the first part of November for what we call our fiscal year '22 application cycle. During that period, the application cycle will be open, any eligible applicant or interested applicant can go to our portal. They can get assistance, including information and webinars, question and answer sessions, and direct email and call center support to help them complete that application process. So again, everything is online, including their loan information is integrated into the system. They don't have to upload those manually, that comes into our system directly. So as a reminder, that URL is nhsc.hrsa.gov.

Unger: And we'll show that on the screen there at the same time. Last question, obviously the big part of this is a commitment to underserved communities. How do you see those communities and minority populations benefiting from programs like this?

Dr. Padilla: Well, as I mentioned Todd, I mean we're celebrating our 50th anniversary. And since we've started this program, communities have benefited tremendously from having a consistent workforce that comes in and provides quality, culturally competent care. We're now at over 66,000 alumni in this program through that 50 year period. All of these communities benefit from increased access to oral health, primary care, OB/GYN services, mental health services, substance use disorder services now. The array of disciplines that I shared are critical in ensuring that we have access. And really at the end of the day, communities are benefiting from having the consistency and having clinicians who are committed to providing services in these underserved communities. Let alone the fact that we stress integration of services, whether it's primary care with behavioral health, oral health and primary care, or even public health and primary care now in the time of COVID. That integrated approach to services is really what we look for in our sites and our clinicians ... from that as well.

Unger: Well, it sounds like an amazing program and much needed based on the conversations I've been able to have with many medical students out there. Again, find out more information at nhsc.hrsa.gov and find out what programs might be right for you. Dr. Padilla, thanks so much for being with us here today and sharing the details of these important programs.

That's it for today's Moving Medicine video and podcast. We'll be back with another segment soon. In the meantime, be sure to click subscribe on the AMA's YouTube channel, Apple, Spotify or wherever you listen to your podcasts. Find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us. Please take care.


Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.

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