NYU School of Medicine shook up the healthcare community last August when it announced that it would offer free tuition to all students.
It was the first major medical school to do so and Kaiser Permanente School of Medicine, which will open next summer in Pasadena, Calif., followed suit in February with a similar offering for its first five classes.
A principal driver behind NYU’s decision was to attract a more diverse group of applicants. Cost and the fear of large medical debt would no longer be a deterrent for students thinking about going to medical school, said Dr. Rafael Rivera, associate dean for admission and financial aid at NYU.
“We have been doing what people have proposed we do for many years—offering financial aid and resources to those who had the highest amount of demonstrated need. But despite that, we weren’t keeping up with the need,” he said.
Lower- and middle-income students were still experiencing the brunt of the debt that continues to rise. “The system wasn’t working,” Rivera said. Tuition at NYU is $55,018 for the 2018-19 academic year and it increases by about 3% each year.
Additionally, students in the class of 2018 graduated from NYU with an average medical school debt of $167,988. NYU projected that the current first-year class will graduate with an average medical school debt of $81,827 and that about 30% of students will have medical school debt.
The offering will run NYU—which is using endowment funds to cover the costs—an estimated $600 million to maintain long term. The school has been raising funds for this for about 11 years.
Kaiser estimated that tuition will cost about $55,000 a year. The school plans to rely on money it spends on free tuition as part of the not-for-profit health system’s broader portfolio of community-benefit activities.
Since the announcement last summer, NYU has seen a substantial increase in the number of students from lower socioeconomic backgrounds and minority populations applying to the school.
NYU received nearly 9,000 applications for the 102 spots in the 2019 incoming class. Compared with last year, the applicants represent a 103% increase in individuals applying who self-identify as disadvantaged, a 140% increase in the number of black applicants and a 40% increase in Pell Grant recipients.
“The accepted pool that we have thus far reflects increased diversity in socioeconomic status, which is an important facet of diversity in the physician workforce that hasn’t gotten the attention it deserves,” Rivera said.
Of NYU’s 561 currently enrolled students, 45 are black and 30 are Latino; there are no Native American students, according to data from the Association of American Medical Colleges.
Although NYU’s experiment is unique, most medical schools throughout the U.S. have changed their admissions process in recent years or invested in pipeline programs to try to attract a more diverse pool of applicants. It’s part of a growing recognition across the industry that a more diverse physician workforce improves patient care and outcomes. And yet, the needle to increase the number of underrepresented minorities in medicine has hardly budged.
From 2014 to 2018, the percentage of black students enrolled in medical school rose from 6% to 7.12%, according to the AAMC. Additionally, Latino medical students increased from 5.3% to 6.4% of total enrollment while Native Americans still account for less than one-half of a percent of all medical students.