It was Maureen Connoly's second day of medical school, and already the 22-year-old student was $15,000 in debt.
By the time I get out I may owe $60,000," shrugged Connolly, who took out three loans on top of a $1,200 scholarship to pay for her first year's tuition at Georgetown University Medical school. 'Money is the big deal these days. Everyone is worried about getting in and paying tuition."
Becoming a doctor carries a high price tag at two of the District's private universities, Goergetown and George Washington. According to the Association of American Medical Colleges, these two schools charge the highest tuition in the country.
This year, tuition for a fist-year medical student is $12,500 at Georgetown and $11,800 at George Washington. The estimated yearly cost for tuition, books, living expenses, instruments and other supplies is $17,400 for an unmarried, first-year student at Georgetown and $17,450 at George Washington.
By comparison, this year's average tuition at private U.S. medical schools is $6,070, according to a July 1978 AAMC survey. The average tuition at public colleges is $1,582 for residents and $3,463 for non-residents.
But unlike other private schools, Georgetown and George Washington cannot obtain aid from a state government. Until the 1976-1977 academic year, the federal goverment, in lieu of state support, paid each of the two schools a per capita grant of $5,000 a year for each student through a special act of Congress.
But the government's current concern with promoting primary care specialties and distributing physicians to under-served areas prompted a shift in federal funding- . Rather than provide per capita grants to the schools, the government is offering direct payments to students through scholarship programs that carry service requirements.
The loss of these per capita grants - coupled with inflation - helped tuition climb.
Some students manage by borrowing money - from family, friends, the government or banks. Some hold down jobs in addition to intensive academic schedules, and still others opt for National Health Service Corps or military scholarships that require service obligations upon graduation.
"I didn't want to burden my parents any further since I'd already spent $3,000 to apply to medical schools in the last three years," said GW first-year student Dough Grier, who joined the Navy under the Armed Forces Health Professions Scholarship Program.
This program provides financial assistance to medical students in exchange for active-duty service in the Army, Navy or Air Force. Those who enlist in the program receive full tuition, educational expenses and a $400 per month living stipend, plus full pay and allowances during an annual 45-day active duty tour.
For each year of participation in the program, students must serve one year in the appropriate service of the armed forces, with a minimum obligation of three years.
"I didn't like the idea of graduating $80,000 in debt, and I'm a little old to have my parents pay," said 26-year-old Navy recruit Andy Jagoda, of the district. "It was a big shock to find tuition so high. When I studied in Italy, tuition was only $100 a year - but there were 2,000 students in my class."
Some students choose National Health Service Corps scholarships to finance their medical education.
These scholarships pay tuition, educational expenses and a stipend, and obligate students to practice in an under-served area of the country for one year for every year of support with a minimum of two years of service, explained third-year GW medical student Rich Roberts, who also is an attorney and serves as the national legislative affairs coordinator for the American Medical Student Association.
"Because these programs allow only three years for a residency, students must choose a primary-care specialty like family practice or pediatrics," noted Roberts, who is financing his education with a National Health Corps scholarship. "So, in effect, the government is buying primary-care doctors and putting them where they want them."
Depending on the medical specialty, residencies can take from two to seven years, so some specialties would not it into this program.
Since National Health Service Corps scholarships restrict students to a primary-care specialty and Armed Forces sholarships may require students to uproot their families to travel, some students finance their medical educations through a variety of federal, state or private loans or scholarship.
Under a new federal program called HEAL (Health Education Assistance Loans), medical students may borrow up to $10,000 per year - up to a maximum of $50,000 - repable within 15 years after completion of residency training. Interest on the loans may not be more than 12 percent annually.
Laura Mabie, a student at Georgetown, said her parents took out a loan to help finance her education. "I worked in a doctor's office as a medical assistant last year to pay for about a third of the tuition," said the 23-year-old Californian. "I didn't get one of the educational loans because of my father's income bracket. He's a doctor, but they don't take into account the fact that I have eight brothers and sisters."
Some, like 27-year-old George Washington student Gordon Handte, of Hyattsville, chose the difficult road of taking out a small loan, coupled with a 25-hour-a-week job to finance his first and second years of medical school.
"This is my 11th straight year of college, so years are important to me now, and I don't want to wind up practicing on some boat docked in a Norfolk harbor," explained Handte, who has a master's degree in pathology and worked in the GW pathology department. The time pressures on third-year students have led him to rely on loans and his savings to pay this year's tuition.
"Working while going to medical school was very taxing and tiring. I lost a lot of sleep and I'm incredibly broke. But it's been the only route that leaves me the flexibility and freedom I need." CAPTION: Medical students at George Washington University Medical School, where tuition is $12,500 per year, listen to a dermatology lecture., By Linda Wheeler - The Washington Post