What it’s like to be $500K in debt: COLUMN

The surprise came in the form of an email from my alma mater.

“NYU School of Medicine is now a tuition-free institution, awarding full-tuition scholarships to all of our enrolled MD program students,” wrote Dr. Anthony Grieco, a professor and Associate Dean for Alumni Relations at New York University’s School of Medicine.

“We realize this news may be both exciting and disappointing for our recent alumni,” the email continued as I scrolled down on my phone.

By now, I also had several text messages from my fiancé, Chris, and our medical school friends.

“Seriously? Why did I go to medical school at 22?” they asked, and, “Can they make this retroactive?”

The keywords in the email were “enrolled MD program students.” I graduated from NYU School of Medicine in 2015, and Chris finished in 2013. Together, we owe over half a million dollars in medical school debt.

The free tuition announcement was delivered Thursday morning to first-year medical students and family members as a surprise ending to the annual “White Coat Ceremony.” During the ceremony, each new student is presented with a traditional white lab coat to mark the start of their medical training.

I remember my own White Coat Ceremony. My proud parents, who had uprooted all of our lives to move from Venezuela to Florida when I was 15, had traveled thousands of miles to support me. They sat in a crowded auditorium along with hundreds of others like them.

This was the day we had all been waiting for.

I was determined and ready to fearlessly pour my heart into this profession, just as my parents had taught me growing up. The day of the White Coat Ceremony, our families took an oath to support us as we vowed to prioritize our learning and our future patients. I knew my career choice would cost money — and a lot of it — but I was excited, and then I was busy. I did not completely understand what debt meant.

For the next three years, I pursued further training in pediatrics, which meant caring for sick children and their worried parents, and taking on shifts that sometimes approached 30 continuous hours. I added mounting medical school debt to the list of my worries.

My monthly payments since graduating medical school have barely even touched the accumulating interest. I have lived in small places, commuted a long way to the hospital, and carefully watched my expenses.

Meanwhile, my fiancé and I watched our non-medical school friends buy homes and start families while we worked to finish our education — and pay for it.

Now, don’t get me wrong. I am in love with my life and own every choice I have made. NYU was the perfect place for me to become a doctor.

On any given day, I had the honor and the privilege of caring for immigrants from all over the world, prisoners from Rikers Island, and New York City’s wealthy residents.

Since graduating from medical school, I have become a pediatrician, and my daily work has been nothing short of fulfilling. While in training, my days continued to start before the sun came up.

I started with my cup of coffee, just like I did in my native Venezuela. Then I went to work, sometimes all day and into the night, caring for my patients. The knowledge from my days at NYU and the pride I bring to my family have contributed to this doctora’s determination and passion.

I am currently taking a break from seeing patients as I work as a freelancer and a consultant in ABC News’ medical unit, and in September, I will start a one-year program at Standford University focused on global health and media. I plan to come back to New York City to practice as a primary care pediatrician after that.

Despite all of this, Dr. Grieco was correct: Thursday’s announcement about free tuition was disappointing. I realize the issue of debt is, by no means, unique to me personally, or even to NYU graduates.

According to the Association of American Medical Colleges, 75 percent of all doctors in the United States graduated with educational debt in 2017 and on average, doctors currently graduating from a private school do so with more than $206,000 in debt.

Pediatricians make an average of $212,000 per year, according to 2018 physician compensation report compiled by Medscape, a health news website. But in New York, where I plan to practice, pediatricians make considerably less and the cost of living is high.

I’ve calculated that even if I do work my way up to the national average, it will take me at least 10 years to pay off my debt.

Being in debt has had a real impact on my fiancé and me. It brings uncertainty and anxiety. As Chris and I plan our future together, we often joke about our “mortgage.”

Except, of course, we are not homeowners — as others pay off their houses, we pay for the knowledge that allows us to go work every day.

Once I was able to move past my initial disappointment, however, I did feel the excitement Grieco had also predicted. A tuition-free medical school has tremendous implications for future physicians, and for patients.

To talk through the significance of it all, I called Dr. Rafael Rivera, NYU Medical School’s associate dean for admissions and financial aid. Dr. Rivera was the one who told me I had gotten into medical school seven years ago and was part of the team that made free tuition a reality.

“We’ve been working on this for over 10 years,” Rivera told me, explaining that the announcement comes at a time when debt has gotten out of control, career satisfaction is down, and physicians are delaying big milestones in their personal lives.

He said NYU’s tuition-free program was made possible through investments from donors that have grown over time. He said the total expense is about $24 million per year. The university is currently $200 million away from making it sustainable, but Rivera says he’s confident the school will be able to raise enough money to keep it free.

Rivera believes eliminating the financial burden will increase diversity in the physician workforce, and empower debt-free doctors to pursue careers in lower-paying specialties like pediatrics and family practice.

“We know people will be more likely to pursue their passions,” he told me. “They’ll also be more likely to work in underserved areas.”

Rivera said he also hopes other medical schools will start to think of creative ways to make education more affordable, even if they don’t have the type of philanthropic backing that a private medical school like NYU has.

One thing they can do, he said, is to make their programs last three years rather than the standard four, which helps students save on tuition. NYU has been offering a three-year medical school option for the past few years, Rivera said.

When asked what he’d say to recent graduates of NYU School of Medicine — those who, like Chris and I, missed out by a few years — Rivera said, “If there was a way we could have done this sooner, we really would have … I hope people know we did the very best we could.”

It’s hard to imagine how my life would be different without all that debt. But at the end of the day, I choose to be happy for all those young medical students who received the announcement Thursday, and grateful for my own education.

Dr. Edith Bracho-Sanchez is a pediatrician and a consultant in ABC News’ Medical Unit.