Financing Medical School; Grants for Foreign Nationals


1.Where do I find money for medical school?

2.Can foreign nationals be supported by U.S. research grants?

Dear GrantDoctor,

I am a second-year medical student. In order to pay for my tuition and expenses, I was receiving federal student loans as well as help from my father. My father was recently in an accident and is now unable to work, so I cannot expect to receive help from him any more. This prompted me to seek other funding to continue my studies. Any help or information that you can provide will be greatly appreciated.

Sincerely yours, Jeffrey D. Martins

Dear Jeffrey,

Sorry to hear about your father's accident; I hope he's doing okay. As for funding your medical school education, the GrantDoctor has no magic potion, but your prognosis could be worse. Your father's loss of income probably means that you'll finish medical school with more debt than you anticipated, but it is by no means the end of your medical education.

Usually the GrantDoctor helps young scientists get grants to help them do scientific research. Your question isn't the kind the GrantDoctor usually chooses to answer. But the Dr. will make an exception in this case, because she sees an opportunity here to win over a bright young scientist to medical research. And Dr. Grant rarely fails to seize an opportunity.

As a result of your father's loss of income, you should ask your institution's financial aid office to recalculate your financial need. You must notify them of the change in your father's financial status and provide them with whatever evidence they request. You will find that your father's loss means that you qualify for more aid.

Most financial aid packages include both grants and loans, the balance varying greatly from one institution to the next. Needless to say, grants and fellowships are better than loans if you can find them. And fifty-five percent of all year-2000 medical school graduates managed to find grants or fellowships last year, according to a survey conducted by the Association of American Medical Colleges (AAMC).

Where do students find these grants and fellowships? Though the ultimate source of the funds is usually the federal government, most get the money directly from their medical schools: 20.9% of all year-2000 medical school graduates reported receiving need-based school scholarships (the kind your father's loss of income improves your chance of winning), and 18.6% reported receiving merit-based school scholarships. Four percent of year-2000 medical school graduates received school awards earmarked for disadvantaged students. If your new circumstances qualify you for this pot of money you're in good shape; competition for these awards is less keen than it is for awards for which everyone qualifies.

The other main source of grants is government programs, with Armed Forces scholarships, at 3.9%, constituting the largest single source, followed by National Medical Fellowships at 1.4%. Exceptional Financial Need Scholarships (2.8%) and National Health Service Corp./Public Health Service awards (1.0%) round out the nonschool grants list. Most of these federal programs have service requirements. The Armed Forces program, for example, requires 1 year of service for each year of medical school funding, along with summer active duty. But you can usually spend your summer active duty taking classes.

The most important--and largest--category in the survey is "other": 23.9% of year-2000 medical school graduates listed grants and fellowships from "other" sources--that is, from a wide range of smaller programs. There's a wealth of potential financial support here; the trick is to find a program that precisely matches your qualifications. As mentioned earlier, your chances of getting a targeted award that fits your profile are much better than your chances of getting an award for which everyone qualifies and applies.

So how do you find them?

Look hard. Some sources (usually of small grants) will be local. Check your local branch of the Rotary Club and similar service organizations. Ask at local hospitals. Other sources will be national or even international, and these can usually be located using online resources such as Next Wave's sister site GrantsNet and Financial Aid Search Through the Web, a.k.a. FastWeb. Other excellent sources of information include AAMC, the National Health Service Corp., and your school's financial aid office.

If you can't find grants and scholarships to compensate for your lost revenue, you can simply borrow more. You are allowed to borrow $18,500 a year in subsidized and unsubsidized Stafford loans up to the cost of attendance calculated by your financial aid office. Seventy-eight percent of all year-2000 medical school graduates reported borrowing money from the subsidized Stafford loan program, and 68% borrowed money from the unsubsidized Stafford program. If you require (and qualify for) more loans, there are many other sources. The AAMC list of the most common sources of loans is rounded out by the federal Perkins loan program (33%), the University Medical School Loans program (22.4%), and the MedLoans alternative loan program (19%).

In 2000 the average student finishing medical school carried more than $80,000 in education-loan debt and another $8000 in credit card debt. That much debt can be a serious burden, especially for students who choose to go into medical research or one of the lower-paying clinical fields like primary care. Indeed, the expense of medical school and the resulting debt burden is recognized as one of the tallest barriers that aspiring medical scholars must climb in order to enter medical research or public service--which brings me, finally, to the point of this column.

To make that climb a little easier, the National Institutes of Health (NIH) offers a range of debt repayment programs for scientists who decide to do basic, clinical, or behavioral research in areas targeted by NIH, such as minority health disparities and AIDS. Loan repayment programs are also available to students from disadvantaged backgrounds who choose to work in any area of research. The National Health Service Corp offers similar programs for physicians and other health professionals who agree to practice medicine in underserved communities. There are also, as I have already mentioned, several traditional medical grant programs that carry service requirements. If the idea of public service appeals to you, you can apply for those grants right now.

Bottom line: There's no need to drop out of medical school. If your new financial circumstances require you to take on an onerous burden of debt, consider service-based or research-based grant repayment programs. It may not be what you planned to do when you decided to go to medical school, but you are likely to find the work rewarding.

--The GrantDoctor

Dear GrantDoctor:

I am a non-tenure-track assistant research professor at a U.S. medical school. I come from Europe and I should be under H1 visa next October. As a senior scientist, I would really like to get my own grant to support my research. I've been told that my visa situation doesn't allow me to do so. It seems quite difficult to get this information from the institution I am working for.

--Dr. Elisabeth Christians

Dear GrantDoctor:

If I apply as a researcher under a U.S. senior scientist who is funded, am I eligible for financial support if I am a foreign citizen?

--Dr. Medha Durge

Dear Drs. Christians and Durge:

Assuming your support will come from standard sources like the National Institutes of Health (NIH), your nationality isn't an issue. As a rule, only traineeships (educational fellowships granted to individual students and postdocs) are limited to U.S. citizens and permanent residents. Research grants are made on the basis of perceived scientific merit. "NIH's mission," writes NIH's Linda Stecklein, "is to fund the best science."

So, Dr. Christians, unless there are special circumstances that you haven't told me about, you are free to compete for (e.g.) NIH research grants. However, according to stated NIH policy, "NIH may consider other eligibility factors relating to the applicant's ability to responsibly handle and account for Federal funds and to carry out the project. These factors include [the PI's ] employment and citizenship status." This means, among other things, that you have to prove that you'll be around long enough to finish the work you propose to do. So, though nothing about your visa status disqualifies you, both your non-tenure-track status and your visa status could count against you. Stecklein also notes that you should be working closely with your medical school's business office when you apply for research grants so that you and your institution are not working at cross purposes.

Dr. Durge: You are not eligible for most traineeships, but there's no rule that prevents you from being supported by a research grant. You must, of course, comply with all Immigration and Naturalization Service rules and regulations in order to work in the U.S. That's a complicated business, and most universities have special offices to help PI's, postdocs and students deal with immigration issues. So once you've found a researcher you want to work with (and who wants to work with you), you should ask him or her to enlist the help of the university in sorting out immigration and work-visa issues. These days foreign nationals constitute a large segment of the U.S. scientific workforce, so most senior scientists are used to dealing with immigration issues.

Both of you: Check back in a few weeks. Sometime in October, the Career Development Center will publish a guide to immigration law for scientists. In the meantime, check out the series on Immigration Law from the Next Wave archives.

--The GrantDoctor

Due to the high volume of questions received, The GrantDoctor cannot answer all queries on an individual basis. Look for an answer to your question published in this column soon! Thank you!

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