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Figure.
Out-of-Pocket Costs by Program Type by Year for 2011-2016 and Cumulatively for All Years
Out-of-Pocket Costs by Program Type by Year for 2011-2016 and Cumulatively for All Years

Shown in each box plot are medians (solid line in the box) and 25th and 75th percentiles (box top and bottom). The upper and lower whiskers extend from the box to the values no further than 1.5× the interquartile range from the box. Outlying points are plotted individually as open circles.

Table.  
Tuition and Veterans Administration Scholarship Support for US MD, JD, and MBA Programsa
Tuition and Veterans Administration Scholarship Support for US MD, JD, and MBA Programsa
1.
Association to Advance Collegiate Schools of Business DataDirect. Global business school data. https://www.aacsb.edu/knowledge/data/datadirect. Accessed May 12, 2018.
2.
Association of American Medical Colleges. Tuition and student fees. https://www.aamc.org/data/tuitionandstudentfees/. Accessed May 12, 2018.
3.
American Bar Association. Statistics: section of legal education and admissions to the bar. https://www.americanbar.org/groups/legal_education/resources/statistics.html. Accessed May 12, 2018.
4.
US Department of Verterans Affairs. Education and training: Yellow Ribbon program. https://www.benefits.va.gov/gibill/yellow_ribbon.asp. Accessed May 12, 2018.
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Research Letter
September 18, 2018

Scholarship Support for Veterans Enrolling in MD, JD, and MBA Programs

Author Affiliations
  • 1Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
  • 2Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
JAMA. 2018;320(11):1197-1198. doi:10.1001/jama.2018.10260

Military veterans may bring a distinct perspective to medicine, law, business, or other professions or occupations. The Post-9/11 GI Bill is a scholarship program that can be used for most accredited degree programs (including undergraduate and graduate programs, such as medical, law, or business school) and is available to all honorably discharged veterans who served on active duty. This program covers all tuition and fees for a veteran if attending an in-state public school. For private or out-of-state public schools, the GI Bill covers a portion of tuition and fees not to exceed the maximum allowed by law per academic year. To supplement the GI Bill’s support, an academic graduate program may elect to participate in the Yellow Ribbon scholarship program at the amount of its choosing to be matched by the Veterans Administration (VA). Total VA scholarship support is funds received from the GI Bill, the graduate program’s offered Yellow Ribbon award, and the matching VA Yellow Ribbon award. We examined VA scholarship support by MD programs, determined by participation in the Yellow Ribbon program, and compared it with juris doctorate (JD) and master of business administration (MBA) programs at the same institutions.

Methods

All US universities offering MD programs accredited by the Liaison Committee on Medical Education, JD programs accredited by the American Bar Association (ABA), and MBA programs accredited by the Association to Advance Collegiate Schools of Business (AACSB) in the 2016-2017 school year were identified and tuition data for academic years 2011-2016 were obtained from the Association of American Medical Colleges tuition archives, ABA statistics service, and AACSB DataDirect.1-3 Yellow Ribbon scholarship and GI Bill participation information was obtained through the VA website.4 Programs were included in the analysis only for the years in which they were accredited.

Medians of per-program tuition in each year (2011-2016), total VA scholarship support, out-of-pocket costs (annual tuition − total VA scholarship support), and percentage of tuition covered were calculated for each program. Medians and interquartile ranges (IQRs) were used to summarize the distributions, Kruskal-Wallis tests were used to compare costs, and χ2 tests were used to compare Yellow Ribbon participation between programs. Analyses were performed using R software, version 1.1.423. A 2-sided P < .05 indicates statistical significance.

Results

The number of MD programs ranged from 133 to 144 per year; there were 100 or 101 JD programs and 121 MBA programs. The median annual tuition over the 6-year study period was $54 896 (IQR, $49 915-$59 895) for MD programs, with 45% of tuition covered by VA scholarship support; $41 061 (IQR, $35 058-$48 956) for JD programs, with 85% covered; and $30 891 (IQR, $21 648-$46 391) for MBA programs, with 100% covered (Table). Median out-of-pocket costs in 2016 were $27 959 (IQR, $7896-$36 859) for MD programs compared with $1078 (IQR, $0-$14 426) for JDs and $1 (IQR, $0-$11 700) for MBAs (Figure). The difference in out-of-pocket costs between programs for all years was significant.

Discussion

The costs for veterans attending medical school were high despite VA scholarship support, with only 45% of tuition covered and out-of-pocket costs more than $27 000 annually. VA scholarship support for MD programs was less than for other professional programs at the same universities. This discrepancy may be due to MD programs benchmarking their support levels only to other MD programs or because veterans more frequently enter MBA and JD programs, prompting higher Yellow Ribbon participation. Benchmarking VA scholarship support to all professional programs could increase both support to veterans entering the medical profession and matched federal scholarship funds that medical schools receive.

This study is limited by a lack of data available regarding veteran attendance at individual graduate programs and additional scholarship funding that may be provided to veterans. Further research is necessary to monitor enrollment of veterans in medical schools and other graduate programs, the graduation rates of veterans who receive VA scholarship support, and, for veterans who become physicians, the location of practice (eg, settings that provide care for other veterans).

Section Editor: Jody W. Zylke, MD, Deputy Editor.
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Article Information

Accepted for Publication: June 26, 2018.

Corresponding Author: Stephen Graves, MS, Department of Obstetrics and Gynecology, Prentice Women’s Hospital, Northwestern University Feinberg School of Medicine, 250 E Superior St, Ste 05-2168, Chicago, IL 60611 (stephen.graves@northwestern.edu).

Author Contributions: Mr Graves had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Graves, Seagle.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Graves, Seagle, Kocherginsky, Yang.

Critical revision of the manuscript for important intellectual content: Graves, Seagle, Kocherginsky, Grace, Shahabi.

Statistical analysis: Graves, Seagle, Kocherginsky, Yang.

Obtained funding: Shahabi.

Administrative, technical, or material support: Grace.

Supervision: Graves, Seagle, Kocherginsky, Shahabi.

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Funding/Support: The research reported in this publication was supported by grant 4P30CA060553-22 from the National Cancer Institute of the National Institutes of Health and by the Department of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine.

Role of the Funder/Sponsor: The study supporters had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

Additional Contributions: We thank the Association of American Medical Colleges, ABA, AACSB, and VA National Center for Veterans Analysis and Statistics for assistance with the primary data. We also thank the Northwestern University Chicago Campus Financial Aid Office for insights on administration of the Yellow Ribbon scholarship and Post-9/11 GI Bill within professional programs. We also thank Marianne Green, MD, Magdy Milad, MD, and Kyle Yoo, BS, Northwestern University Feinberg School of Medicine, for general advice, mentorship, and contributions to the research. All individuals named received no compensation for their contributions.

References
1.
Association to Advance Collegiate Schools of Business DataDirect. Global business school data. https://www.aacsb.edu/knowledge/data/datadirect. Accessed May 12, 2018.
2.
Association of American Medical Colleges. Tuition and student fees. https://www.aamc.org/data/tuitionandstudentfees/. Accessed May 12, 2018.
3.
American Bar Association. Statistics: section of legal education and admissions to the bar. https://www.americanbar.org/groups/legal_education/resources/statistics.html. Accessed May 12, 2018.
4.
US Department of Verterans Affairs. Education and training: Yellow Ribbon program. https://www.benefits.va.gov/gibill/yellow_ribbon.asp. Accessed May 12, 2018.
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