Canadian medical students voice their concerns

For too long the issue of medical school tuition has been raised once each year, at which time students protest, administrators respond that they can do nothing and increases are railroaded through compliant university governments. Your recent articles on tuition1^,2 reached conclusions similar to our in-house, student-conducted research. The latter showed that the percentage of medical students at the University of Western Ontario from families with incomes of less than $60 000 had declined from 25% of the total in 1998 to 14% in 2000 (unpublished data).

In 2001, during a contentious debate about raising Western's tuition fees to a near Canada-wide high of $14 000 a year, studies were quoted by both sides. We hope the findings published in CMAJ will lay to rest the notion that endless increases in tuition fees can be executed without a corresponding decline in accessibility1 and student diversity.2

At Western, a commitment that no student will be denied access to a medical education because of financial status, either initially or during the program, rings hollow in the face of these recent studies. For one thing, student aid such as the Ontario Student Assistance Plan is not indexed to inflation:3 the portion allocated for tuition, $4500, has not increased in more than a decade. For another, remedies aimed at residents and new doctors, such as incentives to practise in rural areas, will never solve the problems of accessibility and student diversity. To attract students from underrepresented groups and classes, tuition fees must be cut in order to reduce the “sticker shock.”

In this era of doctor shortages, creating financial impediments for potential students will ensure that ongoing problems of diversity and accessibility get worse.

Clare Bastedo Jackie Bellaire Jana Malhotra Marko Mrkobrada Andrew Touw Classes of 2004 and 2005 Medical Education Taskforce on Tuition and Accessibility University of Western Ontario London, Ont.