ACS Views on Legislative, Regulatory, and Other Issues

Graduate Medical Education—

• Background
• Other Activity: COGME and MedPAC
• Resident Work Hours

• ACS letter to The Honorable Phil English on the Higher Education Act, 5/24/05
• Letter to The Honorable Mark McClellan, MD, PhD, 6/12/04 (Re: Comments on Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2005 Rates, Proposed Rule [CMS-1428-P]
• ACS Letter to COGME on Workforce Study, 4/30/04
• Physician Coalition Senate Letter on Higher Education Act, 4/19/04
• Physician Coalition House Letter on Higher Education Act, 4/19/04
• ACS Senate Letter on Higher Education Act, 3/30/04
• ACS House Letter on Higher Education Act, 3/30/04
• Letter to Secretary Thompson on Unused Resident Positions, 3/8/04
• Letter to David C. Leach, 8/1/02
• Letter to David C. Leach, 6/6/02

March 30, 2004

The Honorable John Boehner
House Education and the Workforce Committee
2181 Rayburn House Office Building
Washington, DC 20515

Dear Chairman Boehner:

On behalf of the 66,000 Fellows of the American College of Surgeons, I would like to bring to your attention two issues that we hope you will address during the Higher Education Act reauthorization process: extending the economic hardship deferment and increasing the subsidized Federal Stafford loan limit.

As you know, the federal economic hardship deferment allows graduates to defer repayment of their student loans for up to three years if they exceed a federally defined debt-to-income ratio. Many physicians qualify for this deferment during the initial years of their medical residency. However, surgeons, depending on their specialty, must complete between four to seven years of residency training.

We believe the economic hardship deferment should be extended to "the length of a medical or dental internship or residency that must be successfully completed before the borrower may begin professional practice or service, or for the length of time they are in a medical or dental internship or residency leading to a degree or certificate awarded by a hospital or health care facility which offers postgraduate training." This would make the economic hardship deferment consistent with the current guidelines regulating mandatory forbearance for medical residents and remove an obstacle facing aspiring surgeons.

In addition, we urge you to consider increasing the annual limit on subsidized Federal Stafford loans to $12,000 per year. This modest increase would approximately account for the cost of inflation since the limits were last raised in 1992. Most importantly, it will help lower loan interest costs for indebted medical students who are currently graduating with an average student loan debt of $109,457.

We look forward to working with you on these issues throughout the reauthorization process. If you have any additional questions, please contact Jennette Lawrence in our Washington office at 202-672-1517.

Sincerely,

Thomas R. Russell, MD FACS
Executive Director

cc: Members of the House Education and the Workforce Committee

Revised March 7, 2005

ACS Views on Legislative, Regulatory, and Other Issues

Advocacy and Health Policy