In Reply to Nguyen and Makam
We thank Drs. Nguyen and Makam for their remarks. For the independently wealthy, his observations are germane. However, we did not conduct our study to determine whether these fortunate few are better off paying cash for a medical degree rather than investing their money in other ways. The primary objective of our study was to determine whether the benefits of national service scholarships (and other paths to avoiding debt, such as institutional scholarships) offset the lower earnings these graduates may accrue during varying lengths of public service. Our analysis revealed that, for most aspiring physicians, attending medical school with the help of a national service scholarship is an excellent deal. We hope that our findings will encourage federal and state officials, policy makers, and institutional donors to expand the number and range of scholarships so more young people from low- and middle-income families can attend medical school without the need to take on large debts.