Dean's Update
May 30, 2025 - Aron Sousa, MD
Friends,
Last week, the U.S. House used the reconciliation process to pass a budget, which now goes on to the U.S. Senate for consideration. The Senate may well change things and send it back to the House for another set of votes until this closed cycle rumination extrudes a bill both chambers approve. The House-approved bill would end the Grad PLUS student loan program for new borrowers in 2026-27. Our students, who are current Grad PLUS borrowers, would continue to get their loans from that program, but our 2026 admission class would not.
The Grad PLUS loans are used by professional and graduate students, like our MD students, after they have exceeded their direct federal loan opportunities, which typically tap out at about $175,000, although there are complex yearly limits for direct and subsidized federal loans. For most of our students, tuition is the largest part of the cost of medical school. For the College of Human Medicine, the cost of attending a semester of medical school (tuition and staying alive) is about $33,000 for Michigan residents and $47,000 for out-of-state students. Non-resident tuition is about twice the cost of Michigan resident tuition, but staying alive is the same cost regardless of your state residency. Because of yearly limits on other federal programs, our students have enough expenses each year to top out on direct and subsidized loans if they don’t have a personal or family source of financial support. That’s when our students turn to the Grad PLUS loan program to pay the difference between direct federal loans and the total cost of attending medical school.
Our college purposely serves as an opportunity for students from disadvantaged backgrounds, like those from rural communities or families who qualify for Pell Grants. We do this to fulfill our mission. While 49% of our 2024 admitted class count as disadvantaged, fully 57% of our MD students qualify as disadvantaged. As a result of our focus on disadvantaged students, the families of our students tend not to be wealthy. In fact, the parents of our students earn $60,000 less than the median income of medical student parents. (U.S. median $151,000 vs. CHM median $90,000) Beyond that, families at the lowest decile (10th percent) make $100,000 per year. Our students’ parents make $10k less than that, so there are only a handful of medical schools in the country with parental income lower than ours. Clearly, we do not do a wallet biopsy as a part of admissions…and we do not give preference to legacy candidates.
While some of our students’ parents make much more money, half of our students have parents making less than $90,000 as a family. These students generally borrow all tuition and cost-of-living funding to attend medical school. Our college is young, as medical schools go, so we do not have a lot of scholarship support. The vast majority of our students borrow the money they need to go to CHM. Only 18% of our students owe less than $150,000 at graduation. Our median medical school debt is $265,000 per student with debt and 23% of our students owe more than $300,000. They eclipse the subsidized student loan limits in a hurry and then move on to Grad PLUS loans. Our students, and the communities they will serve, are dependent on this program.
You might say yourself, “Self, but these students can just get private loans.” While medical students are a pretty good risk for loans, it is very difficult for students from a disadvantaged background with limited parental income to get private student loans, and there are other aspects of federal loan programs that are necessary for medical students.
Generally, federal loans have a lower interest rate than private loans. Further, federal loan programs have residency loan deferment or income-based repayment that allows students to pay less when they are in residency and not earning enough to pay the full repayment schedule on loans the size of a mortgage. Historically, these loans have also been a part of the Public Service Loan Forgiveness program, which was quite valuable to our students but significantly modified in the House reconciliation bill.
Compared to other medical schools, our students tend to stay in Michigan to work in underserved communities. This year 59% will do their residency in Michigan and 39% will be in a primary care field. The college has an important influence on where students practice. CHM graduates in those residencies are more likely to stay in their communities than students from other medical schools. Our curriculum and community campuses clearly matter to how and where students eventually practice, but an important part of graduating medical students who will stay in underserved communities is admitting students who come from underserved communities. Rural underserved communities, and all underserved communities, depend on students like ours for their care, and our medical students, and medical students across the country, depend on Grad PLUS loans to become doctors. President Guskiewicz justly talks about Michigan State University as “proudly public.” We are all also proud to serve the land grant tradition, in which we provide opportunity through education for our young people (and occasionally slightly less young people). About 84% of our students are Michigan residents. We are all in for the people of Michigan, and their future doctors should have the opportunity to become Spartan MDs regardless of their parents’ income.
Serving the people with you,
Aron
Aron Sousa, MD, FACP
Dean, Michigan State University College of Human Medicine