“Creating the Best Doctors.” More Donors Make the Case for a Free Medical Education

Matej Kastelic/shutterstock

Matej Kastelic/shutterstock

Roughly a year after New York University (NYU) School of Medicine announced it would cover the tuition of all its students, Weill Cornell Medicine rolled out a new financial aid program last month that expands its offerings to provide debt-free education to medical students with demonstrated financial need beginning with the 2019-2020 academic year and then every year thereafter in perpetuity.

The school raised $160 million to fund the program, including a lead gift from the Starr Foundation and support from Joan and Sanford I. Weill and the Weill Family Foundation. Students pursuing dual M.D.-Ph.D. degrees through a separate program receive full tuition and stipends for living expenses from the National Institutes of Health and Weill Cornell Medicine. Together, these two programs will now enable two-thirds of Weill Cornell Medicine’s medical student body to graduate without debt. The school will need to raise more funds in the future to ensure it will cover tuition for eligible students in perpetuity.

The new financial aid program aims to kill two birds with one stone. At a time when nearly 59 percent of medical school graduates are white, Weill Cornell Medicine hopes to attract underrepresented applicants repelled by the prospect of a 2018 median debt burden of $192,000. And second, the school hopes that students will “focus their careers on their interests and talents, rather than the requisite future salaries to repay their loans.”

“It is a great privilege to make such an important and impactful contribution to the futures of our medical students,” said Weill Cornell Medicine Overseer Maurice (“Hank”) R. Greenberg, chairman of the Starr Foundation, and the program’s architect. “Scholarships are crucial to the success of our trainees, freeing them from the weight of excess debt that has traditionally accompanied medical education.”

Differing Approaches

When NYU first announced its donor-funded free tuition plan, I noted that while stakeholders hoped that the carrot of zero debt would encourage students to pursue less lucrative careers, the school had no stick to incentivize graduates to, for example, practice pediatrics in rural Oklahoma. Moreover, as initially constructed, the NYU plan had no income restrictions, meaning that thanks to donor largesse, a student from a wealthy family could graduate debt-free and become a highly paid cardiologist in Beverly Hills.

The New York Times’ Elisabeth Rosenthal wasn’t thrilled with this prospect, calling NYU’s plan a handout for the soon-to-be 1 percent. Aaron Carroll, a pediatrician and researcher at Indiana University was also dubious. “If you had to find some cause to put tons of money behind,” he said, NYU’s plan “strikes me as an odd one.” And Slate’s Jordan Weissman called the gift “a waste” and “a donation from today’s rich to tomorrow’s rich, all at the taxpayers’ expense.”

This criticism echoes the growing concern that universal “free tuition” plans may exacerbate inequality. Why should taxpayers (or donors) bankroll some hedge fund manager’s kid’s college education?

NYU donors were undeterred by this line of thinking. As of August 2018, the school had raised more than $450 million of the $600 million that it anticipates will be necessary to finance the plan. About $100 million of that total came from Kenneth G. Langone, a co-founder of Home Depot, and his wife, Elaine, for whom the medical school is named.

I suspect the architects of Weill Cornell Medicine’s plan kept a close eye on developments at NYU, where, as it turns out, Hank Greenberg is a life trustee. Like NYU, Weill Cornell’s press release didn’t mention a mechanism by which it would funnel students toward less lucrative careers. Nor, if I were to wager, is the school likely to implement one. But Weill Cornell has taken a more selective approach when it comes to providing financial support. Rather than covering the $90,000 tuition for all its students, the school’s program focuses on students who qualify for aid. This approach neutralizes the school from the kind of criticism levied against NYU. No one is calling Weill Cornell’s program “a waste.”

The plan resembles that of Columbia University’s Vagelos College of Physicians and Surgeons, which became the first medical school in the country to institute scholarship-only financial aid last year. P. Roy Vagelos, the former chairman of Merck & Co., bankrolled the plan to the tune of $250 million. He also hoped the gift would free students to pursue careers in family medicine, pediatrics, research and other fields that are less lucrative than the top-paying specialties.

Greenberg and Weill were also probably pleased to learn that NYU’s free tuition model resonated with applicants, and perhaps even more importantly, those from historically underrepresented demographics. Earlier this year, NYU announced that applications for the class of 2023, the first cycle since NYU’s new policy was announced, jumped 47 percent to 8,932, up from 6,069, last year. NYU received 2,020 applications from students who identify as minorities underrepresented in medicine, up from 1,000 last year. And the number of NYU applicants who identify as black, African-American or Afro-Caribbean increased to 1,062 up from 438 last year.

Will it Work?

What will be the outcomes of Weill Cornell’s new program? Administrators and results-driven donors would be wise to keep an eye on three critical figures.

The first is the number of economically diverse graduates the school churns out thanks to more generous financial support. The second key figure would be an uptick in graduates who end up taking lower paying jobs rather than following the money, with the bonus of having zero debt. If these numbers don’t change all that much, donors will rightfully question the impact of the model.

The third figure is Weill Cornell’s $90,000 sticker price, which is roughly $45,000 more than that of NYU. As frequently noted here on Inside Philanthropy, free tuition gifts make for breathless front-page headlines, but they don’t address one of the main drivers behind the student loan crisis—escalating tuition. If administrators and donors wanted to make higher education more affordable to low-income students, they would move heaven and Earth to lower tuition. Michael Bloomberg made a similar argument on the heels of his $1.8 billion financial aid gift to Johns Hopkins University.

Even though Weill Cornell hasn’t adopted an NYU-like free tuition model for all of its students, the math still suggests that donors could get a far bigger bang for their buck and cover even more debt if administrators (and donors!) dialed back their tuition-busting thirst for glitzy capital projects and other expensive undertakings.

In related news, though, Weill Cornell Medicine’s announcement about its new financial aid program also listed two new capital projects designed to “enhance the student experience”—the construction of the Feil Family Student Center, made possible with a $12.5 million gift from New York-based real estate developer Jeffrey Feil and his family, and a new residence hall set to go online in 2023.

$600 Million and Counting

Eighty-six-year-old Sanford Weill graduated from Cornell and worked on Wall Street for more than 50 years, playing a major role in many large banking institutions. He has served as president of American Express and was responsible for creating Travelers Group through a series of acquisitions, eventually merging Travelers with Citicorp to create Citigroup.

The Weills have given more than $600 million to Weill Cornell Medicine, where Sanford currently serves as overseer and chair emeritus of the board. (His daughter, Jessica Bibliowicz, now serves as chair.) Through Cornell, he also helped develop the first American medical school overseas, partnering with the Qatar Foundation for Education. In 2016, the Weills made a $185 million commitment to the University of California-San Francisco to establish the new Weill Institute for Neurosciences.

The Weills are also huge proponents of music and music education. In 2014, Carnegie Hall opened its Judith and Burton Resnick Education Wing. The $230 million project was funded with gifts from the Weills and the Weill Family Fund, Judith and Burton Resnick, Lily Safra and other donors.

Joan was the chairman of the board and a former trustee of Alvin Ailey American Dance Theater. She was also president and board member of Citymeals on Wheels, a board member of the Lang Lang International Music Foundation, and chair of the board of Paul Smith’s College, where the Weills attempted to make a controversial naming gift in 2015.

The Weills are recipients of the 2009 Carnegie Medal of Philanthropy Award while Sanford, who served as Carnegie Hall’s chairman of the board for 24 years, was the 2015 recipient of the Carnegie Hall Medal of Excellence. The couple signed the Giving Pledge, promising to give away half or more of their fortunes either during their lifetimes or at death.

Commenting on his recent gift to the medical school that bears his name, Weill said, “Providing debt-free medical education isn’t just what’s right for our students; it is critical to creating the best doctors for all generations to come. We are proud to be champions of our students at one of the most pivotal times of their lives.”

“He’s an Icon”

A week before the Weill Cornell Medicine announcement, the Starr Foundation made a $50 million gift to the Rockefeller University to establish the Maurice R. and Corinne P. Greenberg Center for the Study of Inflammation, Microbiome, and Metabolism, and the Starr Center for Computational and Quantitative Science.

The 94-year-old Greenberg is currently chairman and CEO of C.V. Starr & Co., Inc. and serves as a member of the board of overseers of the Weill Cornell Medical College. He is also the former chairman and CEO of American International Group (AIG). Greenberg stepped down as chief executive officer of AIG in March 2005 after building it into the world’s largest insurer over four decades.

Shortly thereafter, AIG paid $1.6 billion to settle claims by regulators. “To his accusers,” said the New York Times James Stewart in 2015, “Greenberg is just one in a line of disgraced chief executives from the mid-2000s who resorted to accounting fraud.” The State Attorney General’s Office pursued Greenberg in a 12-year New York State civil court action that was settled without any admission of wrongdoing on February 10, 2017.

A year before the settlement, the Starr Foundation made a $16 million gift to Yale, which renamed its signature leadership education initiative the Maurice R. Greenberg World Fellows Program. At the time, I questioned the propriety of an Ivy League school accepting millions from a potentially “toxic” donor. But four years later, in a post-Sackler/Epstein higher ed philanthropy landscape, Greenberg’s alleged financial chicanery seems relatively quaint in comparison. Time, context and a settlement without any admission of wrongdoing heals all wounds.

Case in point: A week after the Weill Cornell gift hit the wires, St. John’s University’s School of Risk Management (SRM) announced Greenberg would receive a “lifetime leadership” award. “Hank Greenberg is peerless,” said SRM board of overseers chairman Kevin Kelley. “He’s an icon, widely recognized as one of the most influential leaders in the world of insurance, financial services and beyond.”