The American Dental Education Association

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1 Association Report Survey of Dental Student Financial Assistance, Richard G. Weaver, D.D.S.; N. Karl Haden, Ph.D.; Richard W. Valachovic, D.M.D., M.P.H. Abstract: The American Dental Education Association s Survey of Dental Student Financial Assistance obtained data by which to report, in aggregate and by type of school, the amount of financial assistance being received by dental students, in the form of loans, grants and scholarships, and work-study programs. Over 90 percent of the dental students received financial assistance through one or more federal, state, and/or school source. The average amount of assistance per student was $35,100, ranging from an average of $27,700 at public dental schools to $51,100 at private dental schools. Loan programs accounted for almost 88 percent of all financial assistance; grants and scholarships, for 12 percent; work-study programs, for 0.2 percent. Overall, financial assistance exceeded average tuition and fees by 102 percent. With such levels of reliance on financial assistance, it remains imperative that students, even at the undergraduate level, receive the counseling, monitoring, and advice that will help them judiciously seek and manage appropriate types and amounts of financial assistance as they obtain their dental education. Dr. Weaver is Associate Director, Center for Educational Policy and Research; Dr. Haden is Associate Executive Director, Center for Educational Policy and Research; and Dr. Valachovic is Executive Director all at the American Dental Education Association. Direct correspondence and requests for reprints to Dr. Richard G. Weaver, American Dental Education Association, 1625 Massachusetts Avenue, NW, Washington, DC, 20036: phone; fax; WeaverR@ADEA.org. Key words: financial assistance, sources of financial assistance The American Dental Education Association obtained data on student financial assistance for academic year Fifty-one of the fifty-four U.S. dental schools submitted the requested survey data (thirty-four of thirty-five public schools, twelve of fourteen private schools, and five of five private state-related schools). The enrollment of the fifty-one schools is 89.7 percent of the total dental school enrollment. This report presents the findings in aggregate of and individually by federal, state, and school grants and scholarships, loans, and work-study programs. Though requested, the availability of data from school financial aid offices specific to student assistance through family loans and gifts, personal bank loans, and credit card loans is apparently very limited. Therefore these sources of financial assistance are not part of the summary report. Since there are large differences in tuition and fees between public, private, and private state-related dental schools, the findings are presented also by type of school, as well as in aggregate for all schools. Findings Percent of Students Receiving Financial Assistance The percent of dental students receiving financial assistance from one or more federal, state, and/ or school source was 90.2 percent in academic year (Table 1). This continues the increases from academic year when 82.3 percent of the students received such financial assistance. The percent of students receiving financial assistance varied slightly by type of school. For the academic year, 89.1 percent of public school Table 1. Percent of dental students receiving financial assistance through federal, state, and/or school sources % 85.8% 87.8% 90.2% January 2004 Journal of Dental Education 89

2 students received assistance. It was 92.8 percent in private schools and 88.5 percent in private state-related schools. There was a slight decline in the percent of students receiving assistance as they progressed through school, falling from 91.3 percent in the first year to 87.7 percent in the fourth year. Average Annual Assistance Per Student The average amount of financial assistance per student during the academic year was calculated by dividing the total amount of assistance disbursed through the federal, state, and school grant and scholarship, loan, and work-study programs by the number of students who received the assistance. The average for all schools was $35,100 per student (Table 2). At public schools, the average assistance per student was $27,700. It was $51,100 at private schools and $31,000 at the private state-related schools. There was a tendency for the average amount of financial assistance for first-year students ($34,900) to be slightly less than the average assistance per all students. This increased to slightly above the average per all students in the second year ($35,700) and third year ($36,400), falling back below the average in the fourth year ($33,200). The average amount of financial assistance per student at all dental schools increased 7 percent between and The percent increase during this time was 11.2 at public dental schools. The increase was over 25 percent at the private schools. There was a reported 7.7 percent decrease at the private state-related schools. Over the last decade, financial assistance has averaged an annual increase of almost 9 percent. The average increase per year has been about 10.5 percent at the public dental schools. It has been about 9 percent at the private schools and slightly over 3 percent at the private state-related schools. For comparison, average resident dental school tuition and fees increased 16.5 percent between and (Table 3). The percent increase during this time was 18.5 percent at public dental schools. The increase was 15.3 and 14.4 percent, respectively, at private and private state-related dental schools. Since , the average resident tuition and fees have increased almost 85 percent, for an average annual increase of 7.7 percent. The average increase per year has been 9.9 percent at the public dental schools. It has been 7.0 and 5.3 percent, respectively, at the private and private state-related schools. Comparing annual increases in financial assistance with annual increases in tuition and fees, we see that financial assistance over the past decade has increased at a slightly greater rate than tuition and fees, except as reported by the private state-related schools (Table 4). Table 2. Average annual financial assistance per student by type of school Type of School Last % Change All Schools $17,700 $23,200 $28,400 $32,800 $35, % Public $12,900 $17,100 $22,100 $24,900 $27, % Private $26,000 $32,600 $39,100 $40,700 $51, % Private State-Related $23,000 $28,900 $30,500 $33,600 $31, % Table 3. Average first-year resident tuition and fees by type of school Type of School Last % Change All Schools $9,427 $11,436 $13,549 $14,952 $17, % Public $5,106 $6,723 $8,088 $8,983 $10, % Private $18,686 $22,553 $26,371 $28,688 $33, % Private State-Related $14,917 $14,844 $19,538 $20,590 $23, % Source: American Dental Association. Respective surveys of predoctoral dental education institutions, tuition, admission, and attrition, volume Journal of Dental Education Volume 68, Number 1

3 Table 4. Average annual increases in financial assistance and tuition and fees, by type of school, Average Annual Increases Financial Assistance Tuition and Fees All Schools 8.9% 7.7% Public Schools 10.4% 9.9% Private Schools 8.8% 7.0% Private State-Related Schools 3.2% 5.3% To meet costs of books, supplies, materials, and instruments, as well as living expenses, financial assistance exceeds just dental school tuition and fees. Figure 1 displays the relationship between financial assistance and tuition and fees by type of school. Overall, average financial assistance exceeded average tuition and fees by 102 percent. Average financial assistance at public schools exceeded average tuition and fees by 160 percent. This was 55 percent at private schools and 32 percent at private state-related schools. Student Financial Assistance by Source of Assistance Student financial assistance at the fifty-one reporting dental schools totaled almost million dollars (Table 5). Almost 88 percent of the assistance was in the form of federal, state, school, and private loans; 12 percent was as grants and scholarships; and 0.2 percent was through work-study programs (Figure 2). These percentages are the same as those reported for Table 5 also displays the percentages of financial assistance by source by type of school. As a percentage of total assistance, public schools distributed slightly less of their assistance in the form of loans and more in grants and scholarships than private and private state-related schools. These percentages are all within plus or minus one point of those reported for All Schools Public Schools 160% 102% Private Schools 55% Private State-Related Schools 32% 0 5,000 10,000 15,000 20,000 25,000 30,000 35,000 40,000 45,000 50,000 All Schools Public Schools Private Schools Private State-Related Schools Tuition and Fees Figure 1. Average student financial assistance and the percent by which it exceeded average tuition and fees, by type of school, January 2004 Journal of Dental Education 91

4 Table 5. Student financial assistance by source of assistance, Schools Loans $407,221,741 $197,465,080 $161,572,912 $48,183,749 Percent of Total 87.8% 85.8% 89.7% 90.1% Grants/Scholarships $55,648,612 $31,963,464 $18,388,705 $5,296,443 Percent of Total 12.0% 13.9% 10.2% 9.9% Work Study $899,658 $695,572 $204,086 $0 Percent of Total 0.2% 0.3% 0.1% 0% Total $463,770,011 $230,124,116 $180,165,703 $53,480,192 Table 6. Average amount of Stafford loans by type of school Schools Stafford Loans, Subsidized $8,202 $8,108 $8,333 $8,415 (percent of total loans 28.2%) Percent Student Usage 91.3% 90.3% 91.7% 96.0% Stafford Loans, Unsubsidized $18,396 $15,452 $23,826 $27,268 (percent of total loans 54.7%) Percent Student Usage 83.2% 82.8% 81.7% 91.3% Stafford loans accounted for 82.9 percent of total loans. Profile of Student Loan Programs The Stafford Student Loan Program is the primary source of financial assistance for dental students. Stafford loans accounted for 82.9 percent of the total reported student loans. This is most similar to the percentage reported in (81.4 percent). Eligibility for a Stafford loan is determined through a needs-analysis system established by law. The program has a subsidized component (interest does not accrue while in school) and an unsubsidized component (interest accrues while in school). About 91.5 percent of the students reported to have received financial assistance in participated in the subsidized Stafford loan program. The maximum annual amount of funds that could be borrowed through the subsidized Stafford loan program was $8, % Loans Grants/Scholarships Work Study 0.2% 12.0% Figure 2. Student financial assistance by source of assistance for all schools, Journal of Dental Education Volume 68, Number 1

5 The average subsidized Stafford loan was $8,202 (Table 6). The average was $8,108 at public dental schools; $8,333 at private dental schools; and $8,415 at private state-related dental schools. A little over 83 percent of the students receiving financial assistance borrowed through the unsubsidized Stafford loan program. The maximum annual amount of funds that can be borrowed through the unsubsidized Stafford loan program is $30,000. The average unsubsidized Stafford loan was $18,396. While borrowing through the subsidized Stafford loan program was similar by type of school, there is a noteworthy difference in unsubsidized Stafford loan borrowing. The average was $15,452 at public dental schools; $23,826 at private dental schools; and $27,268 at private state-related dental schools. The Perkins Loan Program (Table 7) is available for students who are able to demonstrate financial need to meet their educational expenses. The annual maximum amount for this program is $6,000. However, dollar amounts in this revolving loan program at participating schools are limited. Therefore, average loan amounts do not approach the maximum. Thirty-four schools reported Perkins loans. The average Perkins loan in was for $3,350. The amount was $3,211 at public schools and $3,589 and $4,065 respectively, at private and private staterelated schools. Almost 25 percent of students receiving financial assistance borrowed through the Perkins Loan Program. The loan utilization rate varied by type of school, with a 27.3 percent usage at public schools, 23.8 percent at private schools, and 8.7 percent usage at private state-related schools. Comparing with , the percent usage of this loan increased noticeably at private schools, from about 17 to almost 24 percent. The increase was by three percentage points at private state-related schools. Also the amount of the loans were sizably larger at the private and private state-related schools than they were in , at over 41 and 66 percent, respectively. The Health Professions Student Loan Program is a low interest revolving loan program, funded and administered through the Bureau of Health Professions, Health Resources, and Services Administration, Department of Health and Human Services. Participating schools manage the funds and are responsible for selecting loan recipients. The loans are made only to students who have demonstrated financial need (with parental information being considered even though the student may be independent). Forty-six of the fifty-one reporting dental schools indicated students receiving these loans. Almost 21 percent of the students receiving financial assistance borrowed from this program (Table 8). The participation rate at private schools (13.3 percent) was much less than at the public (24 percent) and private state-related schools (25.8 percent), a difference noted also in the report. The annual borrowing limit for this program may equal but not exceed the cost of attendance (tuition, reasonable educational expenses, and reasonable living expenses). However, schools do not have funds sufficient for making loans of these amounts. The average loan was $7,644, with the highest average of $9,378 borrowed by students enrolled at the private schools. The average was $7,098 at public schools and $8,046 at private state-related schools. The Loans for Disadvantaged Students Program is also funded and administered through the Bureau of Health Professions, Health Resources, and Services Administration. It has the same requirements as the Health Professions Student Loan Program, Table 7. Average amount of Perkins loans by type of school Perkins Loan Program $3,350 $3,211 $3,589 $4,065 (percent of total loans: 2.7%) Percent Student Usage 24.5% 27.3% 23.8% 8.7% Table 8. Average amount of Health Professions Student Loans by type of school Health Professions Student Loan $7,644 $7,098 $9,378 $8,046 (percent of total loans: 5.3%) Percent Student Usage 20.9% 24.0% 13.3% 25.8% January 2004 Journal of Dental Education 93

6 except that the recipient must come from a disadvantaged background. Twenty-three schools reported loan amounts for this program, but only six schools reported the number of students receiving these loans. From the limited data provided, in the aggregate, the average loan amount was $5,637 (Table 9). At these schools, 5.4 percent of the students who received financial assistance received disadvantaged student loans. The annual borrowing limit for this program may equal but not exceed the cost of attendance (tuition, reasonable educational expenses, and reasonable living expenses). With limited loan funds available, though, the participating schools do not have funds sufficient to make loans of these amounts. The Alternative Dental Education Assistance Loan (ADEAL) program is a private, cost-based loan that allows students to borrow up to the cost of attending school, minus other financial assistance. Twenty-two schools reported loan totals (nine public schools, ten private schools, and three private state-related schools), but only eleven reported the number of students who received these loans. At these eleven schools, the average loan through this program was $11,924 in (Table 10). The average was $7,692 at public schools and $14,041 and $6,349, respectively, at private and private state-related schools. Over 20 percent of the private dental school students receiving financial assistance obtained ADEAL loans. It was 12.3 percent of public and private state-related dental school students. While the average amount of individual ADEAL loans has increased since , the total dollar amount of ADEAL loans as a percent of total dollars in loans to students has declined from 2.2 to 1.9 percent. The decline in usage of this loan program is due to the increase in the maximum loan amount authorized for the unsubsidized Stafford loan program in There are Other Private Lender Loan programs available that operate similarly to the ADEAL program. Thirty-nine schools reported loan amounts from these programs (twenty-three public schools, twelve private schools, and four private state-related schools); only fourteen of the schools reported the number of students receiving these loans. At these fourteen schools, the average other private lender loan amount was $16,040 (Table 11). The average loan amount was $8,946 at the reporting public schools, and $18,118 and $7,475 respectively at the reporting private and private state-related schools. Over 24 percent of the students receiving financial assistance at the reporting private schools received these loans, followed by almost 18 percent at the private state-related schools. Student usage of these loan programs was 4.5 percent at the reporting public schools. The total dollar amount of this loan program as a percent of total dollars in loans to students declined from 7.5 to 5.2 percent since , due to the increase in the maximum loan amount authorized for the unsubsidized Stafford loan program in 1997; but it is still a rather highly used program by Table 9. Average amount of Loans for Disadvantaged Students by type of school Loans for Disadvantaged Students $5, (percent of total loans: 0.3%) Percent Student Usage 5.4% Table 10. Average amount of Alternative Dental Education Assistance Loans by type of school ADEAL Loans $11,924 $7,692 $14,041 $6,349 (percent of total loans:1.9%) Percent Student Usage 16.9% 12.3% 20.2% 12.3% Table 11. Average amount of assistance by other private lender loan programs by type of school Other Private Loan Programs $16,040 $8,946 $18,118 $7,475 (percent of total loans: 5.2%) Percent Student Usage 20.5% 4.5% 24.4% 17.6% 94 Journal of Dental Education Volume 68, Number 1

7 Table 12. Average amount of state and school loans by type of school State Loan Programs Incomplete Reporting $6,407 Incomplete Reporting Incomplete Reporting (percent of total loans: 0.5%) Percent Student Usage School Loan Programs Incomplete Reporting $3,101 $4,526 Incomplete Reporting (percent of total loans: 1.0%) Percent Student Usage students at the private and private state-related schools. State and School Loan programs are presented in Table 12. Nine public schools reported students received loans through a state program. Only four of the schools reported the number of students (269) receiving such loans. The average state loan amount at these four schools was $6,402, with percent student usage ranging from about 10 to almost 55 percent. One private school and two private staterelated schools reported students receiving a state loan. However, the number of students receiving such loans was not reported. Total amount of loans at these three schools was less than $70,000. State loans accounted for about 0.5 percent of the total loan amount made to dental students in Twenty-four schools reported having a school loan program: fourteen public, nine private, and one private state-related. This is down from thirty-eight schools reporting such loan programs in Nine of the public schools reported the number of students receiving school loans, which at these nine schools averaged $3,101. Percent student use of school loans at the public schools ranged from 9.3 to 100 percent; with two schools at less than 10 percent, four schools in the area of 15 to 22 percent, and two schools at about 38 percent. Six of the nine private schools reported the number of students receiving school loans, which at these six schools averaged $4,526. Percent student use of school loans at the private schools ranged from 4.5 to 44 percent, with four of the six schools reporting a use of almost 25 percent or greater. School loans accounted for 1 percent of the financial assistance provided through loans. Other types of loans were reported by five public schools, two private schools, and one private staterelated school. Only two of the schools reported the number of students that received these loans. The total reported amount of these loans was $442,500, about 0.1 percent of financial assistance through loans. From the information provided, and from prior financial assistance reports, the loan programs are limited to a few schools, few students receive these loans, and the loan amounts are relatively small. Summary of the Loan Programs Figure 3 and Table 13 provide a composite summary of the loan programs by displaying the percentage each loan program was of the total financial Table 13. Percent of total dollar amount of loans and percent use of loan programs by students receiving financial assistance by type of school Loan Program Percent of Public School Use Private School Use Private State-Related Loan Dollars School Use Stafford Loan (sub) 28.2% 90.3% 91.7% 96.0% Stafford Loan (unsub) 54.7% 83.2% 81.7% 91.3% Perkins Loan 2.7% 27.3% 23.8% 8.7% Health Professions Student Loan 5.3% 24.0% 13.3% 25.8% Loans for Disadvantaged Students 0.3% Dental Education Assistance Loan 1.9% 12.3% 20.2% 12.3% Other Private Lender Loan 5.2% 4.5% 24.4% 17.6% State Loan 0.5% School Loan 1% Other 0.1% January 2004 Journal of Dental Education 95

8 assistance disbursed through loans, the average loan amount by type of loan program by type of school, and the percent use of the loan programs by students by type of school (when sufficient data were provided to compute these various fields). Overall, federal, state, school, and private loans accounted for almost 88 percent of student financial assistance in , the same percentage as was reported in The Stafford loan program was the primary source of student loans, comprising 82.9 percent of the total amount of student loans, up slightly from about 81.4 percent in Over 90 percent of the students receiving financial assistance obtained subsidized Stafford loans; over 83 percent obtained additional support borrowing through the unsubsidized program. Total Stafford loan borrowing per student averaged about $23,550 at public dental schools, $32,160 at private schools, and $35,680 at private state-related schools. While the limit for the subsidized Stafford loan program has remained at $8,500 per student per year, borrowing through the unsubsidized Stafford loan program has continued to increase since the maximum loan amount for this program was raised in The unsubsidized Stafford loan program accounted for almost 55 percent of the total amount of loans in ; it was 52 percent in ; and 35.4 percent in The increased limit to the unsubsidized Stafford loan program (up to $30,000 per year) has effected a continuing decline in the use of the ADEAL and other private lender loans. While loan amounts under these programs are relatively large (average ADEAL is $11,924; average other private lender loan is $16,040), these two programs accounted for only 7.2 percent of the total financial assistance obtained through the various loan programs. About 17 percent of the public dental school students who received financial assistance obtained ADEAL or other private lender loans. Use of these loans was almost 45 percent at private schools and 30 percent at private state-related schools. The Health Professions Student Loan program was the next largest source of loans, at 5.3 percent of Other Loan (0.1%) School Loan (1.0%) State Loan (0.5%) Other Private Loan (5.2%) ADEAL Loan (1.9%) Disadvantaged Student Loan (0.3%) Health Professions Student Loan (5.3%) Perkins Loan (2.7%) Stafford Loan (unsub) (54.7%) Stafford Loan (sub) (28.2%) Pri. State-Related Schools Private Schools Public Schools (% of total loans) $0 $4,000 $8,000 $12,000 $16,000 $20,000 $24,000 $28,000 $32,000 Figure 3. Average amount of loans by type of school 96 Journal of Dental Education Volume 68, Number 1

9 the total loan amount; followed by the Perkins loan program, at 2.7 percent. While these two loan programs had relatively high usage, at 21 and 25 percent respectively, loan amounts were relatively small, at about $7,650 and $3,350 respectively. Incomplete reporting of students receiving state and school loans limited any determination of average loan amounts. But the percentages of the total financial assistance through these programs, at 0.5 percent for state loan programs and 1 percent for school loan programs, were similar to what was reported in However, the twelve schools reporting state loan programs in were two less than the number reporting in Also the twenty-four schools reporting school loan programs were down from the 38 reporting these programs in The program of loans for disadvantaged students is small. It comprised 0.3 percent of total loans in , up slightly from Incomplete reporting of the number of students receiving this assistance precluded a determination of average loan amount by type of school; but of the limited information provided, in the aggregate, the average loan amount was almost $5,640, up from $3,940 reported in Profile of Student Grants and Scholarships Grants and scholarships made up 12 percent of student financial assistance in (Table 5), the same as in This ranged from 13.9 percent of student financial assistance at public dental schools to 9.9 percent at private state-related dental schools. It was 10.2 percent at private dental schools. Of the $55,648,612 awarded in grants and scholarships, over 69 percent was from programs that did not have a payback service obligation following graduation. The largest component of student financial assistance through grants and scholarships was unobligated School-Funded Grants and Scholarships, comprising over 42 percent of all grant and scholarship dollars (Table 14). Forty-nine of the fifty-one reporting schools indicated they had such programs. Almost 36 percent of the students receiving financial assistance received such grants and scholarships, most similar to the percentage reported in The average award was $4,772, up from $4,443 in Public schools had a recipient rate of 41 percent, with an average award of $4,249. Private schools had a student recipient rate of 25.8 percent, with an average award of $6,874. The average award was $3,589 at private state-related schools, with 31.5 percent of students receiving financial assistance receiving unobligated school-funded grants and scholarships. Unobligated Non-School Funded Grants and Scholarships from states, foundations, or other public/private organizations was the third largest source of grants and scholarships, comprising almost 18 percent of all grant and scholarship dollars, another percentage similar to that reported in (Table 15). The average award from these sources was $4,266, with 16.4 percent of the students receiving such awards. Private state-related schools had the highest percentage of students receiving awards at 23.4 percent, but the lowest amount of average award at $2,705. Almost 22 percent of public school Table 14. Average amount of unobligated school-funded grants and scholarships by type of school School-Funded Grants/Scholarships $4,772 $4,249 $6,874 $3,589 (percent of total gts/schships: 42.2%) Student Recipient Rate 35.5% 41% 25.8% 31.5% Table 15. Average amount of non-school funded grants and scholarships by type of school Non-School Funded Grants/Scholarships $4,266 $4,019 $10,882 $2,705 (percent of total gts/schships: 17.8%) Student Recipient Rate 16.4% 21.9% 3.3% 23.4% January 2004 Journal of Dental Education 97

10 Table 16. Average amount of scholarships for disadvantaged students by type of school Scholarships for Disadvantaged Students $6,187 $6,106 $6,824 $4,854 (percent of total gts/schships: 9.4%) Student Recipient Rate 5.4% 6.5% 3.8% 3.4% Table 17. Average amount of scholarships for the uniformed services, Indian Health Service, and National Health Service Corps by type of school Uniformed Services/IHS/NHSC Scholarships $28,159 $20,705 $37,468 $30,807 (percent of total gts/schships: 29.3%) Student Recipient Rate Table 18. Average amount of state-funded obligated grants/scholarships by type of school Obligated State Grants/Scholarships - $1,580 $8,436 - (percent of total gts/schships: 1%) Student Recipient Rate students who received financial assistance received non-school funded grants and scholarships, with an average award amount of $4,019. There was a decline in these type of grants and scholarships at the private schools, recipients falling from 7 to 3.3 percent. However, it appears that the fewer students who received this type of award received larger amounts of support, increasing from an average of $5,315 in to almost $11,000 in In 1998, the federal Exceptional Financial Need Scholarship program and the program of Financial Assistance for Disadvantaged Health Professional Students were folded into the federally supported and financially unobligating program of Scholarships for Disadvantaged Students. Participating schools have to apply for these funds each year. This combined program of scholarships in accounted for 9.4 percent of the total amount of student financial assistance through grants and scholarships (Table 16). In , the three programs accounted for almost 13 percent of assistance through grants and scholarships. Thirty-five dental schools reported making these scholarship awards in , down from forty schools reporting scholarships for disadvantaged students in While the annual maximum award may be equal to the financial needs of the student (from a disadvantaged background), schools do not have sufficient funds to make awards of that amount. The average award was $6,187. The percent of students receiving awards ranged from 3.4 percent for private state-related schools to 6.5 percent for public schools. Average awards ranged from $4,854 at private state-related schools to $6,824 at private schools. Under the arrangement of programs, a few students received scholarships that averaged $14,000 to $15,000, while most students under the programs received average awards of $2,250. Almost 31 percent of the financial assistance provided through grants and scholarships had service obligation requirements. Of these grants and scholarships, those provided by the Army, Navy, and Air Force, the Indian Health Service (IHS), and the National Health Service Corps (NHSC) made up over 29 percent of all grant and scholarship funds (Table 17). Twelve schools reported NHSC scholarships, but not the number of students receiving these awards. Two schools reported IHS scholarships, but not the number of students receiving these awards. Forty schools reported uniformed service scholarships; twenty-two provided the number of students receiving the awards (n=466). The dollar amounts in Table 17 pertain to these twenty-two schools. The average award at these schools was $28,159. However, since the scholarships cover educational costs (tuition, fees, books, materials, and supplies) plus a stipend for liv- 98 Journal of Dental Education Volume 68, Number 1

11 ing expenses, the average amount of the scholarships varied greatly by type of school. The average amount was $20,705 at public schools, $37,468 at private schools, and $30,807 at private state-related schools. Nine schools (seven public, one private, one private state-related) reported students receiving State Grants and Scholarships with Service Obligations (Table 18). Eighteen schools reported such grants and scholarships in In , these grants and scholarships comprised almost 5 percent of the total financial assistance through grants and scholarships; it was 1 percent in Only four schools provided the number of students who received these types of grants and scholarships. At the three public schools, the average award was $1,580; at the private school, the average award amount was $8,436. These averages are less than those reported in Various entities offer grants and scholarships with unique eligibility requirements. Only eight schools reported such awards, accounting for 0.3 percent of the total funds disbursed through grants and scholarships. No schools reported the number of students receiving such awards. Therefore, no average award amounts are available. Summary of Grant/Scholarship Programs Figure 4 and Table 19 provide a composite summary of the grant/scholarship programs by displaying the percentage each grant/scholarship program was of the total financial assistance disbursed through grants and scholarships, the average award amount by type of program by type of school, and the percent of financially assisted students who received the awards by type of school. School-funded and non-school-funded grants and scholarships that had no service obligation requirements accounted for 60 percent of the financial assistance disbursed through programs of grants and scholarships. This is the same percentage as reported in These grants and scholarships also had the largest number of student recipients. In particular, 41 percent of the public dental school students who received financial assistance received an unob- Other (obligated) (0.3 %) State Funded (obligated) (1.0 %) Uniformed Services/IHS/NHSC (29.3 %) Disadvantaged Students (9.4 %) Non-School Funded (unobligated) (17.8 %) School Funded (unobligated) (42.2 %) Pri. State-Related Schools Private Schools Public Schools $0 $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 (% of total grants/scholarships) Figure 4. Average amount of grants and scholarships by type of school January 2004 Journal of Dental Education 99

12 Table 19. Percent of total dollars disbursed and financially assisted students receiving grants/scholarships by type of school Grant/Scholarship Program % of Dollars Public School Use Private School Use Private State-Related Disbursed School Use School Funded (unobligated) 42.2% 41% 25.8% 31.5% Non-School Funded (unobligated) 17.8% 21.9% 3.3% 23.4% Disadvantaged Students 9.4% 6.5% 3.8% 3.4% Uniformed Services/IHS/NHSC 29.3% State Funded (obligated) 1% Other (obligated) 0.3% Table 20. Average amount of work-study support by type of program and type of school Federal Work-Study Program $1,768 $2,101 $1,048 0 Percent Student Usage 2.9% 3.2% 3.4% 0 School Work-Study Program $2,049 $2,916 $837 0 Percent Student Usage 0.6% 0.6% 0.9% 0 ligating school-funded grant or scholarship. This was about 26 and 32 percent, respectively, at private and private state-related schools. While the percent of students receiving school-funded grants or scholarships was less at the private schools, the average amount of the award was larger. This was most significantly so with non-school-funded grants and scholarships from state, foundations, or other public/private organizations. Only 3.3 percent of the private dental school students received such awards (compared to 22 to 23 percent at public and private state-related schools), but the size of the award was almost $11,000 (compared to $4,000 and about $3,000 at public and private state-related schools respectively). The federal grants and scholarships that have service obligations (uniformed services, Indian Health Service, and National Health Service Corps) accounted for over 29 percent of all financial assistance through grants and scholarships. Incomplete reporting of the number of students receiving these awards prevents a determination of the percent of dental students participating in these obligating grant and scholarship programs; but based on the average award received in the schools that did report the number of recipients, it can be estimated that 580 (4.3 percent) of the students who received financial assistance received one of these scholarships. These awards are by far the largest made through grants and scholarships, ranging from an average of almost $21,000 at public schools to almost $37,500 at private schools. About 5.5 percent of the students who received financial assistance received support through the program of scholarships for disadvantaged students, with the percent usage slightly higher at public schools than at private and private state-related schools. Average award amounts were slightly higher at private schools ($6,824). Schools reporting state-funded grants with service obligations declined over the last three years from eighteen to nine, and this program as a percent of total grant and scholarship funds fell from 4.9 to 1 percent. Reporting of the number of students who received such support was incomplete, but the information provided indicates an average award range of about $1,600 at public schools to about $8,500 at private schools. This range is similar to but slightly lower than that reported in While never a very large source of financial assistance, over the last several years, it has become even less so. Only eight schools reported any grants and scholarships that had unique eligibility requirements, and no information was provided as to the number of students who received such awards. Such awards remain less than 1 percent of the total of grant and scholarship funds. 100 Journal of Dental Education Volume 68, Number 1

13 Profile of Work-Study Programs As indicated in Table 5, work-study programs accounted for 0.2 percent of all financial assistance. Twenty schools participated in the federal work-study program (thirteen public, seven private, and no private state-related). This is down from twenty-nine schools reporting federal work-study programs in (twenty public, seven private, and two private state-related). Three schools reported their own work-study programs (two public and one private). This is up from one public school reporting such a program in Overall, 400 students received support through the federal program, down from the 438 reported in The average amount of support was $1,768 (Table 20), down from $1,952 reported in The number of students in the school-sponsored programs was eighty-four. The average amount of support was $2,049. Financial Assistance Received by Postdoctoral Students Forty-two schools provided information on financial assistance received by postdoctoral students. Thirty-eight percent of their postdoctoral students received financial assistance through non-stipend sources as the Stafford loan program, Alternative Dental Education Assistance Loan (ADEAL) program or other similar private loan program, and/or other sources of non-stipend support. The Stafford loan program was the primary source of financial assistance at 46.5 percent of the reported financial assistance received by postdoctoral students (Table 21). The average Stafford loan amount was $16,758. The ADEAL and other private lender loan programs were reported by thirty-four schools. They accounted for almost 30 percent of postdoctoral financial assistance, with loans averaging $27,510. Nineteen schools reported other non-stipend sources of financial assistance for their postdoctoral students. These sources accounted for almost 24 percent of postdoctoral financial assistance, with an average loan amount of $20,753. Discussion The percent of dental students receiving financial assistance from one or more federal, state, and/ or school source was 90.2 percent. This continues the increases that have occurred since 1990 when 82.3 percent of the students received these types of financial assistance. The average amount of financial assistance per student in was $35,100. While this average may be helpful in assessing overall trends in the availability and use of financial assistance and relations of financial assistance to tuition and fees and living expenses (Tables 2 and 3 and Figure 1), it does not reflect the wide range of borrowing or receipt of grants and scholarships by individual and type of school. In the 2002 ADEA Survey of Dental School Seniors, only 51.3 percent of the seniors reported having received scholarship/ grant financial assistance during their dental education, and debt upon graduation ranged from $0 to over $350,000. Twelve percent reported graduating with no educational debt; 10 percent with up to $50,000 of educational debt; 20 percent with educational debt between $50,000 and $100,000; 29 percent with debt between $100,000 and $150,000; and 29 percent with educational debt greater than $150,000. The seniors who graduated in 2002 were asked if they had been concerned with financing their dental education. Almost one-third reported being Much or Very Much concerned with being able to finance their dental education, with 17 percent indicating they had been Very Much concerned. Table 21. Financial assistance received by postdoctoral students % of Financial Assistance Average Amount of Loan Stafford Loan Program 46.5% $16,758 ADEAL/Private Loan Program 29.6% $27,510 Other Non-Stipend Sources 23.9% $20,753 January 2004 Journal of Dental Education 101

14 Less than 24 percent reported No concern with financing their dental education. Forty-nine percent of the 2002 graduating seniors reported that their educational debt was at a level anticipated. Over 43 percent of the seniors reported that they had no income and/or savings, either from self and/or spouse, from which to financially support their dental education. Another 34 percent indicated that only 1 to 10 percent of their education was financed through these sources. Over 61 percent of the seniors reported they financed over 75 percent of their education through loans, grants, and/or scholarships, with almost 44 percent indicating that these sources financed over 90 percent of their educational costs. It is apparent that dental students are very dependent upon the various federal, state, and school loan, grant/scholarship, and work-study programs for financial assistance in meeting their educational costs and living expenses. While a combination of these programs can provide sufficient assistance, there is still a high level of concern with being able to finance a dental education. The effect the high levels of anticipated borrowing and debt might be having on undergraduate student decisions to consider careers in dentistry is not known. But for most, borrowing and debt are a given in pursuing dentistry as a career. Therefore, it is essential that relations with high school and college career counselors be strengthened and expanded. Responses from the ADEA surveys of dental school seniors indicate that 75 percent of the dental students make the decision to pursue dentistry as a career while they are in college, graduate school, or shortly thereafter. Career counselors can influence this decision process. They need the information by which to understand the occupational outlook for dentistry, the rate of return on a dental education, means of successfully financing a dental education, and the ability to manage educational debt upon graduation. With this information, counselors can be more effective advocates of careers in dentistry and offer more complete and pertinent guidance in the career decision process. With such levels of borrowing and educational debt, how are new dentists managing their educational debt? The American Dental Association (ADA) defines a new dentist as one who graduated from dental school less than ten years ago. The ADA 2002 Survey of New Dentists reports that 11 percent of new dentists graduated with no educational debt; 18 percent have already paid off their loans; almost 58 percent were making full monthly payments; 6 percent were making partial monthly payments; about 7 percent were still in a deferment status; and less than 1 percent should be but were not making payments. Full payment averaged $982 per month; partial payment averaged $758 per month. Stafford loans routinely account for over 80 percent of the total reported amounts of student loans. As reported in the same ADA survey, over 75 percent of the new dentists were using the standard 120 flat payment format in paying off their Stafford loans; 21 percent were using a graduated payment format that had payments increasing in size over time; and less than 4 percent were using an income-sensitive format that adjusted payments according to income. Forty-six percent of the new dentists consolidated their student loans; 27 percent accelerated payments to pay off their loans early; and only 17 percent extended their repayment periods beyond the standard ten-year pay-off. It would appear from this ADA survey that recent graduates are, overall, ably coping with and managing their educational debts. Still, with such levels of educational debt being reported by graduating seniors, it remains of continuing importance to work with students in providing the counseling, monitoring, and advice that will help them judiciously seek and manage appropriate types and amounts of financial assistance as they obtain their dental education. 102 Journal of Dental Education Volume 68, Number 1

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