Before you give the Presentation. As a foreword, we, the student life committee, have several suggestions to help make this event more meaningful. First,

Before you give the Presentation.As a foreword, we, the student life committee, have several suggestions to help

make this event more meaningful. First, look over the whole powerpoint and read the notes section; many slides have

links that are useful. Click on them and learn! Update slide with your school’s information to make it more interactive.

Please invite a representative from your financial aid department to attend and look over the slides in advance to ensure accuracy about your school’s data and sell yourselves as a very professional organization. If they are real excited, consider asking them for money $.

Also, consider making a week about financial responsibility: bring in speakers to supplement the ppt on these issues (financial aid reps, financial planners, NHSC ambassadors, etc.) We do urge caution regarding in using financial planners with bank affiliations, etc. 

We recommend working anmd collaborating with other student orgs (strategically). And invite local members of NHSC, and other repayment options to share their experience.

As always, we are available for questions and support, so do not hesitate to contact any of us.

Best,The student life committee—Eric, Courtney, Evan, Katherine, and Liz.

DEBT DAY

Student Life Action Committee

American Medical Student Association (AMSA)

July 2009

Image by wsssst, via Flickr

So you just signed your loans….How will you compare with other medical

students?Average American medical student

graduates with more than $140,000 of debt

87.5% have some outstanding debt75.5% graduate with >$100,000 debt17.7% graduate with >$200,000 debt

AAMC 2008 Graduation Questionnaire

Why so much debt?

AAMC. Tuition and Student Fee Reports, 2008

A Historical Perspective on Debt

Year Public School Tuition

Private School Tuition

1981 2761 89622008 18,784 38,082% Change (real dollars)

265% 52%

Who’s in control?

In 2000, 33% of US medical schools’ tuition was set by the medical school or health science administration.

For 47% of schools, tuition was determined by the Board of Trustees of the parent university

State legislature or other state authority set tuition levels for 20% of schools

Liaison Committee on Medical Education Annual Medical School Questionnaire-Part II 1999-2000. The questionnaire was sent to the deans of all 125 LCME-accredited medical schools and had a 100% response rate.

Trends in Tuition Increases

Steinbrook, Robert, Medical Student Debt -- Is There a Limit?, N Engl J Med 2008 359: 2629-2632

Medical School Revenues in 2008

Liaison Committee on Medical Education Annual Medical School Financial Questionnaire FY 2008

Where does the money go?

Instructional costs range from $48,000 to $51,000 per student per year

Educational resources cost $80,000 to $105,000 per student per year

*Adjusted for 2002 constant dollars

American Medical Association, Medical Education Group, Chicago , IL . Report on the Council on Medical Education - CME Report 2-I-00/Medical School Financing, Tuition, and Student Debt

Okay, so how will this affect me when I graduate?

THE LATEST LEGISLATION:

Congress recently eliminated an important loan deferment pathway during residency.

Effective July 1, 2009.

This law severely reduced the ability of medical school graduates to defer payment of their loans while completing government-mandated residency training.

The government??

College Cost Reduction and Access Act

What’s the policy now?

College Cost Reduction & Access Act of 2007i.e. Income-based Repayment (IBR)

– Effective July 1, 2009

Caps monthly loan payments at 15% of discretionary income (income above 150% of FPL)

All residents qualifyInterest accrues on subsidized loans after

the first 3 years of IBR; interest (as always) accrues on the unsubsidized portions.

Example of IBR

FPL = $10,830 for 1 individual in contiguous US

With the average first year resident stipend of $46,245, monthly payment would be approx. $375

After 25 years of IBR, remaining federal educational debt is forgiven

AAMC Annual Survey of Resident/Fellow Stipends and Benefits. Autumn 2008 Report.Federal Register. Vol. 74, No. 14. Friday, Jan 23, 2009. pg 4200.

Public Service Loan ForgivenessConditions:

Federal loans eligible for forgiveness after 120 payments; andBorrower is employed full-time in a public service job while making payments

Definition of public service job: A full-time job in emergency management, government, military service, public safety, law enforcement, public health, public education (including early childhood education), social work in a public child or family service agency, public interest law services (including prosecution or public defense or legal advocacy in low-income communities at a nonprofit organization), public child care, public service for individuals with disabilities, public service for the elderly, public library sciences, school-based library sciences and other school-based services, or at an organization that is described in section 501(c)(3)…

Other Current Scholarship & Loan Repayment Programs

National Health Service CorpsIndividual State ProgramsPublic Health Service Commissioned CorpsIndian Health ServiceNational Institutes of HealthArmed Forces

Now, you’re only eligible for economic hardship deferment if your income is below minimum wage or <150% of the FPL

This won’t help residents.

What About Deferment?

The Old Way: Economic Hardship Deferment

Residents qualified if their debt burden was >20% of their income.  Also, their income minus their debt had to be <220% of the Federal Poverty Level (FPL) for a family of two. 

This was affectionately known as “The 20/220 Pathway”

67% of residents deferred loan repayment for the first 3 years of their residency.

What can you do?

Keep track of your federal loans at www.nslds.ed.gov

Visit AMSA’s website to stay informed about current policies and advocacy opportunities

Join AMSA’s Show Me The Money Campaign

Show Me The Money Campaign

Learn about your medical school's revenue sources and how your tuition contributes to the total.

Spur discussion amongst students about debt or fighting tuition increases.

Attend the AMSA Student Debt Institute.

More action items at: http://amsa.org/student/tuitionguide.cfm

Attend AMSA’s Debt Institute!This Institute will intensely analyze the

history, its effects on the medical profession and solutions to the mushrooming problem of medical student debt. We will help teach you essential skills in framing this issue to engage in the political sphere of student debt.

Fall 2009, Applications Forthcoming

Come on board!

Join other AMSA members in support of:Ensuring medical education is accessible and

affordable for all students;Eliminating financial barriers to medical education;Alleviating the debt burden of current medical

students and medical graduates;Providing financial incentives for students

committed to careers in primary care by fully funding programs like the National Health Service Corps;

Developing and implementing medical student debt education programs based on sound financial management principles.