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Medical education has always required a great deal of personal and professional sacrifice, though it increasingly comes with a steep financial burden as well. According to the Association of American Medical Colleges, 71% of graduating medical students from U.S. medical schools carry educational debt, with a median debt of $205,000 in 2024.1 This represents a 2% annual increase from the year prior, a trend present since 2009.2 At the same time, the median four-year cost of attendance, which includes tuition, fees, and living expenses, continues to rise. In-state costs for medical school are estimated to exceed $300,000 in 2025.2 Compounding this problem, the rise in cost of medical education has far outpaced inflation as measured by the Consumer Price Index,3 further deepening the financial burden placed on trainees.

However, this burden does not fall equally across all trainees. Trainees from historically underrepresented and socioeconomically disadvantaged backgrounds carry a disproportionate share of the debt. A study from the University of Michigan found that first-generation college (p=0.004) and medical students (p<0.001) were significantly more likely to have higher educational debt.4 Data also show that underrepresented in medicine (URiM) trainees are more likely to enter residency with debt compared to White trainees (OR = 4.16 for Black trainees, OR = 1.71 for Hispanic trainees).5 These disparities are not merely financial but reflect deep-rooted structural inequities that continue to shape who has access to medical training.

Odmara L. Barreto Chang, MD, PhD Dr. Barreto Chang is an Associate Professor in the Department of Anesthesia and Perioperative Care, with a research focus on understanding the molecular and behavioral basis of cognitive impairment after surgery. By focusing on the perioperative period, she seeks to improve both the information patients receive during the perioperative evaluation in terms of their brain health assessment and also develop potential approaches for neuroprotection during the period of surgery and postoperative recovery