New U,S, federal loan caps could disrupt the medical field, study finds
Harvard Pilgrim Health Care Institute
Boston, MA — Researchers from the Harvard Pilgrim Health Care Institute have produced the first national estimate of how many medical students would be affected by new federal loan restrictions imposed by the 2025 One Big Beautiful Bill Act (OBBBA). Their findings suggest the reforms are likely to place substantial financial barriers on aspiring physicians, potentially reducing workforce diversity and worsening existing physician shortages.
The study, “Federal Loans Among US Medical Students, 2008-2020,” was published on November 26 in JAMA.
With the U.S. leading the world in medical school costs, students increasingly depend on federal loans to finance their education. This new study cautions that the combination of rising tuition and OBBBA loan restrictions may force medical students toward private lenders with higher interest rates, discourage them from choosing lower-paid but essential specialties such as primary care, or deter them from entering medicine altogether, disproportionately impacting underrepresented students.
“The average cost of attending medical school has greatly increased in just over a decade,” said Tarun Ramesh, research fellow at Harvard Pilgrim Health Care Institute and lead author of the study. “Federal loan restrictions could leave many medical students, especially those from low-income backgrounds, without affordable options to complete their training.”
Using national data from the National Postsecondary Student Aid Survey, the researchers analyzed federal loan usage, annual borrowing, and total debt among medical student—examining differences by characteristics such as age, sex, income, state of residence, and awareness of loan forgiveness programs. Key findings include:
- A 38% increase in the average annual cost of medical school attendance between 2008 and 2020.
- A sharp rise in the use of Graduate PLUS Loans—which allowed medical students to borrow up to their total cost of attendance but will be eliminated under the OBBBA—from 13% in 2008 to 47% in 2020.
- In 2020, 40% of medical students borrowed more than $50,000 in a single year, and 14% had lifetime federal debt exceeding $200,000—both thresholds that would be capped by the OBBBA.
Low-income and out-of-state students were most likely to exceed both annual and lifetime loan caps. “Graduate PLUS Loans have been a financial lifeline for nearly half of all medical students,” said Hao Yu, Harvard Medical School associate professor of population medicine at the Harvard Pilgrim Health Care Institute, and senior author of the study. “Eliminating this program will create substantial financial barriers for students and most likely reduce diversity in the physician workforce.”
The research team hopes that highlighting the likely real-world impact of the OBBBA’s restrictions on lower-interest federal student loans will prompt policymakers and medical schools to consider the new law’s implications for medical education and physician workforce diversity. They urge exploration of targeted solutions such as loan forgiveness or tuition reduction programs to offset the barriers the new federal restrictions may create.
About the Harvard Pilgrim Health Care Institute’s Department of Population Medicine
The Harvard Pilgrim Health Care Institute's Department of Population Medicine is a unique collaboration between Harvard Pilgrim Health Care and Harvard Medical School. Created in 1992, it is the first appointing medical school department in the United States based in a health plan. The Institute focuses on improving health care delivery and population health through innovative research and education, in partnership with health plans, delivery systems, and public health agencies. Follow us on Bluesky, X, and LinkedIn.
Journal
JAMA
Article Title
Federal Loans Among US Medical Students, 2008-2020
Article Publication Date
26-Nov-2025
Disrupted federal funding for extramural
cancer research
JAMA Oncology
About The Study: The monetary consequences of National Cancer Institute recissions is substantial despite the limited relevance of cancer research to ideological controversies. Disrupted grants affected most states and many public and private institutions. Many grant terminations affected research trainees and junior faculty, suggesting that these terminations not only interrupted the continuity of research studies, but also jeopardized career trajectories of early-stage investigators, with potential downstream consequences on the research workforce and innovation pipeline.
Corresponding Author: To contact the corresponding author, David Hsiehchen, MD, email david.hsieh@utsouthwestern.edu.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamaoncol.2025.4985)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
Embed this link to provide your readers free access to the full-text article
Journal
JAMA Oncology
Strategies to keep drug discovery research alive in the US despite funding cuts from biomedical researchers
Peer-Reviewed Publicationimage:
Overcoming the political constraints on academic and biopharma drug discovery needs.
view moreCredit: Ekins & Slusher, Current Biology
In the face of US federal funding cuts, biomedical researchers propose strategies for continued progress in drug discovery. Publishing November 26 in the Cell Press journal Trends in Pharmacological Sciences, their recommendations include harnessing AI and computational analyses in early-stage research, diversifying funding sources, pursuing earlier licensing and commercialization, and fostering international collaborations.
“Scientific innovation in the US is in jeopardy,” says author Barbara Slusher of Johns Hopkins School of Medicine and Johns Hopkins Drug Discovery. “These are some steps we could take to ensure continued scientific progress despite this challenging climate.”
It takes twelve years on average for a new drug to go from discovery to commercialization. In the US, the early stages of this process are usually carried out by small biotechnology companies and academic research labs that are largely funded by government agencies such as the NIH and NSF. If these small research groups are unable to continue to conduct research, large pharmaceutical companies—which typically only become involved once products have passed a certain stage of testing—will have to look elsewhere to fill their pipelines.
“The concern is that if pharma is not finding innovative, license-ready programs emerging from US small companies and academic labs, they may increasingly look to other countries—such as China—where substantial investment in science and technology is generating a growing pipeline of assets,” says Slusher.
To allow small US companies and academic labs to remain competitive in healthcare innovation, the authors say that researchers should embrace approaches such as AI and computational analyses to cut down on laboratory costs.
“When traditional funding is scarce, computational approaches and AI offer a cost-effective way to accelerate discovery and reduce experimental overhead before expensive laboratory work is undertaken,” says author Sean Ekins, CEO and cofounder of Collaborations Pharmaceuticals.
The authors also say that small companies and academic labs will need to find ways to diversify their funding sources by pursuing grants from philanthropic foundations, pharmaceutical companies, global charities, and even crowdfunding. Labs that produce their own software or specialized technologies could also sell these products to help fund their ongoing research, they say.
“What I’ve learned over the last nine months is that we shouldn’t be reliant on a sole source for our research income,” says Slusher. “I think it’s an important lesson for all scientists to think about diversifying the way they are bringing in resources to fund their laboratories.”
The funding cuts might also mean that small research groups will need to license and commercialize products sooner than they otherwise would, the authors say. They noted that earlier licensing could mean that these small companies make less profit in the long term.
Another strategy to keep small companies resilient is to engage in large collaborations, including international and public-private partnerships, the authors say. They point to the fact that these types of collaborations are the norm in Europe, where they allow small research groups to expand their capabilities by sharing infrastructure and access to data and patient groups.
“This also ties into our diversification of funding. Having collaborations means that I don’t have to bring in 100% of the funding to move a project forward,” says Slusher.
Finding a way to keep healthcare innovation alive in the US is essential for the country’s public health, the researchers say. It’s also essential for the researchers themselves.
“We worry about the impact of these cuts on the next generation of scientists,” says Ekins. “Careers are made or broken with funding, and if the funding isn’t here, scientific talent is going to go elsewhere.”
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Trends in Pharmacological Sciences, Ekins & Slusher, “Resilient pathways for drug discovery in challenging times” https://www.cell.com/trends/pharmacological-sciences/fulltext/S0165-6147(25)00230-5
Trends in Pharmacological Sciences (@TrendsinPharma), published by Cell Press, is a monthly review journal that contains succinct articles on the most exciting recent developments in pharmacology and toxicology research. Topics covered in the journal range from molecular to behavioral pharmacology, and from current techniques to theoretical pharmacology. Visit: http://www.cell.com/trends/pharmacological-sciences. To receive Cell Press media alerts, please contact press@cell.com.
Journal
Trends in Pharmacological Sciences
Method of Research
Commentary/editorial
Subject of Research
Not applicable
Article Title
Resilient pathways for drug discovery in challenging times
Article Publication Date
26-Nov-2025
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