Many Americans already experience lengthy waits to see physicians, often stretching weeks or even months. At this critical time, the country requires more doctors. Yet, federal policies might be deterring capable young individuals from pursuing a medical career. New federal borrowing limits for students have been introduced, potentially causing significant repercussions beyond medical schools. Without renewed consideration from Congress and the administration, these restrictions could exacerbate the existing physician shortage, hinder healthcare access, and narrow the pool of future doctors.
Proponents of these borrowing limits present valid arguments. They claim that unrestricted federal loans have led to increased tuition, encouraged excessive borrowing, and transferred substantial financial risk to taxpayers. They also advocate for colleges to better manage costs. While these objectives are reasonable, medical education differs markedly from other graduate programs.
The 2025 federal budget reconciliation law restricts medical students to borrowing $50,000 annually and $200,000 over their education, with a total federal borrowing cap of $257,500. Although many current medical students are unaffected, these limits will significantly impact prospective applicants evaluating the viability of a medical career. Physicians belong to a highly constrained profession, undergo extensive residency training, and traditionally exhibit low student loan default rates. Applying the same financial structure to medical education risks addressing one issue while creating another: reducing the number of new physicians when the nation requires more.
The timing is particularly concerning. The Health Resources and Services Administration forecasts a shortage exceeding 141,000 doctors by 2038. Numerous Americans already face difficulties accessing primary care, mental health services, and various specialties, especially in rural and underserved regions. Each new physician contributes by enhancing public health, strengthening communities, and boosting economic productivity. Nonetheless, the financial path to becoming a doctor has evolved significantly.
A study published in the Journal of the American Medical Association revealed a substantial increase in the percentage of medical students needing federal loans beyond new limits over the past decade. The financing approach by Congress no longer accurately represents current medical education costs.
The solution isn’t as simple as mandating reduced tuition by medical schools. These institutions are responsible for cost management and, in many cases, are achieving this. Numerous schools, including mine, have maintained tuition hikes below inflation levels while continuing investments in vital areas like simulation technology, cybersecurity, student services, and regulatory needs essential for producing proficient physicians. However, tuition comprises only part of the equation. Living expenses such as housing, food, transport, health coverage, and childcare have substantially increased. Medical school demands full-time commitment, leaving scarce opportunity for external employment. For a majority of students, living costs match or surpass tuition expenses.
Students with familial wealth or guardians able to co-sign loans will likely obtain financing. Others won’t have the same access. Those most affected are often students from rural areas, first-generation college attendees, military veterans, and individuals from underrepresented groups in healthcare. These physicians are more inclined to serve in underserved communities. When financial constraints deter them, patients ultimately endure the consequences.
Private lending entities are bridging some of the financing gaps, yet access increasingly hinges on creditworthiness rather than academic excellence or a student’s commitment to service. Opportunity should rely on ability, integrity, and dedication, not familial wealth or credit access. Medical students represent one of the soundest lending investments in higher education. Medical graduates maintain some of the lowest student loan default rates, indicative of stable employment and a longstanding repayment history.
The Association of American Medical Colleges notes near-zero default rates among medical school borrowers, while federal statistics indicate approximately 1.5 percent default rates for all professional degree borrowers. Communities, philanthropists, health systems, and universities are expanding scholarships and creating innovative financing methods. These endeavors are commendable but insufficient to replace a reliable federal financing structure. Historically, the nation has regarded medical education as a public good investment. This principle should not alter due to changing higher education economics.
If serious about bolstering the physician workforce and enhancing healthcare access, we should avoid imposing financial hurdles on capable students eager to dedicate themselves to healthcare. Congress and the administration need to reassess borrowing limits to prevent a long-term barrier to cultivating urgently needed physicians. The U.S. has never remedy workforce shortages by complicating entry into professions. Medicine should be no exception. Restricting the path to becoming a doctor won’t address America’s physician shortage.
Marc B. Hahn is president and chief executive officer of Kansas City University. A board-certified anesthesiologist, he has over four decades of experience in medical education, including service as a U.S. Army physician.