Medical Student Debt
Physician supply is a direct result of the number of medical school graduates, but more graduates do not assure an increased supply of primary care physicians. The 2018 National Resident Match Program (NRMP) showed the highest number of family medicine matches ever. However, just 12% of allopathic and osteopathic seniors combined choose family medicine as their specialty.
A lack of interest in primary care fields can be attributed to various social and cultural factors; however, the biggest deterrent for medical students tends to be mere economics. The average Michigan medical student graduates with a debt of around $190,000, which is just shy of the median salary of a primary care physician and causes many medical students to pass over primary care in favor of more lucrative specialties. Loan forgiveness programs greatly help medical students choose primary care specialties like family medicine.
Michigan State Loan Repayment Program
The Michigan State Loan Repayment Program (MSLRP) provides loan forgiveness and scholarship opportunities to eligible primary care providers who agree to practice in a designated health professional shortage area for a specified period of time. The program assists employers with recruitment and retention of providers at practice sites with any Health Professional Shortage Area (HPSA) score, and employers are required to make a 50% contribution to their providers' loan repayment contracts. The MSLRP has successfully placed hundreds of providers, including family physicians, in underserved areas of the state.
MSLRP receives funding from National Health Service Corps, State of Michigan, and local/private sources; however, the mix depends on the year and the budget environment.
With 90% of Michigan's 83 counties experiencing at least a partial shortage of primary care physicians and many medical students facing crushing education debt, a consortium of four of the state's medical schools (Central Michigan University, Michigan State University, Wayne State University, and Western Michigan University) in partnership with Michigan Department of Health and Human Services established MIDOCS (Michigan Doctors) in 2017.
In return for a commitment to practice in a rural or urban underserved community for a minimum of two years post-residency, MIDOCS-sponsored residents in the socialities of family medicine, internal medicine, pediatrics, obstetrics and gynecology, psychiatry, and general surgery are eligible for $75,000 in education loan repayment (first payment upon signing an employment contract, second payment at the start of the first year in practice, third and final payment at the start of the second year). The number of MIDOCS residency slots each year depends on the amount of state, university, and federal funding.
Michigan Loan Reimbursement and Employment Solution
Michigan Loan Reimbursement & Employment Solution (MiLES) offers $50,000 in tax-free loan repayment to physician residents during residency in exchange for a two-year post-residency service commitment in a medically underserved area of Michigan. The goal is to match employers with providers who would like to stay in the community beyond their two-year service commitment.
National Health Service Corps
National Health Service Corps (NHSC) is a federal program operated by the Health Resources and Services Administration (HRSA). It primarily provides financial assistance—through loan forgiveness and scholarships—to primary care providers who agree to practice in a designated health professional shortage area for a minimum of two years. The program helps employers recruit and retain providers at practice sites with higher Health Professional Shortage Area (HPSA) scores. In Michigan, NHSC operates in collaboration with MSLRP.
- Medical Opportunities in Michigan
Medical Opportunities in Michigan (MOM) allows students and providers to search for job opportunities and identifies those eligible for loan repayment.
- Michigan Rural Recruitment and Retention Network
The Michigan Rural Recruitment and Retention Network (3RNet) allows students and providers to search for job opportunities at rural practice sites eligible for loan repayment.
- J1-Waiver Program
Annually, the J1-Waiver Program allows 30 foreign medical graduates to remain in Michigan to practice instead of returning to their home countries for a minimum of two years. Preference is given to those applying to work in underserved areas.
- The AAFP on Medical Student Debt