Opinion | I’m managing med school tuition, but will future Minnesota students be able to?

Opinion editor’s note: Strib Voices publishes a mix of guest commentaries online and in print each day. To contribute, click here.

•••

Last month, I submitted my fall medical school tuition payment. It was an eye-watering bill, but through the shock, I felt a huge sense of gratitude that I’m still covered under the old federal loan program.

On July 4, Congress passed the One Big Beautiful Bill Act. Among its provisions was a cap on federal student loans for professional degrees, including medicine, at $50,000 per year and $200,000 total.

Supporters claim the limits will reduce overborrowing and control sky-high tuition. The numbers tell a different story. With the median cost of public medical education already nearly $286,000, while at private medical schools it’s closer to $390,000, students face a gap of $80,000 to $190,000 that must be covered with private loans or family wealth.

But private loans aren’t simply another way to pay tuition; they’re fundamentally different and far riskier. Unlike federal loans, they don’t offer income-driven repayment plans or qualify for Public Service Loan Forgiveness, one of the few incentives drawing young doctors into primary care or rural practice. And they carry variable interest rates that can balloon without warning, with little flexibility during residency or financial hardship.

Students who rely on private debt are under intense pressure to maximize their income, which pushes them away from family medicine, pediatrics, psychiatry and rural practice, all fields that already struggle to recruit young physicians. Wealthier students can rely on family support, while first-generation, low-income and underrepresented students are left vulnerable to predatory lending.

Average medical school debt hovers above $200,000, yet primary-care salaries remain modest compared to other specialties. Family physicians earn around $241,000, pediatricians $243,000, and internists $252,000 — healthy salaries to be sure, but less than half of what many specialists make. When students add private loans to their burden, a career in primary care — rural care — becomes even less realistic.

This is a looming public-health crisis. Fewer internists and pediatricians mean more patients relying on emergency rooms for basic care; worse management of chronic disease, and higher long-term costs for families and taxpayers. In rural Minnesota, it means families lose local access to health care, having to drive hours to see a doctor.

Supporters of the bill’s caps argue that limiting borrowing will slow tuition inflation. The intent may be good, but the impact is misguided.

There are solutions available to us now that build on the big bill’s changes. Congress should raise or exempt medical education from loan caps to reflect the real cost of training; reinstate robust income-driven repayment programs, and invest in pipeline initiatives for first-generation and rural students.

Here in Minnesota, lawmakers can strengthen efforts like the Minnesota Loan Forgiveness Program, which encourages physicians to practice in underserved communities and ensures every county, from Cook to Blue Earth, has reliable access to primary care.