The National Health Service Corps: Cutting Student Debt and Promoting Primary Care

By Christy Crisologo

It was Pauline Rolle’s grandmother who first opened her eyes to the needs of underserved communities in the United States.

“There are people all over the world who need you,” the pediatrician’s grandmother told her, “but there are also people right here who need you.” After completing her training, those words inspired Dr. Rolle to apply for the National Health Service Corps’s Loan Repayment Program. Today she works at the Duval County Health Department clinic in Jacksonville, FL, serving primarily Medicaid and uninsured patients.

“The program is just awesome — it’s just fabulous,” Dr. Rolle said in an article featured on the NHSC website. “The connectivity among public health providers, the conferences, and the educational credits that they offer — not to mention the support in terms of loan repayment — it’s just a tremendous blessing to me and my family.”

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A Win-Win Situation for Doctors and Communities

Dr. Rolle’s story is not unique. The National Health Service Corps (NHSC) is creating win-win situations for doctors and underserved communities in all 50 states and US territories by helping doctors finance their education—through scholarships and loan repayment—and then providing quality physicians to communities that need them.

“We have about one in five people in the United States — living in both urban and rural areas — that have shortages of [health care] providers,” said Kim Kleine, Acting Director of the National Health Service Corps. It is the goal of the Corps to reduce that shortage and meet the health care needs of underserved areas by helping finance the education of primary care providers who commit to serve those areas. “These primary care providers that are part of the National Health Service Corps are really important in the infrastructure of our country, because they are the ones giving care to the people who need it the most.”

While many overlook primary care in favor of other specialties, Kleine emphasized the importance of primary care as foundation of healthcare. “Those of us who are working in the National Health Service Corps day in and day out see the absolutely incredible benefit of what primary care can do in our country,” she said. “It really is the backbone of health care in terms of allowing people to get and stay healthy.” Many people without access to primary care forego preventative screenings, immunizations, and routine dental work, and often delay the health care they need.

Kleine acknowledged that the cost of education is a major reason that people don’t go into medicine, or choose a specialty other than primary care. “We know that medical school right now is really expensive,” she said. “There are lots of folks who have a dream of being a primary care provider and don’t pursue it because costs are so high to get an education.”

The assistance provided by the National Health Service Corps allows providers to focus on providing health care, rather than on the financial strain of their medical education. “You get a combination of incredibly talented and mission-driven folks [in the program],” Klein said. “They go back to these underserved communities and not only provide medical care, but become real leaders in the communities.”

The NHSC has developed three programs to help meet the financial needs of primary care providers with a desire to work in underserved areas. All NHSC members are paid a competitive salary in addition to support received through NHSC educational funding programs. Each program serves to match mission-driven health care providers with the communities that need them.

NHSC Scholarship Program

Students pursuing primary care careers in medicine and dentistry, as well as nurse care practitioners, certified nurse-midwives, and physician assistants can apply for the NHSC Scholarship Program. In addition to a scholarship covering their full tuition, the program provides a living stipend during their education. In return, scholars commit to serve in the Corps one year for each year of financial support they receive (with a minimum of two years’ service).

Through the Scholarship Program, “nearly 1,100 students, residents and health providers are right now in the pipeline,” Kleine said, “meaning the next generation of care providers will soon be graduating and going into the field in areas of our country that need it the most.”

After they have completed their training, scholars meet with NHSC regional teams who help them find a designated NHSC site in an underserved area that will be the best fit for the physician to practice.

“We like to match [scholars] to a site where they will find a career,” Kleine said. “We make such an investment in paying off their tuition that we want them to find a community that they love, that they feel connected to, and where they’ll want to stay long-term.”

Students pursuing a primary care career are eligible to apply for the NHSC Scholarship Program at any point in their education. Kleine encouraged anyone interested to sign up on the NHSC website to be notified as soon as applications are available.

NHSC Student to Service Loan Repayment Program

But what about students who don’t decide to pursue a career in primary care until the end of their schooling? The Student to Service (S2S) Loan Repayment Program provides an opportunity for fourth-year MD and DO students to receive $120,000 in loan repayment funds over the course of their residency training, in return for three years of service in an underserved area after they complete their training.

“We want to incentivize [students] to match to a primary care residency… and then work in a high-need area,” said Kleine. “[The S2S Program] gives them a head start on paying back their educational loans. If after those 3 years they still have educational debt, they can move into the Loan Repayment Program.”

NHSC Loan Repayment Program

The NHSC Loan Repayment Program offers up to $50,000 in tax-free loan repayment for licensed primary care medical, dental, and mental and behavioral health providers who commit to working at NHSC underserved sites for two years.

“If you still have education debt [after your initial time of service], you can apply for a continuation contract,” Kleine explained, “meaning you can stay in the Corps until your loans are completely paid off.”

The Loan Repayment Program is accepting applications on their website now through March 20. “I’d encourage people to apply early because it’s competitive,” Kleine said. Applicants must be employed at an NHSC site by July 15, 2014 in order to be eligible to receive loan repayment funds.
To help match providers with a site that fits their interests, the NHSC launched an innovative job center in 2012. The website — which is open to anyone, whether they are in the National Health Service Corps or not — uses Google Maps to allow users to search and explore which NHSC sites are recruiting and what positions they are recruiting for. “It’s been so successful, we’ve been getting more than 40,000 hits per month,” Kleine said. “It’s pretty incredible.”

Kleine also encouraged primary care providers who work in an underserved area that is not currently listed as an NHSC-approved site to contact the NHSC, as their facility may qualify to become an approved site.

Dedication to Serve the Underserved

A remarkable 85% of Health Service Corps providers stay and serve in their communities even after they have met their service requirements. Kleine credits this to the NHSC’s dedication to recruiting candidates who are committed to making a difference in underserved communities. She emphasized that health care providers should apply because they truly want to serve where there is a need, not just because they want to have their loans paid off.

“We’re really making an investment in them, and we want them to make an investment in those communities,” Kleine said. “We have such a high retention rate in the program, and such a committed and mission-driven Corps of providers… because we evaluate them on their desire and willingness to stay in the underserved communities. That’s a big piece of our evaluation.”

A Period of Historic Growth

Today more communities than ever are benefiting from the National Health Service Corps. “We’ve had historic growth in the NHSC due to the Affordable Care Act,” Kleine said. “The funding has allowed us to more than double the number of providers that are in service in our country…. You have more people than ever getting private insurance, and through our program you have more providers than ever serving our country… it has made historic opportunities for our nation right now in health care.”

There’s no better time to consider joining the National Health Service Corps in its mission to provide quality health care to the entire country, she said. “Having almost 9,000 providers across the country in every single state and US territory—you’re a part of something pretty big and something pretty special.”

For More Information:
National Health Service Corps Website
National Health Service Corps Facebook
National Health Service Corps Twitter

About the Author

Christy Crisologo is SDN’s Communications Manager and Editor-in-Chief. She earned her BA in Communications from Asbury University and lives in Texas with her husband (and primary connection to the medical world) and their two young children.