Databyte: Black and in the Red

Black medical students have more debt

Published on September 30, 2013 by Abdul El-Sayed

Black students are underrepresented among medical students by nearly 100 percent relative to the rest of the U.S. population. What’s worse, medical school enrollment among Black students is falling. If we believe in the value of a diverse physician workforce, one that is representative of the increasing diversity of our population, this is a serious problem.

Unfortunately, we don’t really know why Black students aren’t enrolling in medical school. College graduation rates among Black students are increasing, and many medical schools, valuing the diversity of their student bodies, aggressively recruit Black applicants.

But a recent study published in the journal PLoS ONE  may shed light on the question. The study considered the anticipated debt burden of medical students in a sample of over 2,000 students, representing 111 American medical schools nationwide. The findings showed that 77% of Black medical students anticipated debt in excess of $150,000 upon graduation, compared to 62 percent of medical students overall. After adjusting for demographic differences, Black students were nearly 3 times more likely to anticipate debt in excess of $150,000 upon graduation than Asian students, who had the lowest anticipated debt overall.


This comes at a time when student debt is growing faster than ever. Over the past decade, the cost of medical school grew at twice the level of inflation. Mean medical student debt now sits at nearly $160,000 among graduating students.

The findings suggest, then, that the increasing cost of medical education coupled with the disproportional burden of that cost may be dissuading qualified Black students from careers in medicine to begin with. More likely to come from less wealthy, less educated families, Black students are unlikely to have access to the types of family resources that may be shielding their counterparts from other ethnic and racial groups from debt.

What can be done? The findings suggest that simply increasing acceptance rates among Black students will have little overall effect without also addressing the economic barriers that Black students are facing. In that respect, competitive financial aid packages, low-interest loans, and favorable loan repayment programs are needed.

And the political will to provide these services will require a paradigm shift with respect to how we think about student debt. Rather than an individual financial choice, we need to recognize that student debt is actually shaping the workforce in meaningful ways. In that sense, student debt,  although borne by individuals, is actually a collective problem–one that requires a collective solution.

Ultimately, a diverse physician workforce is in everyone’s best interest. And therefore, so are effective solutions to the explosion in student debt and its disproportionate racial burden.

Edited by Dana March

Abdul El-Sayed
Abdul El-Sayed is a social epidemiologist and physician-in-training. His research explores how our social realities make us sick. Abdul is also Fellow at Dēmos, a non-partisan public policy center in New York. His commentary engages healthy policy questions in the US and globally, with a particular focus on social inequalities and disease prevention in light of health trends. Follow him at @elabdul.

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1 Comment

Also very interesting to me is how poorly white families are doing by this measure. White households have the highest average household income and wealth, yet are second in med school debt. Do whit families feel less obligated to pay for med school than say Asians? Do they do a worse job saving for post grad education than Latino parents? One thing holds across the board-being a doctor when you grow up comes at a hefty price tag.

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