The American Medical Association (AMA) has raised serious alarms over the 2025 budget-reconciliation bill, cautioning that if it passes the U.S. Senate in its current form, it would make medical school financially out of reach for most students, even those who are exceptionally qualified. The organization believes that such a shift in student-loan policy would not only limit access to the medical profession but would also worsen the already critical shortage of physicians across the United States.
As it stands, becoming a physician is one of the most demanding and high-stakes educational paths in the country. It requires four years of medical school, an additional three to seven years of residency training, and between 10,000 to 16,000 hours of clinical experience. This extensive and rigorous preparation ensures that physicians are the most capable members of any healthcare delivery team. “The high-stakes field of medicine demands education, expertise, acumen and coordination that is best delivered by a physician,” the AMA emphasized.
However, the cost of this education is already staggering. Medical school is the most expensive type of post-secondary education in the U.S., with over 70% of students graduating with an average debt of $212,341. In 2024, the cost of completing a medical degree at a public in-state school exceeded $286,000, while students at private medical schools faced expenses over $390,000.
Now, proposed legislative changes are threatening to make this educational path even less accessible. The AMA has responded by submitting official comments to Congress, outlining its concerns over specific elements of the bill—particularly changes affecting Federal Direct Unsubsidized Loans and Federal Direct Graduate (GRAD) PLUS loan programs.
One major proposal in the House version of the bill is a cap of $150,000 on the amount a student can borrow for professional education through Direct Unsubsidized Loans. This figure falls well short of the average financial requirement for medical school. Compounding the issue, the bill also calls for the elimination of both subsidized loans and GRAD PLUS loans, and it proposes limits on parental borrowing to support children’s education.
The bill doesn’t stop there. Another key change would redefine physician residency training, rendering it ineligible as a qualifying public service for the Public Service Loan Forgiveness (PSLF) program. This change could have a serious ripple effect. “Nearly 90% of medical school graduates carrying student debt last year who intended to enter into a loan forgiveness program said in their graduation questionnaire that they wished to participate in the PSLF program,” the AMA noted.
If residency no longer qualifies toward PSLF, fewer young physicians may be willing to take on jobs with eligible employers, many of which are located in rural or underserved regions. This would inevitably limit healthcare access for patients in the areas that most need it. As the AMA stated, “Denying PSLF eligibility to residents will harm patient care in those areas in greatest need.”
The consequences for healthcare access, especially in rural America, could be severe. Many patients already face long waits to see a physician or even difficulty in finding one at all. “Patients, particularly in rural areas, are having difficulty finding a physician and getting timely appointments,” the AMA said. This issue is likely to escalate given a projected physician shortfall that could reach 86,000 by the next decade.
A significant part of this shortage stems from demographics. Nearly half of all practicing physicians are 55 years or older, and one in five is over 65. At the same time, the U.S. population is steadily growing, with the number of individuals aged 75 and above expected to rise by nearly 55% by 2036. This trend will heighten the demand for and complexity of medical care.
Patients themselves continue to express strong support for physician-led care. According to recent AMA surveys, 91% of patients believe physicians’ education and training are essential for receiving optimal care, and 95% say it is important for doctors to play a role in their diagnosis and treatment.
In light of this, the AMA argues that Congress should be working to make it easier—not harder—for students to enter the medical profession. “At a time when our nation needs more physicians, Congress should be taking action to lessen the barriers for new physicians, not increasing the financial burden of their education,” the AMA asserted.
To address these challenges, the AMA is pushing for a multi-faceted approach aimed at reducing the financial strain on medical students. “The AMA believes that the cost of a medical education should never pose a barrier to a career in medicine,” the organization stated. Through its advocacy efforts—both independently and in partnership with others in the medical community—the AMA is pushing for policies that mitigate this burden.
This includes maintaining stable public funding for medical schools to help control tuition costs, encouraging financial literacy among students, and expanding service-based scholarships, such as those offered through the National Health Service Corps Program.
The AMA underlines the foundational role physicians play in the nation’s healthcare system and insists that everything possible should be done to strengthen that foundation. “Physicians are the foundation of our nation’s entire health care system, and we must make every effort to strengthen that foundation going forward.”
The changes proposed in the House bill could significantly shrink the pipeline of future doctors. They would do so by making medical school unaffordable, limiting available borrowing options, and removing incentives for doctors to work in areas most in need of healthcare services. “The student-loan changes now under consideration in Congress could reduce the pipeline of future physicians by making medical school unaffordable for many prospective students,” the AMA warned.
Ultimately, the AMA is calling on lawmakers to understand and support the unique and indispensable role physicians play. As the organization put it, “Congress should recognize the vital contributions and unique role of physicians in our society, and provide support for medical education that aligns with the financial and educational burdens physicians face as they provide the care that Americans want and deserve.”
In a healthcare landscape already stretched thin, the AMA’s message is clear: ensuring access to medical education is not just about helping students—it’s about safeguarding the health of an entire nation.