While tuition cost shouldnt necessarily be a deterrent from a career as a physician, the reality that the majority of medical students anticipate they will graduate with upwards of $150,000 in student-loan debtaccording to an AMA Insurance surveyis a daunting one.

Many students look for ways to lessen the tuition burden. Though not as widely available as they are for undergraduate study, medical school scholarships are available. It also can help save to stay in your state of residence for medical school and attend a public institution.

Paying public school tuitioneven for students who are not residents, in some casesis going to yield significant savings when compared with tuition costs at a private medical school.

A 2017 study based on tuition data gathered between 2006-16 found that the median cost of attendance for students paying in-state tuitionacross all statesover four years was $232,800. That figure compares favorably to the $306,200 four-year median cost of attendance for medical students attending private institutions over that time frame. Students attending public schools paying in-state tuition saved $73,400, according to the data.

That study also found that students paying in-state tuition had medical school debt loads that were about $20,000 lower than those attending private schools.

In-state tuition costs are always lower for residents, but the amount will vary. Based on data from the Association of American Medical Colleges, the most affordable medical school in the nation is Texas Tech University Health Sciences Center School of Medicine. For in-state medical students the current cost of tuition, student fees and health insurance is about $19,000 per year. For out-of-state students that number is around $32,000. That 40% tuition increase for out-of-state attendees is a fair baseline for how most states charge studentsthough there are some very notable exceptions.

That math was a factor for Avani Patel, MD, when she decided to attend the University of Mississippi School of Medicine in Jackson. Im someone who doesnt like the idea of debt, said Dr. Patel who will begin her residency training in the psychiatry program at Mississippi in July. If youre getting a very similar education, why would you pay more unless you want to pay more for the name or prestige?

Selecting a medical school requires a student to have some idea of what they envision their training experience to be. Dr. Patel valued hands-on clinical experience above other factors such as research opportunities, which made Mississippi a fit.

When I was researching medical schools, I knew affordability was important, so was being close to family and also feeling Id be very clinically strong, she said. I didnt want to go somewhere where I wouldnt have a ton of hands-on experience. Sometimes that doesnt happen at larger more prestigious institutions because they have to work down the hierarchy ladder [of other trainees]. They have fellows and residents to factor in, so you are going to be the last one to get any hands-on experience.

As far as factoring tuition cost into your decision, Dr. Patel views it as a something that is personal.

I always say self-awareness is key, Dr. Patel said. This is a choice that you have to make when youre very young but try to understand when youre researching [medical schools] what you are taking in terms of potential debt.

If youre interested in primary care and know you most likely [will] pursue primary care in your career it might make sense to go for a more affordable option. Its going to be less of a debt load, and youre going to get a great education. If youre looking to be the top neurosurgeon in the country and you need the top-notch research, for you it might be worth taking on a much higher debt load if it means going to an institution with the prestige and the resources that might be able to provide the opportunities you are looking for.

Medicine can be a career that is both challenging and highly rewarding, but figuring out a medical schools prerequisites and navigating the application process can be a challenge into itself. TheAMA premed glossary guidehas the answers to frequently asked questions about medical school, the application process, the MCAT and more.

Have peace of mind andget everything you need to start med school off strongwith the AMA.

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How much can you save by staying in-state for medical school? - American Medical Association