When Robert Grossman was named chief executive of NYU Langone Health and dean of New York University School of Medicine in 2007, he was already thinking about how to make tuition free for NYU’s medical students.
Dr. Grossman discussed the possibility with Home Depot Inc. co-founder Kenneth Langone, the longtime chairman of the medical center’s board of trustees. Mr. Langone got on board with the idea right away and began to recruit other donors, Dr. Grossman says.
Just over 11 years later, the two made a stunning announcement at the white-coat ceremony for the incoming class of 2022, a tradition where new medical students receive a white coat to mark the start of their training. Dr. Grossman and Mr. Langone told 102 incoming students and their families: New York University is covering tuition for all of its medical students—starting with you.
Although NYU’s tuition initiative isn’t the first of its kind, it is the first of such scale. The medical school has raised more than $450 million of the $600 million it will need to fund the initiative into perpetuity, including $100 million from Mr. Langone and his wife, Elaine.
Some critics were skeptical about the initiative, arguing it wouldn’t do much to open doors for underrepresented minorities, nor would it incentivize students to go into primary care, a field that has long faced shortages.
In a conversation with The Wall Street Journal, Dr. Grossman discussed why covering medical-school tuition addresses a “moral imperative” and responded to critics. Here are edited excerpts of the conversation.
WSJ: How did NYU come to decide to fund all of its medical students?
DR. GROSSMAN: Right from the start, I said we had an aspirational agenda, and one of the things we thought about was having a tuition-free medical school. I was always a scholarship student and I came from a family that didn’t have a lot of means. So I knew what it meant not only to get scholarships and loans, but also to try to pay them back.
WSJ: What are the specific goals?
DR. GROSSMAN: I thought that it was critically important to do anything we could to take stress out of medical school. The material you have to learn is ferocious. There’s a transition between college and becoming a mature doctor. You look at the prospects after you graduate medical school—the training program is incredibly long and you’re not making anything for three to 14 years after if you do a residency or a fellowship.
WSJ: But some would argue that medical students will eventually earn good salaries and will not have a problem paying off their loans.
DR. GROSSMAN: There’s a significant training period after medical school. That could be three years and then beyond. In that period, you’re paid a relatively small sum of money—$50,000 to $70,000 a year—and, you are, in most cases, working very hard. It’s an 80-hour workweek. Then it’s a very long path until you build up your own practice. Those are formative years where a lot of people are starting families, having partnerships. There are tremendous opportunity costs.
WSJ: People have assumed that NYU’s goals were to increase diversity and encourage people to go into less lucrative fields like primary care. But making tuition free wouldn’t necessarily address these issues.
DR. GROSSMAN: I thought the point that people were missing was that this is for everyone. We’re not being selective. We’re not trying to target particular groups. Our primary goal was to give every member of our class an opportunity to have tuition-free medical education. Diversity is important for us. Primary care is important. But the goal was not to create primary-care physicians. We wanted people to have choice. We wanted to give people an opportunity to be the best possible physicians and go where their talents are. If you’re talented in, say, surgery, why should you be forced to go into primary care just because you get your tuition free?
We need specialists and we need primary-care physicians.
WSJ: Why not provide funding based on merit or need?
DR. GROSSMAN: We wanted to be inclusive, frankly, and it’s very difficult at the margins to decide who gets what. What we saw was the tremendous stress—financial stress—on the students, on their families. People say: “Well, you’re giving money to rich students.” Well, who’s actually rich? Are the students rich? What’s the relationship between the students and their parents? We don’t profess to know anything.
WSJ: What do you mean when you say this is a “moral imperative”?
DR. GROSSMAN: Is it moral to load students up with debt when the prospects after medical school are somewhat diminished, and there’s a long period of training, during which most of them won’t be able to pay back the debt they have? You leave these students with decisions that are morally very challenging. Can I get married? Can I have a family? Can I buy a house? Can I do all these things because I’m trying to have a career and pay off debt and amassing interest?
And how dependent should medical schools be on tuition? If you think about the morality, they’re transferring the cost burden of education to the families and students.
WSJ: Will free tuition help NYU draw more top talent? If someone is undecided between NYU and Harvard, will it tip the scale in NYU’s favor?
DR. GROSSMAN: It wasn’t about any other school. We were competitive before we did the free tuition. Our students are in the 99th percentile for the MCAT test, and their grade-point average is 3.93.
WSJ: But do you think this could be a welcome secondary effect?
DR. GROSSMAN: Maybe. I’m not sure this is the case, but I think students will look for value and they will say: Here’s a school that’s No. 3 in the U.S. News rankings, and I’ll have no tuition. And there’s a school that may be ranked No. 1, but I still have to assume a certain amount of debt. I think that will weigh in their decision if they’re thinking about value.
WSJ: Have you seen an increase in the number of applicants since the announcement?
DR. GROSSMAN: I think so. But we had a lot of applications before. [Note: According to the office of admissions and financial aid, NYU School of Medicine received just over 6,000 applications during last year’s cycle. It expects 8,700 to 8,800 during this cycle.]
WSJ: NYU has raised more than $450 million so far. When will it reach the $600 million needed to fund the tuition program into perpetuity?
DR. GROSSMAN: I think within the next two to three years.
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