Rising tuition fees a nightmare for many medical students
Barbara Sibbald
CMAJ 1998;159:553
Barbara Sibbald is Associate Editor, News and Features, at CMAJ.
© 1998 Canadian Medical Association
Ontario's medical school tuition fees may soon rival those in the US, and there are fears that this could create economic barriers for potential students. Last December the province deregulated fees for professional programs, allowing universities to raise tuition fees as high as they like; 4 of Ontario's 5 medical schools promptly did. McMaster now charges $13 000 for its 12-month program, while annual tuition fees at the University of Western Ontario (UWO) have reached $10 000 for an academic year. Darlene Fenech, a third-year McMaster student and Ontario's representative on the Canadian Federation of Medical Students (CFMS), says the increases are "completely un-Canadian — there should be universal access to education just as there is to the health care system."
CFMS's main fear is that high fees will limit access to medical school to the wealthy. Part-time work is already hard to find, and many medical students have only a few weeks off each summer. As well, government loans haven't kept pace with rising expenses, so students are left borrowing from banks and paying interest from day 1. Fenech says this could leave them with debts of between $80 000 and $100 000 when they graduate.
Rising tuition fees don't appear to have had an immediate impact on the number and quality of applicants at either UWO or the University of Toronto, but UWO Dean of Medicine Robert McMurtry says the higher fees will create barriers. "Words like tragic come to mind," he says. "We have to get this message across: 15% cuts [in university funding] in Ontario are unacceptable."
Dr. Bill Easton, chair of the CMA's Council on Medical Education, says other provinces are watching what happens in Ontario with great interest, and BC is considering taking protective measures to keep Ontario students from seeking a cheaper education there. CFMS President Josh Tepper warns that several provinces are considering major fee increases. "Newfoundland has threatened similar draconian action, but backed down in the face of evidence provided by the student society and CFMS. And Manitoba has very quietly been using the summer months and exam periods to implement major fee hikes."
Easton's main fear is that the high fees will make it impossible for some students to enter or complete medical school. That's what happened to Jasmine Sinclair, a 38-year-old Toronto woman with a master's degree in environmental sciences. She's been taking undergraduate science courses for the past year and would have been eligible to apply for medical school next year. Because of the higher tuition fees, she's not going to bother. "This is one more major stumbling block for people who have been struggling all their lives," says a "heartbroken" Sinclair.
The CFMS says it wants medicine to remain an affordable career, with entry based on academic performance, not wealth. It is responding to Ontario's fee hikes by gathering information, lobbying politicians and trying to find money for needy students. The federation is also participating in a special CMA task force that is working with MD Management in hopes of forming an investment fund that will provide interest-free loans to students. The CFMS has also lobbied Ontario's education ministry for increased loans for medical students, and is asking the minister to funnel some of the increased tuition-fee income into loans and bursaries.
CFMS is also conducting a survey to assess current medical school costs, funding sources and debt loads at schools across Canada. It will also provide a baseline reading of the socioeconomic status of Canada's medical students. "Then we can go back in 5 years and see if these increases really have had an affect," says Fenech.
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