medical school is expensive.

醫學院是昂貴的。

But where is all of that tuition money going?

但這些學費都去哪兒了呢？

Is it actually going towards your education?

它是否真的用於你的教育？

Or is it just financing the dean’s second Lamborghini?

還是隻是資助院長的第二輛蘭博基尼？

Let’s find out.

讓我們拭目以待。

Dr. Jubbal, MedSchoolInsiders.com.

Jubbal博士，MedSchoolInsiders.com。

The average medical student graduates with around $242,000 of student loan debt with

醫科學生畢業時平均有大約242,000美元的學生貸款債務，其中包括

the vast majority of that coming from medical school tuition.

其中絕大部分來自醫學院的學費。

That’s a lot of money no matter who you’re talking to.

無論你和誰談，這都是一筆不小的數目。

But what makes medical school so expensive?

但是，是什麼讓醫學院的學費如此昂貴？

Has it always been like this?

它一直是這樣的嗎？

Not quite and here’s why.

並非如此，原因在此。

If you were a first-year medical student in 2000, you could expect to pay around $17,000

如果你是2000年的一年級醫學生，你可以預期支付大約17,000美元

per year in tuition.

每年的學費。

When adjusted for inflation, this comes out to about $26,000 per year.

按通貨膨脹率調整後，每年約為26,000美元。

This is by no means cheap; however, it’s significantly less than the numbers we’re

這決不是便宜的；然而，它大大低於我們的數字。

about to get into.

即將進入的。

Let’s fast forward to today.

讓我們快進到今天。

If you’re a first-year medical student starting this year, you can expect to pay around $55,000

如果你是今年開始的第一年醫學生，你可以預期支付大約55,000美元

per year in tuition – more than double what you would have paid just 20 years ago.

每年的學費--比你在20年前支付的學費高出一倍多。

Of course, this number is just an average and there are some medical schools that charge

當然，這個數字只是一個平均數，也有一些醫學院收取

less and others that charge more.

越來越少，而其他的則收費更高。

Regardless, that is around $220,000 just in tuition for four years of medical school.

不管怎麼說，僅醫學院四年的學費就有22萬美元左右。

This doesn’t take into account living expenses, transportation, and all of the other expenses

這還沒有考慮到生活費、交通費和其他所有的費用。

that will come up during your time in medical school.

你在醫學院期間會遇到的問題。

Unfortunately, it’s only getting more expensive as well.

不幸的是，它也只會越來越貴。

It’s estimated that the average cost of medical school rises by approximately $1500

據估計，醫學院的平均費用上升了約1500美元

each year.

每年都是如此。

Now that we know how much medical school in the US costs, where do these numbers come

現在我們知道了美國醫學院的費用，這些數字是怎麼來的？

from?

從？

Do medical schools just throw darts at a dartboard to decide how much to charge students?

醫學院是否只是向鏢靶投擲飛鏢來決定向學生收取多少錢？

Or is there a method to the madness?

或者說，瘋狂中是否有一種方法？

To start, running a medical school is expensive.

首先，辦一所醫學院是很昂貴的。

It takes tens of millions of dollars, if not more, just to keep things running each year.

僅僅為了維持每年的運行，就需要數千萬美元，甚至更多。

These costs can be broken down into two main categories: instructional costs and educational

這些費用可分為兩大類：教學費用和教育費用。

resources.

資源。

Instructional costs include any expenses that are directly related to teaching.

教學費用包括任何與教學直接相關的費用。

Professor salaries, simulation equipment, lab supplies, and actors for standardized

教授工資、模擬設備、實驗室用品和標準化的演員

patients would all fall into this category.

病人都會屬於這一類。

Another instructional expense that we don’t often consider is that medical schools generally

另一項我們不常考慮的教學費用是，醫學院一般會

have to pay hospitals and clinics to allow their students to rotate at their facilities.

必須向醫院和診所付費，以允許他們的學生在他們的設施中進行輪換。

Although this is a necessary part of the training to become a physician, the reality is that

雖然這是成為醫生的培訓的必要部分，但現實是

having medical students decreases productivity.

擁有醫科學生會降低生產力。

Teaching a student takes time away from clinical care and is an added responsibility for residents

教導學生需要佔用臨床護理的時間，是住院醫師的額外責任。

and attending physicians.

和主治醫生。

As such, medical schools often need to pay for the opportunity to have their students

是以，醫學院往往需要為學生的機會付費

rotate at these facilities.

在這些設施中進行輪換。

Educational resources are all of the other costs that don’t directly contribute to

教育資源是指所有其他不直接促成的費用

a student’s education but are still related to it.

雖說是學生的教育，但仍與之相關。

This includes administrator salaries, research activities, scholarships, access to databases,

這包括管理員工資、研究活動、獎學金、數據庫的使用。

and maintenance of facilities, to name a few.

和設施的維護，僅舉幾例。

Although these don’t always directly impact a student’s ability to learn, they are still

雖然這些並不總是直接影響學生的學習能力，但它們仍然是

necessary to keep the medical school or university up and running.

為保持醫學院或大學的正常運轉而必須的。

It’s estimated that instructional costs range from around $48,000 to $51,000 per student

據估計，每個學生的教學成本約為48,000美元至51,000美元。

per year and the cost of educational resources ranges from approximately $80,000 to $105,000

每年，教育資源的成本約為80,000美元至105,000美元。

per student per year.

每個學生每年的費用。

Combined, this is significantly higher than the tuition that most medical students pay

綜合來看，這大大高於大多數醫學生所支付的學費。

each year.

每年都是如此。

Naturally, your next question is probably, how do medical schools afford all of this

自然，你的下一個問題可能是，醫學院是如何負擔得起這一切的？

if not just tuition?

如果不只是學費？

The answer is that medical schools receive income primarily from four sources: tuition,

答案是，醫學院的收入主要來自四個方面：學費。

endowments, government funds, and medical services.

捐贈基金、政府基金和醫療服務。

The one you are probably most familiar with is tuition - the money that medical schools

你最熟悉的可能是學費--醫學院的學費。

receive from their students.

從他們的學生那裡得到的資訊。

Next, there are endowments, which are charitable donations from individuals or organizations.

其次是捐贈，這是個人或組織的慈善捐贈。

These may be physicians who graduated from the school or other members of the community

這些人可能是畢業於該校的醫生或社區的其他成員

that want to contribute to that school’s medical education.

希望為該校的醫學教育做出貢獻。

These charitable donations can vary from hundreds of dollars to tens of millions of dollars;

這些慈善捐款可能從數百美元到數千萬美元不等。

therefore, some schools rely on large numbers of small donations whereas others rely more

是以，一些學校依靠大量的小額捐款，而另一些學校則更多地依靠捐款。

on large individual donations.

在大額個人捐款上。

Most schools fall somewhere in the middle.

大多數學校都處於中間的某個位置。

After that, there’s government funding.

之後，還有政府資助。

This is taxpayer money that is allocated to medical schools for purposes of education

這是納稅人的錢，分配給醫學院用於教育的目的。

or research.

或研究。

Lastly, many academic medical institutions own hospitals and clinics and therefore generate

最後，許多學術醫療機構擁有醫院和診所，是以會產生

revenue from seeing and treating patients.

從看病和治療病人中獲得收入。

How much a school charges for tuition will depend on how much money they receive from

一所學校收取多少學費，將取決於他們從以下方面獲得多少資金

the government, endowments, and medical services.

政府、捐贈基金和醫療服務。

A school that receives more money from these sources will be able to charge less in tuition,

從這些來源獲得更多資金的學校將能夠收取更少的學費。

and vice versa.

反之亦然。

Allopathic medical schools tend to be affiliated with state universities and large academic

對抗療法醫學院往往附屬於州立大學和大型學術機構。

institutions.

機構。

As such, they tend to receive more funding from the government and generate more money

是以，他們往往從政府那裡獲得更多的資金，併產生更多的錢。

from medical services, both of which decrease tuition costs for students.

從醫療服務，這兩個方面都減少了學生的學費成本。

In contrast, osteopathic schools tend to be private institutions.

相比之下，骨科學校往往是私立機構。

They often receive little, if any, funding from the government and are often not associated

它們通常很少得到政府的資助，如果有的話，而且往往與政府無關。

with large medical institutions.

與大型醫療機構合作。

This is why osteopathic schools tend to charge their students higher tuition.

這就是為什麼骨科學校往往向學生收取更高的學費。

As an example, tuition may account for 10%, or less, of an allopathic medical school’s

例如，學費可能佔一個對抗療法醫學院的10%，甚至更少。

revenue, whereas it may account for as much as 15-50% of an osteopathic medical school’s

收入，而它可能佔骨科醫學院收入的15-50%。

revenue.

收入。

This is one explanation for the rapid increase that we are seeing in the cost of medical

這是我們看到的醫療費用快速增長的一個解釋。

education.

教育。

In recent years, there have been many budget cuts that have affected the state’s appropriations

近年來，有許多預算削減，影響了國家的撥款

for medical education.

用於醫學教育。

In short, government funding is decreasing.

簡而言之，政府資金正在減少。

As a result, these expenses are being passed onto students in the form of increased tuition.

是以，這些費用正以增加學費的形式轉嫁給學生。

If budget cuts continue to occur, we can expect tuition to continue to increase in the coming

如果預算削減繼續發生，我們可以預期在未來的日子裡，學費將繼續增加。

years.

年。

In addition to rising costs and decreasing funds, many people believe that there is another

除了成本上升和資金減少外，許多人認為，還有一個

factor at play that is driving up the price of medical school tuition – one that has

推動醫學院學費價格上漲的因素--一個已經

to do with supply and demand.

與供應和需求有關。

That being said, this is more theoretical than the previous two points, so take it with

話雖如此，這比前兩點更具理論性，所以請注意。

a grain of salt.

一粒鹽。

Medical school isn’t just expensive, it’s also highly competitive.

醫學院不僅昂貴，而且競爭也很激烈。

Each year, tens of thousands of high achieving students apply to US medical schools, and

每年都有數以萬計的成績優異的學生申請美國醫學院，而

less than half of them get in.

不到一半的人可以進入。

It’s only getting more competitive too as more students apply to medical school each

隨著越來越多的學生申請醫學院，競爭也越來越激烈。

year.

年。

If we take the most recent 2021-2022 medical school application cycle, for instance, there

如果我們以最近的2021-2022年醫學院申請週期為例，有

were approximately 10,000 more applicants to US MD schools compared to just the previous

與之前相比，美國醫學博士學校的申請者增加了約10,000人。

year despite their being relatively the same number of medical school spots.

儘管他們的醫學院名額相對相同，但在這一年裡，他們的成績卻不盡相同。

That’s an increase in applicants of approximately 18% in just one year.

這意味著在短短一年內，申請人增加了約18%。

Whether this past year is an outlier as a result of the global pandemic or a glimpse

無論過去的一年是由於全球大流行病而導致的一個例外，還是瞥見了

into what we can expect from here on out, nobody can say for certain; however, the general

對於我們從現在開始可以期待什麼，沒有人可以肯定地說；然而，一般的

trend has been that the number of applicants is increasing at a faster rate than the number

趨勢是，申請者人數的增長速度快於申請者人數的增長速度。

of new medical school spots.

的新醫科學校名額。

This creates a mismatch between supply and demand as there are many students that want

這就造成了供需之間的不匹配，因為有許多學生想要

to become doctors, but not enough medical school spots to accommodate them.

想成為醫生，但沒有足夠的醫學院名額來容納他們。

As such, some theorize that, in addition to driving up competitiveness, this is also driving

是以，一些人認為，除了推動競爭力的提高外，這也推動了

up tuition costs.

增長的學費成本。

As medical school admissions become increasingly competitive, fewer and fewer students have

隨著醫學院招生的競爭越來越激烈，越來越少的學生有

the luxury of choice.

奢侈的選擇。

Getting into medical school anywhere is an accomplishment, so students will often pay

進入任何地方的醫學院都是一項成就，所以學生往往會支付

whatever it costs to attend that school.

無論上該學校需要多少費用。

After all, what’s another $50,000 when you’re already taking out $300,000+ in loans?

畢竟，當你已經拿出30多萬美元的貸款時，再拿5萬美元又算得了什麼呢？

Medical students don’t usually have to worry about paying for school either as the government

醫科學生通常也不必為支付學費而擔心，因為政府

is happy to provide loans.

很高興能提供貸款。

Investing in a medical students education is a pretty low risk investment for the government

對政府來說，投資於醫學生的教育是一項相當低風險的投資。

as medicine is a relatively guaranteed path to a high salary and most physicians will

因為醫學是一條相對有保障的高薪之路，而且大多數醫生會

have the financial resources to pay back their loans.

有財政資源來償還貸款。

In addition, even if a physician goes bankrupt, student loans are more difficult to discharge

此外，即使醫生破產了，學生貸款也更難解除

than other types of loans which means that there is a high likelihood that they will

與其他類型的貸款相比，這意味著他們很有可能會

recoup their investment – plus interest of course.

收回他們的投資--當然還有利息。

As such, there is very little incentive for the government to intervene with the rising

是以，政府很少有動力去幹預不斷增長的經濟。

costs of medical education.

醫學教育的費用。

After all, medical schools still have fewer spots than there are applicants, so the rising

畢竟，醫學院的名額仍然少於申請者，是以，不斷上升的

cost of education is not affecting the number of physicians that are entering the workforce.

教育成本並沒有影響進入勞動力市場的醫生的數量。

This leads many to believe that medical schools are charging more for tuition simply because

這使許多人相信，醫學院收取更多的學費只是因為

they can.

他們可以。

It doesn’t matter what price they set, because there will be thousands of premeds who are

他們設定什麼價格並不重要，因為會有成千上萬的預科生在

willing to pay it and a government that’s ready to provide the loans to allow them to.

願意支付，並且政府準備提供貸款，讓他們支付。

It all comes down to competition.

這一切都歸結為競爭。

When you have multiple options, you can choose the one that is the best value.

當你有多種選擇時，你可以選擇一個最有價值的選擇。

When you only have one option, you’re forced to take what you can get.

當你只有一個選擇時，你就不得不接受你能得到的東西。

For example, let’s say there are a hundred premeds and each one gets into two medical

例如，假設有一百個預科生，每個人都能進入兩個醫療機構。

schools, one state school and one private school, each with 100 spots.

學校，一所公立學校和一所私立學校，每所學校有100個名額。

If the state medical school charges $30,000 per year in tuition and the private medical

如果州立醫學院每年收取30,000美元的學費，而私立醫學院每年收取30,000美元的學費。

school charges $50,000 per year in tuition, the student has the power to decide whether

學校每年收取50,000美元的學費，學生有權力決定是否

or not the extra $20,000 per year to attend the private school is worth it to them.

或每年多花2萬美元上私立學校對他們來說是否值得。

If it isn’t, they’ll choose the state school over the private school.

如果不是這樣，他們會選擇公立學校而不是私立學校。

If every student chooses the state school over the private school, the private school

如果每個學生都選擇了公立學校而不是私立學校，那麼私立學校

will eventually have to lower its tuition if it wants to compete.

如果它想競爭，最終將不得不降低其學費。

Now, let’s say there are 300 students.

現在，我們假設有300名學生。

Now there are enough premeds for both medical schools to fill all of their seats and then

現在有足夠的預科生來填補兩所醫學院的所有席位，然後

some.

一些。

In this second scenario, the power of choice is in the medical school’s hands so there’s

在第二種情況下，選擇權在醫學院的手中，所以有

no incentive to decrease costs.

沒有減少成本的動力。

There are enough students that they can fill their classes completely.

有足夠的學生，他們可以完全填補他們的課程。

In fact, they may even be able to increase costs if the only options are to go to their

事實上，如果唯一的選擇是去找他們，他們甚至可能會增加成本。

school or wait another year to apply.

學校或再等一年再申請。

This is another hypothesis for how the cost of medical education has been able to increase

這是關於醫學教育費用如何能夠增加的另一個假說

to the extent that it has.

到了這個程度。

In reality, the rising cost of medical education is the product of multiple factors.

在現實中，醫學教育成本的上升是多種因素的產物。

As with most things in life, it’s not so black and white that we can point to a singular

與生活中的大多數事情一樣，它不是那麼黑白分明，我們可以指出一個單一的

cause.

原因。

Regardless, the reality is that medical school is expensive, and it’s only going to get

不管怎麼說，現實是，醫學院的學費很貴，而且只會越來越貴。

more expensive in the years to come.

在未來的幾年裡會更加昂貴。

Although many of the points we’ve discussed in this video are beyond your control, that

儘管我們在本視頻中討論的許多要點都是你無法控制的，但這

doesn’t mean you are doomed to be hundreds of thousands of dollars in debt that you’ll

並不意味著你註定要欠下幾十萬美元的債務，你會

never be able to pay back.

永遠無法償還。

Instead, you should focus on the things that you can control – like becoming a highly

相反，你應該把重點放在你能控制的事情上--比如成為一個高素質的人。

competitive applicant that medical schools are willing to pay to go to their schools.

有競爭力的申請人，醫學院願意為他們的學校付費。

That’s right, if you’re a highly competitive and sought after applicant, medical schools

這是正確的，如果你是一個競爭激烈和受歡迎的申請人，醫學院

will try to win you over to attend their medical school by throwing money your way, which is

試圖通過向你扔錢來爭取你上他們的醫學院，這就是

how I got my entire medical school tuition and most of my living expenses covered.

我是如何得到整個醫學院的學費和大部分生活費用的。

There are multiple other advisors on MedSchoolInsiders.com that have also earned sizable scholarships

在MedSchoolInsiders.com上有多位其他顧問也獲得了可觀的獎學金。

or even full rides to medical school and have helped several of our clients earn them too.

甚至是醫學院的全額獎學金，並幫助我們的幾個客戶也獲得了這些獎學金。

This obviously can’t be guaranteed, but by working with these elite physicians, it’s

這顯然不能保證，但通過與這些精英醫生合作，它是

the best shot an applicant can have.

這是申請人可以擁有的最佳機會。

These are real doctors who were top performers that can show you exactly how they did it.

這些都是真正的醫生，他們都是表現出色的人，可以向你展示他們是如何做到的。

You’re not going to find this level of expertise and value anywhere else, because, simply put,

你不可能在其他地方找到這種水準的專業知識和價值，因為，簡單地說。

other advising companies weren’t built by and comprised of elite performers.

其他諮詢公司並不是由精英人士建立和組成的。

You can’t learn how to become a top performer and get a full ride merit-based scholarship

你不可能學會如何成為一個表現出色的人，並獲得全額的擇優獎學金

from a doctor who wasn’t able to do that themself.

從一個自己無法做到的醫生那裡。

If you want to be a stellar applicant and receive one-on-one advising, tutoring, interview

如果你想成為一名出色的申請人，並獲得一對一的指導、輔導、面試和培訓。

preparation, personal statement or secondary editing, mentorship, and more to become the

準備、個人陳述或二次編輯、導師指導，以及更多，以成為

strongest applicant you can be, visit MedSchoolInsiders.com.

你可以成為最強的申請人，請訪問MedSchoolInsiders.com。

Our services can help elevate you to become the kind of applicant that medical schools

我們的服務可以幫助你提升成為醫學院校的申請者。

pay to attend their school.

付費參加他們的學校。

Thank you all so much for watching.

非常感謝大家的觀看。

If you enjoyed this video, be sure to check out our videos on How to Afford Medical School

如果你喜歡這個視頻，請務必查看我們關於如何負擔得起醫學院的視頻

as well as our video on Student Loans 101.

以及我們關於學生貸款101的視頻。

Much love and I’ll see you there.

非常愛你，我們在那裡見。