Tuition for first-year medical students at George Washington University will climb to $19,000 next fall, a $4,000 a year jump, the university announced yesterday.

The rise is the latest in a spiral of major increases that has made the cost of medical education higher at Washington's two unsubsidized private medical schools, George Washington and Georgetown, than at any other university in the United States.

This year medical school tuition at Georgetown is $15,950, the highest in the country and $950 more than George Washington. Wes Christensen, a Georgetown spokesman, said the university is scheduled to set its rate for next year in March and suggested that it "probably will be in the same range" as George Washington.

Howard University, the District's third medical school, receives a large special subsidy from the federal government as a school primarily for blacks. Its current tuition of $3,000 is less than half that of any other private U.S. medical college though it is considerably above the $2,321 average for state residents at public medical colleges. The average medical tuition at private colleges now is $9,285, according to the Association of American Medical Colleges, but the association said virtually all of them, except for GW and Georgetown, get some state support.

With living expenses estimated at $8,500, the total cost for a first year student at George Washington next year will come to about $27,500.

Even at the lower cost for this year, GW officials said, some students accumulate more than $75,000 in debts, most with federal guarantees and subsidies, before they graduate. About a third of the school's 600 students get federal scholarships by joining the armed forces or enrolling in the National Health Service Corps. But Dr. L. Thompson Bowles, dean for academic affairs, said that because of budget cuts the health service corps will give no new scholarships next year. He said federal loan programs are threatened though they have not been cut back significantly yet.

"There's a real threat now to a good many students," Bowles said.

Nonetheless, George Washington has attracted a bumper crop of about 7,500 applicants for next fall's entering class of 150, according to Bowles. But he said the school is concerned that its high cost and the heavy debts that many students pile up may deter bright, middle-income students from coming or steer them to high-paid specialties.

"According to all our data this isn't happening yet," Bowles said yesterday. "But we're concerned, very concerned."

Bowles said the tuition will increase by 27 percent next fall on top of a 27 percent increase this year because of the final phase-out of direct federal aid for medical schools. He said the university also decided to end the subsidy of more than

million a year for the medical school from the group medical practice run by its professors, and use the money instead for delayed renovations and new equipment.