Dear (insert name here),
My name is Jessica ______; I am a 26-year-old graduate student from North Carolina, and I will soon be entering the Physician Assistant (PA) program at Duke University. I am thrilled to have been accepted to such a wonderful program, and very excited to start school and embark on a rewarding medical career. However, the rising costs of education have recently led me to spend hours in front of my computer seeking out financial assistance. To my shock and disappointment, I have found virtually no aid whatsoever for PA students beyond loans. Given the rapidly changing model of medicine in favor of the mid-level practitioner, I feel that this is an unacceptable gap in the system.
Over the past few decades, we have seen how effective mid-level practitioners such as PAs and nurse practitioners (NPs) can be. As physicians increasingly turn away from primary care and toward higher-paying specialties, PAs and NPs are quietly filling in the resulting gaps, providing a nearly equivalent level of education and experience for a fraction of the cost. Physicians have communicated a high level of satisfaction with PAs, and patients often state that they feel that their PAs spend more time with them than their doctors and take their concerns more seriously. Simply put, not every patient needs to be seen by a doctor. A good percentage of daily care can be easily handled by mid-level practitioners, leaving the truly complex cases for the physicians. This fact is beginning to be recognized globally as well, with multiple PA education programs springing up in the Netherlands, Australia, Canada, the UK, and South Africa. In recognition of our success, American PAs are being heavily recruited overseas, both to teach in these new programs as well as simply to practice medicine, demonstrating firsthand the vital role of the PA and paving the way for new graduates to take over.
Though PAs are increasingly well-respected across the medical field by physicians and patients alike, there exists a blatant inequality in the educational system responsible for the training of these practitioners. While there are multiple programs in place for financial assistance for medical students, there is virtually nothing available for PAs. To use my own institution as an example, fifty percent of a Duke medical student’s demonstrated financial need is covered by internal scholarships and grants, which do not need to be repaid; the student only needs outside funding (loans, external scholarships, or help from family) for fifty percent of his or her costs. For the PA program, however, with an estimated total program cost of $116,000, the only internal aid available is that which is dispersed through the program itself, generally a pittance; current students report having received around one thousand dollars. Following this model, a medical student (who spends twice as long in school and graduates with three times the earning power) will incur the same amount of debt as a PA student, who spends a mere two years in school and receives a far lower salary with which to repay his or her debt.
This financial picture appears to hold true across the board, not only at Duke; moreover, this inequality extends beyond the institutions themselves and into the myriad of external scholarships. There are countless funds available for undergraduates, as well as for nurses, teachers, and doctors, but a graduate student pursuing any other path is often at a loss. Graduate students are commonly newly independent of their parents, living hand-to-mouth on their first real-world job while struggling to pay their bills; yet the vast majority of available financial help goes to undergraduates, who generally pay less tuition to begin with and are often still covered under their parents’ policies for cell phones, health insurance, car insurance, and the like.
There does exist the occasional loan forgiveness program for students entering the medical field, in which student loans are forgiven in exchange for a certain number of years of service in a medically underserved area. The competitive National Health Service Corps (NHSC) is a well-known example. However, should I choose to pursue it, the North Carolina version of this program (NC Health, Science, and Mathematics Student Loan Program) would cover barely 10% of my projected educational costs, yet requires the same amount of service as the NHSC, which covers the entire cost of education. In a state like ours, with such a strong medical reputation, this program seems a halfhearted effort at best.
North Carolina is home to several prestigious institutions of higher learning—more than most states can claim—as well as top-notch hospitals and pharmaceutical companies. In terms of medicine, our state is a clear national leader. As such, I feel that we should pave the way for the rest of the country in demonstrating the value we place on our mid-level practitioners, most notably PAs. Many more PA-specific scholarships and grants must be made available, both within our universities and outside them, and our loan forgiveness program needs to be improved—for if it were made more attractive to pre-PA students such as myself, North Carolina would gain much-needed practitioners where they are in the shortest supply.
There is no reason to think that the current trend away from primary care MDs will shift anytime soon. With the high levels of competence and dedication demonstrated by PAs and NPs across the world, as well as the degree of physician and patient satisfaction, it seems clear that PA education, training, and service should be recognized by helping these practitioners incur less debt. After all, we all need medical care from time to time. It seems a fair exchange to help those who might one day help you.
Thank you for your time.