Provisions in the “One Big Beautiful Bill Act” would limit the amount of federal student loans medical students can borrow, and critics worry this could worsen physician shortages across rural areas and specialties. But for one chief medical officer, the greatest impact of the caps could be the loss of options for new graduates.
The bill — which passed the House May 22 and is with the Senate, as of June 10 — would enact sweeping cuts to Medicaid and other healthcare programs. The bill would also eliminate the Grad PLUS loan program for graduate students, including medical students. It would also cap federal loans for graduate and professional students to $150,000 and limit eligibility for the Public Service Loan Forgiveness program by no longer allowing loan repayment made during medical residency to count toward forgiveness. Students would still be allowed to take as much debt from private loans as they want.
“I know there are external forces at play, but from a medical perspective, especially as someone who’s a primary care physician in hospital medicine, [the provisions are] a little concerning,” Erik Summers, MD, chief medical officer at Medical University of South Carolina in Charlston, told Becker’s. “I didn’t have parents or anyone paying my tuition, so I had to take out loans. I remember those private loans: they had higher interest rates and were more aggressive to pay back. Even though you’re young, you notice those numbers rise — $100,000, $150,000, $200,000 — and you feel that external pressure.”
The Association of American Medical Colleges found medical students graduate with an average debt of $206,924 in 2023. Supporters of the bill say the changes could lower tuition costs and limit taxpayer exposure. Medical associations have also spoken out against the bill over concerns it would add barriers to medical education and residency, and could worsen opportunities for clinical training in rural and underserved areas.
For Dr. Summers, the primary concern is that these provisions could push more students into high-paying specialties, and away from the roles they love.
“What bothers me most is when someone tells me, ‘This is what I want to do, but I can’t afford to do it,'” he said. “That’s heartbreaking. First, we’re losing their passion. And second, they may end up in a specialty they don’t love, which isn’t good for them or for their patients.”
Teaching hospitals and medical schools have said the provisions could worsen the physician shortage by limiting the number of students able to afford school.
“While I think some people might not pursue medicine, I believe that number will be small,” Dr. Summers said. “We have more DO schools, more new programs opening up, and we still can’t meet demand. That might drop off a bit, but I believe the profession itself still draws a lot of interest. I don’t think the cost alone will deter many from starting the journey.”
However, once students are in medical school and residency, they will want to minimize their debt, which could push them into high-paying specialty fields for the income.
“That, I think, is the real concern,” he said. “I want people to go into medicine for the right reasons. You should go into this field because you want to serve people, help others and make a difference.”
This could leave a number of specialties already suffering with shortages to see fewer incoming residents, such as pediatrics, internal medicine, family medicine, OB-GYN, endocrinology, infectious disease, and even pathology, Dr. Summers said.
“Losing even more providers in these fields or decreasing the pipeline of people entering them is really worrisome,” he said. “Yes, we’ve looked at using advanced practice providers to help fill that gap, and I’m a strong supporter of that, but we still need physicians.”
If passed, the cuts would start for new borrowers in the 2026 to 2027 academic year and for existing borrowers in 2029 to 2030. The final decision on the bill is expected to be made in early July.
