WILLMAR -- When Dr. Paul Schulz meets each year with first-year students at the University of Minnesota School of Dentistry, he tells them: You've chosen a good career path; now how will you pay for your training?
"It has to be that idealistic spark that brings them there," said Schulz, a clinical associate professor at the School of Dentistry and director of the outreach program and mobile dental unit.
But students in the health professions also will be graduating with thousands of dollars' worth of debt, he said. "It's like buying a house and you haven't made a penny."
Regional health educators are working to increase the awareness of scholarship and loan repayment programs that help ease the financial burden.
The cost of training future dentists and doctors is substantial and climbing with each passing year. In 2010, the average student graduating from medical school in the U.S. owed $157,000 in educational loans, according to the American Medical Association. For students in dentistry, the average is close to $250,000.
Extra years of schooling add to the cost of becoming a pharmacist, physician assistant, nurse practitioner or other allied health professional as well.
Training costs can be a major deterrent to pursuing a career in the health professions, said Wendy Foley, program coordinator for the Southern Minnesota Area Health Education Center.
"We hear from some of the students that one of the barriers is 'I don't want to spend the rest of my life repaying student loans,'" she said. "We don't want the finances to be a barrier for not going to college. We are encouraging students to look at creative options on how to repay their student loans."
Private scholarships are one option. These can come from many sources; one example is the Affiliated Community Health Foundation, which gives scholarships to students in the southwestern and central Minnesota towns served by Affiliated Community Medical Centers who are pursuing careers in health care. Last year the foundation awarded more than 50 scholarships, 36 of them to medical students.
Growing numbers of students also are turning to state and national loan forgiveness programs to help them manage the repayment of their educational loans.
One of the largest is the National Health Service Corps, which offers both scholarships and loan repayment in exchange for working in medically underserved areas.
Within the past three years the program's size has more than tripled, both in funds available and number of applicants. The health care reform law passed last year included $1.5 billion for the National Health Service Corps. The program also received $300 million in federal stimulus money in 2009.
There are now a record 10,000 participants in the Corps, the federal government said last month. Demand for scholarships is so great that only about 20 percent of qualified applicants are funded.
Concern about training costs is very real, Schulz said.
Schulz, who grew up in Montevideo, applied for a National Health Service Corps scholarship while going through dentistry training in the 1980s.
"It paid all of my tuition, books, fees, lab fees -- everything," he said. "There didn't seem to be a down side."
In return, he spent three years working first in an underserved area in California and then at an inner-city dental clinic in Minneapolis.
Students who participate in the program generally get their pick of federally designated health professional shortage areas in which to locate, Schulz said. They can work solo or with other dentists who also act as mentors -- "plus you're getting experience," he said.
Awards start at $60,000 for two years of service in the Corps. Primary care providers who fulfill a five-year service commitment can receive up to $170,000 in loan repayment.
From Foley's perspective, there's another advantage to the National Health Service Corps program: It helps shore up the rural health care work force by bringing clinicians to underserved areas, some of whom may choose to settle there after their obligation is paid.
There's a demonstrated link between rural exposure and where students ultimately decide to practice, she said. "When students have the opportunity to actually be able to serve in a rural community, it gives them a view of what rural life is about."
"That's the other outcome we're looking for," Schulz agreed.
More than 20 years after completing his training, Schulz is still involved in rural outreach. He visits Willmar often to teach in the Rice Regional Dental Clinic, a training program that partners with the University of Minnesota to provide rural experience to dentistry students while bringing dental care to an underserved low-income population.
The National Health Service Corps "isn't a good fit for everyone," but it's a viable option for students seeking help with their training costs and willing to do community service, he said. "The scholarships are available. The loan repayment is available. I talk about this to students every year."