Nathaniel Lohman: UW medical student debt metastasizes as dean and CEO search continues

By Nathaniel Lohman

In June, University of Washington President, Ana Mari Cauce formally announced a leadership search for the next joint CEO of UW Medicine and dean of the UW School of Medicine.

Dr. Paul Ramsey served as the last permanent dean and CEO from 1997 to 2022. Dr. Tim Dellit, UW Medicine’s former chief medical officer, has been serving as interim CEO and dean since Ramsey’s retirement.

Whichever candidate is ultimately selected will have their work cut out for them. UW Medicine’s hospitals continue to lose tens of millions of dollars annually. Financial losses threaten service cuts. And relations with resident physicians and medical students has been tense at times in recent years over issues ranging from working conditions and compensation for residents to the treatment of diversity and race in the medical school curriculum.

It is also vital that the next dean address the eye-watering debt students accrue while studying at UWSOM. The school’s current treatment of medical student finances lacks transparency and justice. It undermines efforts to recruit the most talented and diverse trainees possible and jeopardizes the school’s mission to meet the Northwest region’s health care needs.

Tuition at UWSOM increased more than five-fold during Ramsey’s tenure and has nearly doubled in the last 10 years.

In concrete terms, what does this look like? For Washington residents to attend the first year of medical school at the university, the tuition for the 2023-24 school year totals $54,684, and the official student budget, which includes expenses like room and board but excludes the costs for health insurance, swells to $94,123.

Student budgets for the second through fourth year of medical school at UW are equally exorbitant. They currently range from $90,067 to $93,953 annually and are expected to rise at 2-3% per year throughout the tenure of current students.

For a typical student who cannot depend on significant personal or familial wealth to subsidize the cost of their medical education and chooses to finance their studies entirely with unsubsidized federal student loans, which currently accrue interest at 7.05-8.05% annually beginning immediately at disbursement, indebtedness at graduation can quickly approach half a million dollars.

Several peer medical schools to UW, both public and private, have introduced or expanded programs to drastically reduce student indebtedness. Medical schools at UCLA, Kaiser Permanente, Columbia, Cornell, NYU, Mayo, Stanford and Washington University (in St. Louis) offer extensive grants and scholarships that cover the cost of attendance for many or all attendees with financial need.

In comparison, despite ranking among the top two medical schools in the country for primary care training every year since 1995 and receiving the second greatest amount of federal research grant money, UWSOM provides a minority of students quite modest grants relative to the cost of attendance. Moreover, matriculating students are informed whether they will receive a grant only after they have enrolled at UWSOM. They must choose to attend UWSOM without full knowledge of the financial burden they are accepting. It is ironic and tragic that entering UWSOM as a student, like entering a hospital as a patient, an individual agrees to take on an undefined yet potentially life-altering amount of debt.

To address medical student debt and secure UWSOM’s continued leadership in primary care medicine, the next dean will need to raise a lot of money for the scholarship fund and control further tuition increases. Additional scholarship funds may come from state coffers, which contribute just 3% of UWSOM’s costs for medical education, or private sources. A capital campaign on the order of $1 billion would allow UWSOM to cover full financial need of its attendees in perpetuity.

What an incentive for talent to train and stay in the Northwest region that would be. Little would put an Amazon smile on my face like attending the Bezos Medical School at UW tuition free. Perhaps only attending the MacKenzie Scott Medical School would widen my smile further. I’d be open to other options, too.

Nathaniel Lohman is a graduate of UW’s master’s in public health program and a second-year medical student at UWSOM. He served as a Peace Corps Volunteer in Dominican Republic and worked for a number of years as an epidemiologist in Mozambique.