By Robert R. Slater, Jr., MD, FACS

In my opinion, offering “free” medical school education, as has been proposed and is being tested in New York, is a horrendous concept for several reasons.

First, it is a basic tenet of human psychology that if one thinks an item has no “cost” then it has no value. From a classic psychology experiment, it is known that if an old couch is put out on a street curb with a sign that says “Free for the Taking,” the couch will go untouched. The couch is considered worthless. If, however, the same couch on the same curb has a sign that says “For sale, $50,” the couch will soon be stolen because someone thinks they got away with a commodity that has value and “worth.” The same results derive from thought experiments substituting other objects for “couch.” In an analogous fashion, if medical school education is just given away “free” it will not be valued as much as if students are paying for it. Students will not strive as hard to learn as much as they can or take the coursework as seriously, and future doctors will not be as well trained as their future patients deserve.

There is also an important sense of pride that comes from achieving something when it is “earned” rather than just “given” out for free. Students will treasure more what they learn when they feel the knowledge gained is “earned.” Further, if the medical school tuition is “free” for the students, it simply means someone else is paying for it, as well as the salaries of the faculty. Whoever is paying will want to keep the costs as low as possible, which in turn will mean faculty salaries will be lower. Accordingly, there is a high likelihood that over time, the quality of the faculty will be negatively impacted. Once again, this suggests the future doctors may not be as well trained under such a system.

Certainly, it makes good sense to work out a payment system for those less well off financially to continue to be able to pursue their dreams of becoming physicians and surgeons. It will always be important to continue offering new and expanded financial aid packages for those who want to apply for loans or grants based on need. Repayment in the future for loans dispersed now will still maintain the value of the medical school education and ensure the doctors of tomorrow are as well trained and as proud of their spectacular accomplishments as they can be.

Other institutions ought not to follow the experiment now running at NYU.

Sacramento, CA