Dear Alumni/ae and Friends:

In this issue of Medicine at Michigan, I have the pleasure of introducing you to Shannon Sullivan, a 27-year-old from Grosse Pointe who is one of 165 new physicians in the Medical School’s Class of 2001.

Shannon and I have a lot in common. Both of us were born and raised in the Detroit area, and we received our M.D. degrees from the U-M Medical School. Our backgrounds diverge in undergraduate training; while my pre-med years were also at Michigan, Shannon has an undergraduate degree from Princeton University and a Master’s Degree in Public Health from the U-M’s combined M.D./M.P.H. program.

I completed my residency in radiation oncology at the University of California in San Francisco. This June, Shannon is headed to UCSF, too, for her residency in pediatrics. She’s planning a career in public service as a children’s health advocate.

But our experiences differ markedly when it comes to student indebtedness. When I graduated from the U-M Medical School in 1972, my in-state tuition was $1,260 per year and I didn’t owe one dime. Upon her graduation on June 8, 2001, Shannon’s in-state tuition was $18,574 per year and she will leave Ann Arbor owing more than $156,000.

Unfortunately, Shannon has a lot of company. Eighty-five percent of the students in this year’s graduating class had to borrow money — on average, about $104,000 — to pay for medical school tuition and living expenses. In fact, when the Class of 2001 walked across the stage in Hill Auditorium on commencement day, they owed collectively more than $15 million.

Shannon knows that the rewards of a career in pediatrics and public policy will not be measured in dollars. With interest on her loans now accruing at the rate of $1,000 per month, she expects to be making payments for most of her life. She tells me she refuses to allow concerns about paying off debt dictate her choices in life. I admire her altruism, but wonder if she fully appreciates how difficult it will be to repay these loans.

In the early 1970s, my salary as a University of California-San Francisco house officer was about $14,000 and I lived very comfortably. Beginning house officer salaries at UCSF are now $36,000. Shannon is already trying to figure out how to make monthly loan payments of $913.55, while paying for rent, food, taxes and basic expenses in one of the most expensive cities in the United States.

The heavy debt burden faced by medical students like Shannon is a nationwide problem, but it is a particularly serious issue for us in the U-M Medical School, because we compete for the best students with schools that provide more scholarship support. Every year we lose promising students to medical schools with larger endowments offering more generous financial assistance.

Our emphasis has always been on admitting a diverse student body, and we actively recruit non-traditional students. (See our cover story on page 20.) Like Shannon, many of our students have additional postgraduate degrees or are committed to careers in public or community service. Many are older with families to support, or come from less privileged backgrounds. The most promising future physicians often are the same students who are most likely to incur major debt, unless they receive significant scholarship support.

Ann Arbor’s high cost of living pushes the total cost of a U-M M.D. degree up to $35,000 per year for a first-year, in-state student and $50,000 per year for a fourth-year, out-of-state student. When we compared the average debt incurred by our Class of 2000 with debt loads from the top 20 medical schools in the country, U-M ranked sixth in average student debt, and our students owed more than graduates of many prestigious, high-cost, private medical schools — including Duke, Stanford, Johns Hopkins and Harvard. Unless we increase our ability to provide financial support for U-M medical students, many of our best and brightest applicants will go elsewhere.

For this reason, scholarships have become a top fund-raising priority. This year, for the first time in its 151-year history, the Medical School offered 20 new, full- or part-tuition Dean’s Scholarships to some of our most sought-after applicants. So far, 10 have accepted our offer and will begin their medical educations at the University of Michigan in August.

My dream is to build a permanent endowment that will allow us to provide scholarship support to all of our students. Many U-M alumni/ae, friends and patients already have made generous contributions to our scholarship programs. But to increase our ability to offer substantive scholarships to more students, I will need your help. You’ll be hearing more from us about scholarship endowment funding in the near future. Please give it some serious thought and respond as generously as you can.

We cannot continue to ignore the long-term consequences, to our profession and to our country, of escalating medical student debt. It scares away some of the best and brightest students from entering the field of medicine, and it can unfairly hold sway on the career choices of our graduates. I hope we can join together as alumni/ae of the great University of Michigan Medical School and help the next generation of physicians begin their careers filled with the excitement of being a physician, not overwhelmed by the prospects of years of indebtedness.

Sincerely,

Allen S. Lichter, M.D.
Dean