Journal of General Internal Medicine

, Volume 31, Issue 10, pp 1237–1241

Forgiven but not Relieved: US Physician Workforce Consequences of Changes to Public Service Loan Forgiveness

  • Ari B. Friedman
  • Justin A. Grischkan
  • E. Ray Dorsey
  • Benjamin P. George
Perspective

DOI: 10.1007/s11606-016-3767-2

Cite this article as:
Friedman, A.B., Grischkan, J.A., Dorsey, E.R. et al. J GEN INTERN MED (2016) 31: 1237. doi:10.1007/s11606-016-3767-2

ABSTRACT

Public Service Loan Forgiveness (PSLF) was established in 2007 for public sector and nonprofit enterprise employees to pursue educational loan forgiveness. Under PSLF, graduates are offered complete loan forgiveness after 120 qualifying monthly payments while employed at public or nonprofit institutions, including payments made during residency for physicians. In response to concerns that PSLF will heavily subsidize lawyers, doctors, and other professionals, the President’s 2017 budget proposes limiting maximum forgiveness. Using data from the Association of American Medical Colleges Graduation Questionnaire (n = 55,905; response rate of 80 %), we found that intended participation in PSLF among medical school graduates grew 20 % per year since 2010. Future primary care physicians intend to use PSLF more than programs that were historically designed to promote primary care, such as the National Health Service Corp (NHSC). The federal government’s projected cost of PSLF will reach over $316 million for 2014 graduates (net present value), approximately seven times the annual contributions from the NHSC. The proposed cap will reduce the total anticipated forgiveness by nearly two-thirds and substantially reduce subsidies for physicians. More targeted measures of loan forgiveness could be considered, such as making forgiveness contingent on pursuing specialties that society needs or practicing in shortage areas.

KEY WORDS

medical students medical education medical education debt student loan repayment loan forgiveness primary care workforce physician manpower physician shortage health finance health economics 

Supplementary material

11606_2016_3767_MOESM1_ESM.pdf (309 kb)
ESM 1(PDF 309 kb)

Copyright information

© Society of General Internal Medicine 2016

Authors and Affiliations

  • Ari B. Friedman
    • 1
  • Justin A. Grischkan
    • 2
  • E. Ray Dorsey
    • 3
  • Benjamin P. George
    • 3
  1. 1.Leonard Davis Institute of Health EconomicsUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.University of Rochester School of MedicineRochesterUSA
  3. 3.Department of NeurologyUniversity of Rochester Medical CenterRochesterUSA

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