Free Tuition at NYU Medical School May Reduce Accessibility for Low, Middle-Income Students

By Katya Pollock (PO ’21)

The New York University School of Medicine recently announced that it would offer full-tuition scholarships to all current and future students, regardless of need or merit. The school’s associate dean of admissions and financial aid presented the new tuition plan as a move to improve the school’s economic accessibility: “what we want to do is level the playing field [for low and middle-income students] by taking tuition completely off the table.” The tuition-free policy intends to address the systemic skewness of NYU Medical School’s students to children of upper-income families. Rather than encourage economic diversity, however, eliminating tuition may have the opposite effect: it could exacerbate the school’s inaccessibility to lower income applicants and inflate the proportion of its students who come from upper-income backgrounds.

Although a lack of economic diversity is a concern among all higher education institutions, representation of low and middle-income students is exceptionally low in private medical schools like NYU. An analysis by the Association of American Medical Colleges found that in 2005, nearly 60% of medical students in private institutions came from families with incomes in the highest national quintile. The disproportionately low enrollment of students from low and middle-income backgrounds in medical schools contributes to physician shortages in lower income communities, since doctors tend to serve populations which reflect their own socio-economic backgrounds. According to NYU Medical School’s CEO, the new tuition plan was conceived with this understanding that “a population as diverse as [the United States’] is best served by doctors from all walks of life.”

Even so, NYU Medical School’s announcement could reduce the school’s economic diversity. The announcement is expected to attract a larger number of applicants of all income levels in future admissions cycles. Assuming no increase in the number of student seats available, the school’s admissions process will become more selective. Given that there is a significant positive correlation between income and MCAT scores, an increase in the school’s selectivity will disproportionately reduce the likelihood of admission for students from lower income backgrounds. With no indication that the school will enact an economic diversity quota to favor lower income applicants, the new tuition-free policy may cause low and middle-income students who would previously have been accepted to be crowded out by higher income applicants. Although the intent of the new tuition plan is to remove barriers for applicants from low and middle-income backgrounds, it could in effect further skew admissions towards upper-income applicants who stand to benefit least from receiving tuition-free education.

NYU Medical School’s announcement draws attention to a surge in the number of higher education institutions initiating free tuition programs. In this year alone, the University of Virginia, University of Michigan, and University of Illinois have each announced that they will waive tuition for low-income, in-state students. The trend has emerged from a political environment in which the public’s concern over affordability in higher education has not been met by equivalent federal political action. Individual institutions themselves, as a result, have had to respond to public pressure to address affordability. In a 2018 survey of college presidents conducted by Inside Higher Ed, 98% of college presidents cited “concerns about college affordability and student debt” as the factor most responsible for declining public support. Individual institutions such as the NYU School of Medicine have attempted to distinguish themselves by offering donor-funded free-tuition programs which appear to address unaffordability. The school has raised $450 million in donor contributions – $100 million of which was contributed by a single donor –  to cover the $55,018 yearly tuition cost of each student.

The limitations of free-tuition programs designed by individual institutions, including that of NYU Medical School, originate from conflicting incentives. Colleges and universities devote a large portion of their resources to improving their position in school rankings because they hold significant influence in student application decisions. Maintaining and improving a school’s ranking, however, requires continually increasing the selectivity of the school’s admissions process. Since both standardized test scores and high school extracurricular involvement are positively correlated to income, increased selectivity can reduce the proportion of admitted students who come from lower-income backgrounds. Without counterbalancing measures which favor lower income students, the goal of improving a school’s ranking through increasing selectivity runs against expanding economic accessibility.

If NYU Medical School or any other higher education institution seeks to truly improve economic accessibility, it should allocate funding to initiatives which specifically target low and middle-income students. Investing in need-based financial aid, for example, would not increase the number of applicants from upper-income backgrounds but would encourage applications from students of low and middle-income families. Low and middle-income applicants would, therefore, would not be crowded out by an increase in the number of upper-income applicants. More generous financial aid would also reduce the financial burden of education for students in direct proportion to their family incomes, instead of allocating funding equally among all students without consideration of need.

The design of NYU Medical School’s new tuition plan suggests an alarming possibility of greater distortions in higher education enrollment caused by new institution-specific free-tuition programs. Until successful political action is undertaken to address public concern over the affordability of higher education, individual institutions will continue to bear pressure to address rising tuition costs with large-scale changes.




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