The Canadian Imperial Bank of Commerce (CIBC) says medical education costs are now so high relative to potential earnings that it will no longer grant medical students preferred lending rates.
“We have [set] limits on the debt amounts that we feel medical students can incur and reasonably expect to repay in the years following their training,” says John Mayes, CIBC's general manager for professional programs.
“Right now many students are bumping up against those limits because they must finance high medical education costs through loans.”
Those “limits” lie in the $100 000 to $130 000 range and represent substantial burdens because, unlike government-sponsored student loans, interest begins accruing immediately, up to a decade before a medical student starts earning a full income.
And that has people like Mayes worried. In a letter sent to the Canadian Federation of Medical Students (CFMS) in March, he wrote: “[Your] request for below-prime loans and free premium credit cards was considered, but we aren't in a position to provide reductions of this sort when we consider the overall potential client profitability… . The amount of debt appears to be growing far faster than the income potential of [medical students'] subsequent earning years.”
The CFMS and other organizations have also been trying to pry more grants and loans from different levels of government, but with little success. In fact, the CFMS vice-president for education says Mayes' calculations about the future earning potential provided by a medical degree appear to conflict with the opinions of government grant and loan officials. “Government officials don't understand the problem,” James Clarke, a fourth-year student at Dalhousie, told CMAJ. “They say, ‘You’re going to make tonnes of money when you graduate, so what's the problem?' They don't realize there's at least 2 years of residency between graduation and practice.”
The main factor in the rising bill for a medical degree is the cost of tuition. The University of Toronto now tops the list in Canada with a first-year fee of $14 500; Western ranks second, at $14 000.
“I am a physician,” says Dr. Keith Martin, a Canadian Alliance member of Parliament from British Columbia who graduated from the University of Toronto in 1986, “but I could not have gone to medical school if costs had been what they are today.”