According to the Association of American Medical Colleges (AAMC) Medical Student Education: Debt, Costs, and Loan Repayment Fact Card for the Class of 2023, the median medical school education debt is $200,000 and will continue to increase (AAMC, 2023a). Although this level of debt is very high, physicians’ decision to invest in their future is smart, given that the 2022 average physician salary in a Health System / IDN / ACO was $400,207 (Doximity & Curative, 2023). Despite high debt, the number of students applying to medical school remains strong at 52,577 for 2023-2024 (AAMC, 2023b). According to the AAMC’s 2022-2023 Financial Aid Summary Report (FASR) Executive Overview, students funded their medical education in several ways including student loans at 70.4%, grants/scholarships without a service commitment at 26.4%, grants/scholarships with a service commitment at 3.1%, and work-study programs at 0.1% (AAMC, 2023c).
Geisinger Commonwealth School of Medicine was founded in 2008 as The Commonwealth Medical College (TCMC) and integrated into the Geisinger Health System in 2017. As an independent, private medical school, TCMC was able to offer limited scholarships and student debt began to rise. Once integrated into Geisinger, the institution became uniquely positioned to create an innovative service commitment program called the Abigail Geisinger Scholars Program to reduce student debt. In addition, this program addresses the physician workforce shortage in the specialties of Family Medicine, Internal Medicine, Medicine/Pediatrics, and Psychiatry within the Geisinger service area (Scheinman et al., 2023; Schmude et al., 2024). Similar to the National Health Service Corps and the Health Professions Scholarship Program, the Abigail Geisinger Scholars Program provides funding for medical school in return for a 4-year service commitment at Geisinger once their residency program has concluded (Scheinman et al., 2023; Schmude et al., 2024). Students accepted into the program as first-year medical students have their tuition and fees covered and receive a $2,000 monthly stipend for non-educational expenses (Scheinman et al., 2023; Schmude et al., 2024). Up to 45 students in each matriculating class can become part of the Abigail Geisinger Scholars Program (Scheinman et al., 2023; Schmude et al., 2024). SooYoung VanDeMark, Geisinger College of Health Sciences, School of Medicine student, said “Not having that crushing debt and receiving the monthly stipend really does help your mental health. In my class, there are 44 other scholars. It’s nice to be among other students who have the same attitudes as I do about genuinely doing good in our immediate community. We all say that on our applications, but sometimes you wonder if people will continue on that path. The scholars program keeps us on track and reinforces that as we progress in our education and experiences. Being a part of the scholar’s program is one of my favorite things about Geisinger Commonwealth.”
Multiple steps must be taken to implement a successful service commitment program, and proper stakeholders must be engaged. First, it is vital to identify appropriate constituencies to engage in the discovery process regarding a service commitment program and how it will be funded. Second, policies, processes, and procedures must be developed to provide the framework for the recruitment, promotion, graduation, and return to practice at Geisinger for those enrolled in the service commitment program. Finally, robust student support and a longitudinal engagement program are critical services needed to retain students in the program and return to practice. Student support services that engage students and faculty with the program are essential. Some of the support services offered include:
- Expert advising from Geisinger primary care clinicians, mentoring from primary care residents, and peer mentoring from Abigail Geisinger Scholars
- The opportunity to participate in primary care research projects with Geisinger investigators starting the first year, including summer research opportunities
- Prioritization to Geisinger sites for clinical experiences
- Early immersion into primary care core sites and signature primary care programs
In addition, we offer enrichment seminars focused on the specialties within the program, journal club, and the primary care advocacy group. Nick Gershey shares his thoughts on the seminar series, “Hearing about the lives of these physicians, how they conduct themselves every day and hearing about why they do medicine — it’s been one of the great benefits of the Scholars program. The program’s focus of bettering the Geisinger community at large is what keeps me motivated in pursuing my goal of becoming a physician.”
These support services and the curricular requirements create a community of practice among the Scholars. They can help to retain scholars in the program, thereby graduating from medical school with little to no debt and addressing the primary care and psychiatry physician shortage in the Geisinger service area.
Anitza Quintero, Geisinger College of Health Sciences, School of Medicine student, noted “Being hands-on, learning and immersing myself in a different culture started drawing my attention to community-focused medical schools. I found that Geisinger was doing that; it was helping the community. Very early on I realized that Geisinger values giving — not only giving financial support but giving your time and passion. I think giving is the foundation of change, so that resonated with me.” A service commitment program takes time, talent, and resources and, when implemented strategically, can benefit the student, organization, and society.
References
Association of American Medical Colleges (2023a). Medical Student Education: Debt, Costs, and Loan Repayment Fact Card for the Class of 2023. Retrieved from https://students-residents.aamc.org/media/12846/download.
Association of American Medical Colleges (2023b) FACTS. Retrieved from 2023 FACTS: Applicants and Matriculants Data | AAMC.
Association of American Medical Colleges (2023c). 2022-2023 Financial Aid Summary Report (FASR) Executive Overview.
Doximity & Curative (2023). 2023 Physician Compensation Report. Retrieved from https://press.doximity.com/reports/doximity-physician-compensation-report-2023.pdfScheinman.
Scheinman, S. J., Adonizio, T., Schmude, M., Jeffries, W., Hartle, J. E., & Byerley, J. (2023). Abigail Geisinger Primary Care Scholars: An Innovative Educational Program Addressing Critical Workforce Needs. Journal of Medical Education and Curricular Development, 10, 23821205231184033. https://doi.org/10.1177/23821205231184033.
Schmude, M., Adonizio, T., & Spatz, C. (2024). Case Study: Developing, Implementing, and Assessing a Medical School Service Commitment Program to Address Financial Barriers and Workforce Needs. In J.H. Paris & S.J. Kania III (Eds.), A Comprehensive Guide to Graduate Enrollment Management: Advancing Res (routledge.com) (pp. 183-190). Routledge.
About the Authors
Dr. Michelle Schmude is the Vice Provost for Enrollment Management and Associate Professor at Geisinger College of Health Sciences. She graduated from the University of Pittsburgh with a bachelor’s degree in business and history, earned a Master of Business Administration from Point Park University and received her Doctor of Education degree from Wilkes University. Dr. Schmude is a faculty member in the Harvard Macy Institute’s Program for Health Professions Educators and President of the Academy for Professionalism in Health Care. Her scholarly activities focus on professionalism, professional identity formation, admission trends, advising/mentoring/coaching, and using ePortfolios to promote and assess competency.
Roxanne Seymour is an Associate Director of Financial Aid at Geisinger College of Health Sciences. She received a Bachelor of Science in Accounting and a Master of Business Administration with a concentration in Accounting from the University of Scranton. She is also a graduate of Marywood University receiving a Master of Science in Higher Education. She is currently a third-year resident pursuing a Doctorate in Educational Leadership at Wilkes University. Roxanne has 23 years of experience in the financial aid industry. She has managed multiple areas in financial aid; including developing educational programs to educate students on loan debt and borrowing responsibly. Her dissertation topic will be based on a student’s perception of using a loan to pay for their education with a focus on whether the students feel borrowing on student loan to obtain the degree will benefit them financially in the future.