UPDATED WITH ADDITIONAL COMMENTS AND INFORMATION August 17, 2018 // The New York University (NYU) School of Medicine says it will offer free tuition to all current and future students regardless of need or merit, making it the largest and highest-ranked medical school to make such an offer.

NYU officials said they made the decision in the hopes of attracting a more diverse group of students who will no longer have to fear that medical school is out of reach because they would incur a mountain of debt. The debt load has also pushed some graduates away from less lucrative fields, such as primary care, obstetrics, and gynecology, toward higher-paying specialties.

"This decision recognizes a moral imperative that must be addressed, as institutions place an increasing debt burden on young people who aspire to become physicians," said Robert I. Grossman, MD, the Saul J. Farber Dean of NYU School of Medicine and CEO of NYU Langone Health, in a statement.

"We believe that with our tuition-free initiative, we have taken a necessary, rational step that addresses a critical need to train the most talented physicians, unencumbered by crushing debt," he said, adding, "We hope that many other academic medical centers will soon choose to join us on this path."

Debt is not the only factor that influences whether someone applies to medical school or ultimately what specialty they choose, but it is a factor that NYU can control, Rafael Rivera, MD, MBA, associate dean for admissions and financial aid, told Medscape Medical News. "Even anticipated debt loads can add to the anxiety a medical student feels throughout their training."

Julie Fresne, MA, senior director of student financial services and debt management at the Association of American Medical Colleges, said that she thinks the tuition-free offer will entice more students to apply who otherwise would not have. Students who take the Medical College Admission Test and then do not go on to apply to a school cite lack of academics and cost as the two biggest factors, Fresne told Medscape Medical News.

Often, those who are dissuaded because of cost are those from historically underepresented backgrounds in medicine and tend to come from lower socioeconomic circumstances, she added.

The NYU statement cited data from the Association of American Medical Colleges, which has found that 75% of all American physicians graduated with debt in 2017. The median cost of medical education at a private medical school is $59,605 per year, and the median current debt of a graduating student is $202,000. About a fifth of physicians graduating from a private school leave with a debt of more than $300,000, said NYU.

The cost of a year's tuition at NYU is $55,018. Students will still have to cover their living costs, which, at the NYU-subsidized rate and including health insurance, would run about $28,000 a year, said Rivera. He noted that the tuition-free offer covers 442 students, which include 93 who will enter for the 2018-2019 school year. Those students who are already enrolled and who have 3 years left in the program will be receiving free tuition going forward, and they will receive a refund for what has already been paid, according to the New York Times.

NYU is not imposing any postgraduation requirements, such as requiring students to practice in a certain geographic area or in a particular specialty. "We want people to pursue career choices, because that's what they're passionate about," Rivera said. He said his goal was to create a class of physicians who will become the workforce that patients need and that the admissions process may change in some ways, but not in others. When asked, Rivera did not elaborate on how admissions would change.

He maintains that debt is a consideration for some students when they go to choose a specialty. Fresne, however, said that "data show a certain percentage of students do take their debt into consideration, but by and large, that is not the driving factor for specialty choice."

The cost of a year at NYU is $55,018. The New York Times reported that NYU has 93 first-year students; another 350 students have up to 3 years remaining before they obtain their degrees. All of these students will be receiving free tuition going forward, and they will receive a refund for what has already been paid.

NYU is paying for the students' education through an endowment that is currently $450 million but that it hopes will eventually grow to $600 million. That is a conservative figure that is believed to be enough to cover tuition in perpetuity, said Rivera. Kenneth G. Langone, the cofounder of Home Depot, and his wife, Elaine — for whom the medical school is named — have contributed $100 million.

"Thanks to the extraordinary generosity of our trustees, alumni, and friends, our hope — and expectation — is that by making medical school accessible to a broader range of applicants, we will be a catalyst for transforming medical education nationwide," said Langone, who is also chair of the board of trustees of NYU Langone Health, in the statement.

Other Trailblazers

NYU said it is the only top 10–ranked medical school in the nation to offer free tuition. Other medical schools currently have or have recently launched similar programs.

The University of Houston's new College of Medicine announced in July that all 30 medical students in its inaugural class will receive free tuition when the school opens in the fall of 2020, thanks to an anonymous $3 million gift.

In December 2017, the Columbia University College of Physicians and Surgeons — through a gift from alumni and former Merck CEO Roy Vagelos, MD — announced that it would cover tuition for all students who qualify for financial aid and who receive student loans. The scholarship would replace the student loans. Columbia estimated that 20% of its student will receive full-tuition scholarships.

The David Geffen School of Medicine at the University of California, Los Angeles, also offers full, merit-based free tuition, room and board, books, and supplies, as well as a stipend. Students who remain in good standing keep the scholarship through all 4 years of their enrollment. The school estimates that 20% (or 33 students) of each entering class qualifies. The program was endowed with $100 million by namesake benefactor David Geffen in 2012.

In 2008, the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University announced that it would pay full tuition for students who enter their 5-year specialized program.

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