AMA calls for medical school-loan debt relief, changes to medical exams

Key takeaways:

• A new policy supports loan forgiveness for physicians practicing in Indian Health Service, Tribal or Urban Indian Health programs.
• The AMA also called for changes to medical exams to reduce burnout in trainees.

The AMA House of Delegates adopted two policies aimed at reducing the financial burden of medical student graduates and alleviating the workload of medical trainees.

The changes would help address limited access to care in rural settings, ongoing physician shortages and increase the amount of time that medical trainees spend learning in clinical settings, according to a press release.

Loan forgiveness

The AMA said it previously advocated for changes to assist medical school graduates with educational debt, as findings from the Education Data Initiative showed that most graduates owe an average of $250,995.

The new policy calls for “an immediate change” to the Public Service Loan Forgiveness Program that would grant relief to physicians who practice in an Indian Health Service (IHS), Tribal or Urban Indian Health program, the release said.

The policy also aims to address physician shortages in these programs, which would ultimately improve access to care for patients in rural or underserved areas. According to the AMA, the IHS program had a physician or health-professional vacancy rate of 25% in 2018.

“This is a win-win for medical students and tribal communities,” Jesse M. Ehrenfeld, MD, MPH, immediate past president of the AMA, said in the release. “About 83 million Americans live in areas that don’t have sufficient access to a primary care physician. That is unacceptable. At the same time, students are graduating from medical school with huge financial burdens. Working under the IHS or other similar programs offers a great learning experience for new physicians as they serve communities that so desperately need better access to medical care.”

Medical examinations

According to the AMA, physicians in training work long hours tending to patients while also being required to take several examinations, including the United States Medical Licensing Examination (USMLE) Step 3 and Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) Level 3.

So, the organization’s new policy seeks to improve the flexibility of examinations and reduce physician workload by changing the USMLE Step 3 and COMLEX-USA Level 3 from:

• a numerically scored examination to a pass/fail examination; and
• a 2-day examination to a 1-day examination.

The policy also calls for residents to be allowed time off to take the exam without having to use their paid time off or vacation time.

“Preparing for and taking these exams is time-consuming, costly and stressful,” Aliya Siddiqui, MS, an AMA Board of Trustees member, said in the release. “As medical graduates and residents are embarking on their careers and juggling heavy workloads, they are being forced to use valuable time off to take these exams. Making changes to the testing process will only increase the time that new physicians are able to spend learning in clinical settings with patients.”

References:

• AMA House of Delegates adopts policy on medical education. https://www.ama-assn.org/press-center/press-releases/ama-house-delegates-adopts-policy-medical-education. Published June 12, 2024. Accessed June 12, 2024.
• Indian Health Service must act to lower staff physician vacancies. https://www.ama-assn.org/practice-management/sustainability/indian-health-service-must-act-lower-staff-physician-vacancies. Published Nov. 20, 2023. Accessed June 12, 2024.