We estimate that we can make medical school free for roughly $2.5 billion per year — about one-thousandth of what we spend on health care in the United States each year. What’s more, we can offset most if not all of the cost of medical school without the government’s help by charging doctors for specialty training.

Under today’s system, all medical students have to pay for their training, whether they plan to become pediatricians or neurosurgeons. They are then paid salaries during the crucial years of internship and residency that turn them into competent doctors. If they decide to extend their years of training to become specialists, they receive a stipend during those years, too.

But under our plan, medical school tuition, which averages $38,000 per year, would be waived. Doctors choosing training in primary care, whether they plan to go on later to specialize or not, would continue to receive the stipends they receive today. But those who want to get specialty training would have to forgo much or all of their stipends, $50,000 on average. Because there are nearly as many doctors enrolled in specialty training in the United States (about 66,000) as there are students in United States medical schools (about 67,000), the forgone stipends would cover all the tuition costs.

While this may seem like a lot to ask of future specialists, these same doctors will have paid nothing for medical school and, through their specialty training, would be virtually assured highly lucrative jobs. Today’s specialists earn a median of $325,000 per year by one estimate, 70 percent more than the $190,000 that a primary care doctor makes. (Although a large shift away from specialty training may weaken the ability of our plan to remain self-financed, the benefits would make any needed tuition subsidies well worth it.)

Our proposal is not the first to attempt to shift doctors toward primary care, but it’s the most ambitious. The National Health Service Corps helps doctors repay their loans in exchange for a commitment to work in an underserved area, but few doctors sign up. The National Institutes of Health offers a similar program to promote work in research and public health, but this creates more researchers, not more practitioners.