Ontario Medical Student Bursary Fund aims to ease

fiscal pressures on medical students today and in the future

by Albert Schumacher, MD, OMA President-Elect,  Chair, OMA Student Bursary Fund Committee
 

The Ontario Medical Association, in partnership with its registered charity, the Ontario Medical Foundation (OMF), is spearheading a major campaign intended to alleviate the escalating problem of fiscal pressures affecting the pursuit of medical education in the province.

This month, the OMA and OMF celebrate the official launch of the Ontario Medical Student Bursary Fund (OMSBF), established to assist the medical students of today and tomorrow in achieving their academic goals.

The Bursary Fund launch marks the culmination of nine months of exhaustive research and planning, which have been undertaken to ensure the venture’s long-term viability. A committee of OMA elected officials, staff, and external consultants has dedicated hundreds of hours in developing the framework to support this significant philanthropic endeavour.

The impetus to explore the establishment the Ontario Medical Student Bursary Fund arose at the May 1999 meeting of OMA Council, during which delegates were apprised of the unprecedented financial strain which currently grips the province’s medical students, the projected impact of this trend on future access to medical education and, ultimately, the potential consequences for the physician human resource base in Ontario.

At that meeting, Council delegates were provided a startling picture of the rising cost of medical education in Ontario as a result of government deregulation of tuition fees. Since 1997, tuition fees for first-year medical students have more than doubled. Average 1999 tuition for first-year medical students is $10,387 – a 108 per cent increase over the 1997 average fee of $4,977. Council delegates subsequently passed the following resolution:

"That the OMA, as a priority, formally and publicly oppose deregulation of tuition fees for undergraduate medical education and commit appropriate resources to resolving this crisis."

The OMF, a registered charity established by OMA members in 1967, was asked to take on the issue of establishing a charitable fund, with the logistical and staff support of the OMA.

Research has since been conducted to determine the feasibility of a charitable fund dedicated to assisting Ontario medical students. Departmental representatives from across the OMA have worked to establish the requisite legal, financial and administrative structure, strategies to develop core relationships with external communities of influence, and communications plans.

The OMA Board of Directors has dedicated $500,000 toward the campaign, to be attributed over several years. These funds will in part offset the OMSBF campaign costs, permitting all other gifts to flow directly to bursaries for needy students, as will the balance of the OMA’s contribution.

The Canadian Medical Association and its subsidiary, MD Management, have dedicated an addi- tional $500,000 toward the venture, and will serve as principal sponsors of the bursary fund.

Preliminary fund-raising efforts within the Ontario medical community have been very successful – a complete list of OMSBF Founders appears on p. 31.

The campaign is now officially broadening its scope across the province, with promotional materials to be distributed to potential donors via Ontario faculties of medicine and as enclosures with the Ontario Medical Review.
 

The Case for the OMSBF

The fundamental purpose of the Ontario Medical Student Bursary Fund is to raise money for bursaries for Ontario medical students who require financial assistance.

There is a large discrepancy between the cost of a medical education and the financial assistance available to fund it. Good programs of financial support for students are an important aspect of keeping medical education accessible to qualified students.

Of the 2,000 medical students in Ontario's five medical schools, one-third need additional funds each year to make ends meet.

Even before tuition was deregulated, a significant proportion of undergraduate medical students identified their primary source of stress as financial.


The province of Ontario is experiencing a severe physician shortage and demographic forecasts suggest that the situation will only worsen as our population ages and grows. The OMA believes it is important to encourage, not discourage, students to pursue a career in medicine.
 

Historic overview of tuition fees

A comparison of the cost of living, as measured by the consumer price index, students’ expected future income as measured by average gross OHIP billings, and tuition costs, over the past two decades reveals that annual tuition fees have increased at an annual rate far exceeding both the cost of living and average gross earnings. During this period, annual medical school tuition fees increased by a total of almost 880 per cent (see table below).

During the 1980s, there was relative congruence in growth among these three variables. This congruence has disappeared in the 1990s as the cost of living and physician earnings moderated while tuition costs accelerated rapidly. As a result, annual tuition costs in relation to average annual billings has increased three-fold throughout the 1980s and 1990s.
 

Impact on physician resource base

The financial constraints facing medical students today may affect:

1. What specialties students choose: Students’ decisions about what specialty to practise and where to practise may be constrained and restricted by the need to pay off debts. Longer training programs, often in disciplines already deemed underserviced (i.e. obstetrics, neurology, anesthesia, and general surgery), may be passed over in favour of specialties which facilitate quicker market entry, lower debt and quicker loan repayment.

Ontario is currently facing, and will continue to face, severe shortages in certain specialties. Every effort must be made to encourage medical students to pursue these specialties.

2. Where they choose to practise: Physician supply is already severely constrained in rural and northern practice; high debt may discourage graduating students from seeking additional training to prepare for rural practice.

Some students may perceive that the United States affords greater opportunity for higher remuneration and lower income tax, enabling them to be debt-free in a shorter period of time. Results of a recent University of Ottawa study show that 67 per cent of medical students said they were not currently considering moving to the U.S., but 92 per cent of respondents said they would consider moving if graduating debt-loads became higher.

3. The future composition of the medical community: Many students will self-select out of medicine to avoid the crippling debt that would be incurred over the years of training.

A significant number of medical students say they would have been deterred from attending medical school if they had known tuition would be so high.

Tuition increases without available financial support will ultimately change the face of those who practise medicine in this province. The medical care system needs individuals from different socio-economic, cultural, rural and urban backgrounds to serve an equally diverse population of patients.

The OMA firmly believes it is in society's interest to ensure that medicine remains a rewarding and affordable career accessible to students based on their passion and academic performance, not their financial status.
 

Related initiatives

The OMA is currently investigating the possibilities of both the federal and provincial government providing matching funds for the Ontario Medical Student Bursary Fund.

In addition, the OMA Student Deregulation Task Force is researching the impact deregulation is having on individual medical students, the medical student population as a whole, and on health care in general. The OMA continues to meet with government officials to discuss deregulation issues (see p. 34).
 

How will funds be raised?

According to a November 1999 Angus Reid survey, Ontario physicians are willing to take the lead in addressing this situation. Eighty-four per cent of respondents favoured establishing a bursary fund, and 64 per cent said they were "likely" or "very likely" to contribute. The average four-year gift indicated was more than $1,300.

Ontario physician leaders have volunteered to undertake an intensive "campaign of campaigns" over the next two years. Alumni of Ontario universities will be contacted by participating faculties of medicine or the OMF. Physicians educated outside Ontario will be approached by the OMF via a home telemarketing campaign scheduled to begin February 16. Face-to-face meetings will also be undertaken with leaders of the medical industry.

For information on how to contribute, or to forward questions or comments about the OMSBF, please contact Miriam Steinhouse, campaign director, at 1-800-268-7215, ext. 2896, or (416)340-2896, or Sandra Zidaric, campaign manager, at 1-800-268-7215, ext. 2913, or (416) 340-2913.

 
Tuition fee schedule entering medical school: 
Historic overview
University
 
1979
 
1989
 
1999
 
Ottawa $937 $1,929 $7,941
Queen’s $825 $1,929 $9,901
Toronto $900 $1,929 $11,000
McMaster $1,437 $2,894 $13,092
Western $1,014 $1,929 $10,000
Average first-year tuition $1,023 $2,122 $10,387