Trump’s ‘big beautiful bill’ is driving aspiring U.S. doctors to reconsider their careers

Doctors in the U.K. say a lack of available jobs and wage disputes are persuading them to take their skills to Canada. Adrian Ghobrial reports.

By the time Eddie Jiang was in high school, he knew he wanted to become a doctor. He chose an in-state college with existing federal loan programs so he could afford to go straight to medical school after college.

He graduated from Stony Brook University in New York in May, and now he’s not so sure his plans will work out.

U.S. President Donald Trump’s sweeping tax and spending cuts package, known as the “big beautiful bill,” is changing the way aspiring doctors like Jiang can finance their education.

Starting this week, there is a cap on federal loans for professional programs such as medical, dental and law school. It limits federal loans to US$50,000 per year, with a total limit of US$200,000. It also eliminates Grad PLUS, a program that lets students borrow the full cost of attendance, regardless of credit. The Trump administration claims that loan caps will drive down graduate school costs.

Under these new federal loan caps, Jiang says, he will probably have to work for more than two years after college to afford medical school. If he finds stable work during those gap years, he said, he may not return to medicine.

“It’s very jarring to me that money has become this important in my decision to become a doctor,” said Jiang, a psychology major from New York.

According to the Association of American Medical Colleges, the median four-year cost of attendance for the class of 2026 was US$297,745 for public schools and US$408,150 for private schools.

The association says that almost half of students seeking an M.D. rely on Grad PLUS, and they borrow more than US$1 billion via the program annually.

Trump’s tax and spending cuts package, which was passed by Congress in summer 2025, “fundamentally changes the medical school financing landscape for aspiring physicians,” said Kristen Earle, the program leader for student financial aid services at the Association of American Medical Colleges.

There’s concern too that it could make med school less accessible and exacerbate an existing physician shortage. In 2024, the Health Resources and Services Administration projected a shortage of 87,150 primary care physicians by 2037.

“In the wake of this policy change, many future physicians will find themselves in a worse financial position and may be disincentivized from pursuing fields they are passionate about — such as primary care — where salaries are lower,” said Nikitha Balaji, national president of the American Medical Student Association.

Some college students are already reconsidering their plans to go to medical school. They’re turning to private loans, planning to take take additional gap years — or thinking about changing careers paths entirely.

Aiming for lower cost education

The Trump administration says that enforcing loan caps will force graduate schools to reduce tuition costs.

In a May congressional hearing on Department of Education priorities, Secretary Linda McMahon said that with loan caps in place, schools will “have fewer applicants coming into their universities” and when “they realize part of the reason is because the cost is too high, they will lower those costs.”

Louisiana Republican Sen. Bill Cassidy, a physician and the chairman of the Senate Health, Education, Labor, and Pensions Committee, also said he believes that capping loans and eliminating the Grad PLUS program would ultimately lower costs for students.

“The increasing availability of federal loans has resulted in skyrocketing tuition prices, trapping students in a cycle of overwhelming debt that they can’t pay back,” said Cassidy, who attended Louisiana State University for medical school. “By capping inflationary graduate loan programs, we prevent students from overborrowing and put downward pressure on rising college costs.”

The Association of American Medical Colleges says that rising medical school tuition costs are not causally associated with accessible loan programs. After the introduction of the Grad PLUS program in 2006, tuition at medical schools increased at a slower rate than in prior years. According to the association, the primary driver of increases in med school costs in recent years has been the rising cost of living, not tuition.

The Grad PLUS loan program was a topic at the Senate HELP Committee’s May 2025 “State of Higher Education” hearing, including a 2023 paper that found the program led to significantly higher graduate program prices.

But Leslie Turner, associate professor at the University of Chicago Harris School of Public Policy and one of the authors of the paper, said that’s not the whole story. Eliminating generous federal loans may not reduce costs for students, she said.

The study’s findings could indicate that eliminating the program could lead to slower price growth but probably not a decrease in the level of tuition, she said. Institutions could provide more grants and scholarships to make up for the difference, but she said she wouldn’t count on it.

Turner added that, based on data from 2001 to 2022, public medical school tuition costs are rising at a greater rate than at private medical schools. Decline in state funding for public education systems could lead these schools to rely more on tuition revenue. Providing additional funding to public institutions could be one policy that could lower costs for students.

“Given the current state of higher education finance, the cuts to federal funding, the restrictions on international student visas, the overall uncertainty, it’s unlikely institutions will have the capacity to increase financial aid given to students,” Turner said. “I think most schools would like to continue the current generosity of their programs, but it’s just a very precarious financial situation across the higher ed landscape.”

A potential solution, but not for all

Private loans could be a solution for med students who can’t borrow what’s needed, but they often carry higher interest rates, offer limited repayment flexibility and have few forgiveness options. They may require co-signers and offer no income-driven repayment, leaving students with massive, inflexible debt.

Jadyn Sinclair was admitted to Brown University’s Program in Liberal Medical Education and committed last year to enroll in medical school in 2029.

She estimates that medical school will cost her US$400,000 over four years. Until recently, she expected to pay that back once she became an attending physician. But if US$200,000 is no longer covered by federal loans, she said, she’ll have to rely on private loans.

Sinclair said she feels betrayed, having committed under a “completely different circumstance.”

“If I’d known this would happen, I may not have committed to med school at this point,” Sinclair said.

Many students may not be able to access private loans, either. The availability of private student loans has shrunk significantly in the past 20 years, Turner said, and it never really bounced back after the end of the Great Recession.

“Private lenders look at the applicant’s credit history, their credit score, and may decide to not even extend an offer of loan to individuals without an extensive credit history, or with low credit scores, and interest rates may be linked to the borrower’s creditworthiness,” Turner said.

In the absence of increased availability of private student loans, professional programs like medical schools may become less accessible, Turner said.

Abandoning dreams

Yale University student Faven Wondwosen has dreamed of becoming a doctor since childhood.

“My parents never went to college, and they’re both immigrants. I was really hesitant to pursue medicine not because I wasn’t sure if I wanted to be a doctor, but because I was insecure about my own capabilities,” Wondwosen said.

Over the past two years, she completed eight premed prerequisite courses, worked on research in a lab and trained to become an emergency medical technician.

“I think I had 30 exams over the course of one semester. And I’m starting to see, ‘Oh, I actually can do this.’ And now it doesn’t matter how hard I work, there’s a big chance I can’t be a doctor,” she said.

Last year, Wondwosen shifted gears and stopped pursuing premed requirements and is now planning to pursue a career in academia instead. Although her dream is to be a doctor, she said, her priority is supporting her family after graduation.

“My dad’s a truck driver, and my mom works in retail. I have to figure out a career that makes me a similar amount of money to take care of my parents. I want my parents to relax. They have worked extremely hard,” Wondwosen said.

“This whole concept of the American dream, where it’s like, if you work hard enough, you’ll get there, it’s just, frankly, a lie,” she said. “I thought that if I worked hard enough, it would eventually just all work. Maybe that was naive.”

Jiang said that with loan caps in place, he expects to work several years after college before starting medical school, and he expects he’ll have to hold a job while studying.

“There’s this rather unspoken thing about people in medical school having side gigs too, like serving or DoorDashing,” Jiang said.

Had he known he would struggle to afford medical school, he said, he might not have spent his summers volunteering in hospitals and labs. He might have chosen an entirely different path.

“If you had told me in high school, ‘You cannot take more than $200,000 in loans for medical school, and you know that average debt is upwards of that,’ I would have found a job immediately after I graduated high school and worked a paying job every summer to pay for the difference.”

Now, he says, he’s “in too deep” and no longer competitive or specialized for other careers.

“The skills I’ve cultivated within a lab aren’t going to do anything in, say, finance,” Jiang said.

Asuka Koda, CNN