Amid a physician shortage, we’re making medical school harder to afford

The physician shortage is not a distant problem—it’s a ticking clock. By 2034, the Association of American Medical Colleges projects a shortfall of up to 124,000 physicians, and the pandemic has only accelerated burnout and early retirement among current doctors. Yet, at this exact moment, we’re debating whether to make the path to an MD even steeper. On one side, fiscal conservatives argue that the federal government cannot continue subsidizing ever-rising tuition costs without accountability. They point to income-driven repayment plans that have ballooned in cost and question whether taxpayers should foot the bill for degrees that often lead to lucrative salaries. There’s merit in that concern—medical school debt now averages over $200,000, and while physicians earn well, the burden falls unevenly on those in primary care or public health. But here’s the flip side: we don’t just need more doctors; we need *diverse* doctors who will practice in areas that are already medically underserved. If we price out talented students from lower-income families, we narrow the pipeline to those who can afford six-figure tuition outright. That’s not just an equity issue—it’s a public health issue. Rural communities, which already struggle to recruit physicians, will feel the sting first. The article rightly notes that we’re not choosing between “more doctors” and “less debt” in a vacuum. We can reform residency funding, incentivize service in underserved areas, and tackle the underlying cost of medical education itself. But doing so requires political courage to challenge the status quo on both sides—the spending hawks who want to cut first and ask questions later, and the education lobby that resists any accountability for rising costs. We need a pragmatic middle path: targeted loan forgiveness for those who commit to primary care or rural practice, expanded scholarships for first-generation students, and a serious look at why medical school tuition has outpaced inflation for decades. The clock is ticking—and the next generation of doctors is watching.