Kaiser Permanente, the California-based health system that is preparing to open one of the few American medical schools not connected to a university, was set to announce Tuesday that it would waive tuition for every student in its first five graduating classes.
Kaiser Permanente, which has its own hospitals, clinics, doctors and insurance plan, is following the New York University School of Medicine, which announced last year that it would eliminate tuition for all current and future students. Like N.Y.U., Kaiser’s main goal is to keep students from forgoing lower-paying specialties like family medicine because of crushing debt, or foreclosing the option of medical school altogether because of the cost.
“Even middle-class families are finding medical school hard to pay for,” said Mark Schuster, the founding dean and chief executive of the Kaiser Permanente School of Medicine. “We’re going to see how this plays out and learn from it.”
He said the school would start accepting applications in June and open in Pasadena in the summer of 2020. The annual tuition will be about $55,000, he said, adding that while it was not planning to cover tuition beyond the first five classes, it would provide “very generous financial aid” based on need after that.
Unlike N.Y.U., which is raising $600 million from donors to pay for its tuition plan, Kaiser Permanente is tapping into the portion of its revenue that it spends on “community benefits,” which all nonprofit hospitals have to provide to keep their tax-exempt status. The company says it spent $2.3 billion on community benefits in 2017, including charity care for the uninsured and other spending that promotes community health. It has nearly $73 billion in operating revenue over all.
Each class will have 48 students, smaller than average for a medical school. But what will set it apart most, Dr. Schuster said, is teaching Kaiser Permanente’s model of integrated care, in which doctors work on teams with other types of medical providers, including pharmacists, psychologists and social workers, supported by technology and data, to make sure none of a patient’s health needs slip through the cracks.
The Kaiser Permanente School of Medicine under construction in Pasadena, Calif. The school will accept applications in June and open in 2020.CreditLiz Kuball for The New York Times
Students will skip the lecture-type science courses that typically dominate the first year of medical school and immediately start “integrated clerkships” in Kaiser Permanente hospitals and clinics, starting with primary care and adding surgery, obstetrics and gynecology, pediatrics and psychiatry the second year.
Another focus will be teaching medical students how to be aggressive champions for their patients. Dr. Schuster said one such role model was Dr. Mona Hanna-Attisha, the pediatrician in Flint, Mich., whose analysis of local children’s blood tests proved that the city’s water was causing widespread lead poisoning.
“We want our students to have the confidence and skill to do what she did and speak truth to power,” Dr. Schuster said. “That involves being able to go outside the clinic, write the op-ed when needed, go to a community advocacy group and say, ‘I need your help.’ I don’t know if other schools are teaching that.”
N.Y.U.’s offer seems to have already had an impact: Its medical school saw applications increase by 47 percent for next year, to 8,932. The number of applicants who identify as black jumped by 142 percent, to 1,062.
Neither Kaiser Permanente nor N.Y.U. will cover room and board for students, though Kaiser will offer them insurance through its system, Dr. Schuster said.
Other medical schools have taken steps recently to decrease their students’ financial burden. Columbia University’s is using a $250 million gift for a new endowment that will fund scholarships and grants meant to ensure none of its medical students incur debt.
About three-quarters of medical school students graduate with debt, according to the Association of American Medical Colleges; members of the 2017 graduating class who had debt reported a median amount of $192,000.
In addition to Dr. Schuster, a pediatrician who came to Kaiser Permanente from Harvard Medical School, Kaiser has hired about a dozen other people to serve as deans, department chairs and a senior vice president. It has received preliminary accreditation from the Liaison Committee on Medical Education, a somewhat different process than usual because unlike the universities that open medical schools, it is not already a degree-granting institution. Kaiser Permanente’s medical school will be one of four new ones in Southern California, but Dr. Schuster said there was a longtime need there.
“For the population, there are not nearly as many medical schools as one might expect,” he said, adding that California exports more medical students than it keeps. “We will each have our own niche, area of particular focus, and there’s room for all of us.”
