University of Virginia Health System

If you're considering applying to a health professions school, you're probably wondering, How much is this going to cost? or, If I get accepted, how will I afford it? Most students must seek some form of financial aid to help cover the cost of attending a medical or other health professions school. Financing your education can seem overwhelming. However, following some simple guidelines and consulting good resources can help you locate financial aid that fits your needs.

Many students view the use of credit cards as an attractive and convenient option for personal spending. But for college students thinking about going to any professional school, especially the four-year doctoral programs, it may later come as a shock to discover the high cost of undisciplined use of PLASTIC. The real damage is done not by interest rates, which are bad enough, but by the accumulated debt and possible loss of a good credit rating. Professional education, especially medical and dental education, is four years in length and is usually higher in cost than undergraduate education; many, if not most, students take loans to pay that cost. But borrowing may not be available to those who are considered to be credit risks or those with too much outstanding debt. If students default on a federal loan during undergraduate school, they are jeopardizing the future of receiving further federal loans. There have been students with health professions school acceptances who could not attend (or had to defer attendance), because they could not, for the reason above, raise the money.

Another common consequence of the uncontrolled use of credit cards is that, in order to keep paying the bills, students take outside jobs, sometimes jobs which require too many work hours, or several jobs simultaneously. There are only 24 hours in a day: students are heading for academic disaster when they try to balance 12 to 15 hours or more of classes (accompanied by the necessary study hours for each course) with the demands of excessive extracurricular employment. Considering the academic strain, financial burden, loss of sleep, and lack of a healthy social life that can accompany undisciplined use of credit cards, it becomes clear that credit cards are not necessarily a college student's friend.

It is helpful to begin your financial planning before you start the application process. You are likely to encounter some unanticipated expenses unless you consider, in advance, the requirements and procedures for applying to health professions schools. To estimate the cost of the application process, consider the following factors:

• MCAT (or other required exam): In 1997, the fee for taking the MCAT was $160.00. Financially disadvantaged individuals can submit a MCAT Fee Reduction Request Form, which can be obtained from your undergraduate health professions advisor, or from the Section for Student Services, AAMC, 2450 N Street, NW, Suite 201, Washington DC 20037-1131, (202) 828-0600. Payment of the fee includes sending scores to six schools. There is also a fee for sending additional score reports. Applicants to health professions schools (other than medical school) should also consider the cost of taking required exams.
• AMCAS (or other application service): Currently, AMCAS charges a $50.00 non-refundable initial fee. The total service fee depends on the number of schools to which you are applying. AMCAS also offers a Fee Waiver Program for financially disadvantaged individuals. The AMCAS instruction book can be obtained from AMCAS, Section for Student Services, 2450 N Street, NW, Suite 201, Washington DC 20037-1131, (202) 828-0600. More information is available from the AMCAS home page on the internet <http://www.aamc.org/stuapps/admiss/amcas/start.htm>. Applicants to a health professions school (other than medical school) should also consider the cost of using an application service.
• Supplemental fees: In addition to AMCAS fees, individual schools will charge supplemental fees for additional application materials. These fees generally range between $50.00 and $100.00 per school. Financially disadvantaged students, particularly if they have already received a fee waiver from AMCAS, should check with the admissions office at each school regarding a waiver of supplemental application fees.
• Fees for non-AMCAS schools: Non-AMCAS schools will charge application fees. Financially disadvantaged students should check with the admissions office at non-AMCAS schools regarding a waiver of application fees.
• Transcripts: Schools you have attended may charge a fee for sending your transcripts to other schools. Check with the registrar at the school(s) you have attended.
• Interview expenses: You should consider the cost of travel, food, lodging, parking, taxi or van fares, interview attire, and other expenses for your interviews at health professions schools.
• Acceptance deposit: Most medical schools will require a deposit, usually less than $100.00, at the time you indicate your acceptance of an admission offer.

It is recommended that students, from the beginning of the application process, keep a detailed record of expenses: how much you spend, where you spend it, when you spend it, and what you spend it on. If you drive to an interview, keep track of mileage. Get receipts for toll and parking fees. If public transportation is used, receipts should be requested and kept. Also, keep copies of all forms, receipts, and written communications, and a log of all phone calls, related to your application process (see Appendix E for a worksheet). By doing this, you will have a solid information base to draw from if questions, problems, or concerns arise. You will also find these record-keeping skills useful as you maintain a budget and seek financial aid during the years of your health professions education.

Costs Associated with Attending Health Professions Schools

In assessing how much it will cost to attend a health professions school, consider not only tuition (public institutions cost less than private ones, and in-state tuition will be less than out-of-state tuition), but also the cost of living, your financial needs, and your ability to manage money. A typical student budget includes allocations for food, housing, utilities, clothing, computer, modem, and printer, medical instruments, supplies, entertainment, health insurance, transportation and car insurance, gifts, savings, and emergencies. Remember to include credit card and other debt that you may have. Consider carefully ways in which you can control and reduce spending in many of these areas. For example, get a roommate, locate housing within walking or biking distance of your school, avoid eating out and ordering in, and make long distance calls when rates are low or call collect. The average indebtedness of all medical students graduating in 1996 was $75,103. Expect that for each dollar you borrow from student loan programs to finance your education (tuition and living expenses), you will pay back at least 3 dollars (principal + interest). For students who graduated in 1996, this means paying back $225,309!

Sources of Financial Aid

With the exception of pharmacy and public health students who fund their education primarily with grants and scholarships, loans comprise the largest source of financial aid for health professions students. Loans can be either subsidized or unsubsidized. Subsidized loans carry little or no interest -- they are "good" loans. Unsubsidized loans (i.e. commercial loans) carry higher interest. If you will need a loan to help finance your education, try to apply for those which are subsidized. "Institutional Assistance" refers to any loans, scholarships, or grants included in a financial aid package offered to you by the school you plan to attend. Below is a description of some of the available loans and scholarships:

• Need-Based Funds: Federal loan programs such as the Perkins and Subsidized Stafford Loans provide funds to students based on need. Financial need is defined as the difference between the total family contributions and resources, and the standard student budget for a particular school. (For more information on how to calculate your family contributions, see "Resources" below). Information on need-based funds, and cost-based funds (described below) should be available from college libraries, medical schools, and state departments of education.
• Cost-Based Funds: The Federal Unsubsidized Stafford Loan and the Health Education Assistance Loan (HEAL) are programs that do not require a need analysis based on family contributions and resources.
• AAMC MEDLOANSSM Program: Through this program, medical students can apply for Federal Stafford Loans (subsidized and unsubsidized) and the Alternative Loan Program (ALP). Medical school financial aid officers will have information on this program.
• Armed Forces Health Professions Scholarship Program: Available through the Army, Navy, or Air Force, this program offers support to students while in school, in exchange for service after completion of the degree program.
• National Health Service Corps: Medical students can enlist in this program which offers competitive scholarships and loan repayment in exchange for a service obligation to be fulfilled in a health professional shortage area (HPSA).

In addition to federal loan and scholarship programs (with and without service commitments), there are many other sources of financial aid you should consider: yourself; your family; your spouse; state governments, and local communities which may offer assistance in exchange for service in specified fields or locations; community, religious, fraternal, alumni, or ethnic organizations; employers; unions; and special interest groups.Eligibility for Financial Aid

Keep in mind that schools will have their own guidelines and criteria for providing financial aid to students. You should contact your school's financial aid office for specific information regarding their policies. There are, however, some eligibility criteria that hold for most financial aid programs:

• U.S. citizenship or permanent resident status
• Maintenance of a satisfactory academic record
• Compliance with requirements for Selective Service registration
• Good credit history and evidence of fulfilling prior financial, service, or other obligations (no defaults on previous educational loans)

Your Responsibilities

Before applying for financial aid, particularly loans or programs with service commitments, you must understand what "borrowing" means. When you borrow to pay for your education, you are making an investment in your future, but you are also obligating some portion of your future income and/or services toward the repayment of the aid you receive. The decision to apply for financial aid is also a decision to maintain a budget, allocate your resources wisely, and apply some self-imposed restrictions on spending and lifestyle until the conditions of repayment have been satisfied.

As a student seeking financial aid, you have the primary responsibility for gathering information, researching different sources and programs, determining which type of aid will fit your needs, completing applications, meeting deadlines, maintaining detailed records, and communicating with your financial aid officer and the lender/holder of your loan(s). It's a lot of work, but don't be discouraged! Put financial aid in the context of your priorities, long-term goals, and "overall plan." Ask for assistance from your advisor or financial aid staff when you have questions or concerns. Applying for aid will be easier if you organize your records from previous loans, and payoff other debts such as credit cards and car loans. Keep in mind that the sooner you apply, the better your chances of getting aid, so apply early.

Once you have a loan(s), be sure to keep copies of all financial aid applications and information that comes to you from your financial aid officer or the lender/holder of your loan. Also, arrange for written confirmation of all conversations, and changes or agreements made by telephone regarding your loan.

Resources

There are many resources that can help you learn more about the types of financial aid available; the process of applying for financial aid; and the skills you need to construct a realistic budget, remain knowledgeable about your financial situation, and be responsible in your borrowing and spending. These resources are available from your pre-health professions advisor, school library, career planning/counseling office, health profession school's student affairs or financial aid office, or from the publisher. Don't hesitate to ask your advisor, librarian, and other professionals to help you locate publications containing financial aid information. The publications listed below are some of the resources that can help you begin to look for financial aid that fits your needs. (An * indicates publications that were used in preparing this section of the manual.)The Debt Management Workbook: A Five-Step Plan for Successfully Repaying Your Educational Loans. Pub. No. HRSA-P-DS-93-1. National Medical Fellowships, Incorporated. U.S. Department of Health and Human Services, Public Health Service, Health Resources and Services Administration, Bureau of Health Professions. 1993. Cost: Free, by calling 301/443-1590.

fastweb. The fastweb offers free scholarship information.1994-1995 Financing Medical Education. The National Association of Medical Minority Educators, Inc.

*Financial Planning and Management Manual for U.S. Medical Students, 1994. Association of American Medical Colleges. Cost: $7.50 plus shipping and handling.

*Financing Your Health Professions Education and *Financial Planning and Debt Management for Health Professions Students. National Medical Fellowships, Inc. 110 W. 32nd Street, New York, NY 10001. (No longer distributed by NMF.)

How to Estimate your Family Contribution At this site, enter yourself as an independent student, select Federal Methodology, and include your parents' income and asset information, as well as your own and your spouse's, if applicable. The federal methodology considers family size, number in college, income taxes paid, and other non-discretionary variables in calculating expected family contribution. This NASFAA web site also contains other useful financial aid information. Informed Decision-Making: Part I, Financial Planning and Management for Medical Students; Part II, Sources of Financial Assistance for Medical School. National Medical Fellowships, Inc. 1993. Cost: $15.00 (sold as a set). *Medical School Admission Requirements, United States and Canada. Association of American Medical Colleges. Cost: $15.00 plus shipping and handling.Minority Student Opportunities In United States Medical Schools, 1993-94. Association of American Medical Colleges. Cost: $7.50 plus shipping and handling.

A Strategy for Financial Success: 10 Good Habits to Achieving Your Dream. This organization provides educational materials on personal finance and debt management. They can also be reached at The Access Group, Box 7430, Wilmington, DE, 19803. (800) 282-1550. State and Other Loan Repayment/Forgiveness and Scholarship Programs. Association of American Medical Colleges. Cost: Free.

You can obtain ordering information for AAMC publications by contacting:

Association of American Medical Colleges, Membership and Publication Orders, 2450 N Street, N.W., Washington, DC 20037-1126

(202) 828-0416 FAX (202) 828-1123

You can obtain ordering information for National Association of Medical Minority Educators (NAMME) publications by contacting:

Charles Terrell, Associate Dean for Student Affairs, Boston University School of Medicine, 80 East Concord Street, Boston, MA 02118-2394

(617) 638-5130, e-mail: cterrell@med-mail.bu.edu

You can obtain ordering information for National Medical Fellowships (NMF) publications by contacting:
National Medical Fellowships, Inc., 110 W. 32nd Street, New York, NY 10001
(212) 714-1007

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