Federal budget changes threaten medical education, student access
Sweeping changes in federal student aid programs included in the budget reconciliation bill could dramatically reshape the landscape of medical and graduate education. Leaders at Southern Illinois University School of Medicine say the proposals would not only burden students with greater financial strain but also threaten the pipeline of physicians needed to care for rural and underserved communities.
“The new federal directives are not theoretical,” said Dr. Jerry Kruse, dean and provost of SIU Medicine. “They will directly harm the people and communities we serve—especially in central and southern Illinois. This isn’t politics. It’s patients, it’s providers and it’s progress on the line.”
The legislation, dubbed the “One Big Beautiful Bill Act,” would cap federal student loans for graduate and professional students and eliminate the Grad PLUS loan program, which currently allows students to borrow up to the full cost of attendance. Both the House and Senate versions of the bill would limit borrowing to between $150,000 and $200,000—far less than the median cost of medical school, which exceeds $286,000 for public institutions and $390,000 for private ones, according to the Association of American Medical Colleges (AAMC).
About half of medical students rely on Grad PLUS loans to bridge the gap between tuition, living costs and existing federal loan limits. Without that safety net, students would need to turn to private lenders with higher interest rates and fewer repayment options.
Dr. Haneme Idrizi, associate dean of student affairs, warned that the changes could discourage many from even applying. “I’m a proud daughter of immigrants. I would not have become a pediatrician without federal loans,” Idrizi said. “The proposed cap would reduce access to medical education and shrink the physician pipeline at a time when we desperately need more doctors in primary care, psychiatry and pediatrics.”
Idrizi added that students are already voicing doubts about whether they can afford to continue. “SIU was founded to train physicians to serve rural and underserved areas. These cuts undermine that mission.”
Impact on patients and communities
Medical education leaders argue that access to student loans is directly tied to access to health care. Dr. Karie Schwertman, an SIU family physician and faculty member, said that funding decisions made in Washington reverberate through exam rooms in Illinois.
“I grew up in a poor family. I remember going without electricity and driving hours to see a dentist who allowed a payment plan,” Schwertman said. “Today, I serve similar families—people who depend on Medicaid and people who depend on doctors willing to practice in rural areas. If loan caps and debt push students away from medicine, communities like ours will be left behind.”
Schwertman, who leads a comprehensive clinic integrating primary care, behavioral health and pharmacy services, said that financial barriers could mean fewer physicians entering fields where the need is greatest. “We need support, not barriers,” she said.
Student perspective
For many students, the financial uncertainty is daunting. “I’ve wanted to be a physician since I was a teenager, but I don’t come from a wealthy background,” said Tyler Jones, a fourth-year medical student. “If Grad PLUS loans disappear, I honestly don’t know how I would continue my training. Private loans aren’t realistic when you’re already carrying six figures of debt.”
The AAMC warns that restricting federal loan options could worsen the national physician shortage, particularly in underserved areas. A recent survey found that 63% of graduating medical students plan to use a loan-forgiveness program such as Public Service Loan Forgiveness (PSLF). The proposed bill would exclude residency years from counting toward PSLF, further discouraging students from choosing lower-paying but high-need specialties.
Private donations play a critical role
While SIU Medicine continues to advocate against the federal cuts, leaders emphasize that private donations to scholarship funds will become even more vital. “Scholarships are not just about reducing debt—they are about opening doors,” Kruse said. “When a student receives financial support, it affirms that their community believes in their dream of becoming a physician.”
SIU Medicine relies on alumni, philanthropic partners and community supporters to help bridge the financial gap for students. These scholarships are often the deciding factor for whether a talented applicant from a working-class or rural background can attend medical school.
“Our students are driven to serve, but debt can force them to reconsider their career path,” Idrizi said. “Private scholarships give them the freedom to choose family medicine, pediatrics or psychiatry—not just the specialties that pay the most.”
Schwertman agreed. “Investing in students is investing in healthier communities,” she said. “Every scholarship dollar helps ensure that patients in our region will have access to compassionate, skilled physicians for years to come.”
Looking ahead
Despite the uncertainty, Kruse reaffirmed the school’s mission. “We were founded on the principle of social accountability,” he said. “Even in the face of these threats, we remain unwavering in our mission—to educate, to heal and to serve the people of this region with compassion and excellence.”
For SIU’s students, faculty and alumni, the message is clear: access to medical education is not just a financial issue. It’s a matter of public health, equity and the future of care in Illinois.
