A Canadian study could prove that rising tuition fees keep low-income students out of medical school.
The Canadian Medical Association Journal has published a paper that compares medical students from the province of Ontario, which has more than doubled its medical school fees since 1997, with students from the rest of Canada, where rises were relatively lower. It found that in Ontario, the proportion of residents with a family income of less than C$40,000 (£17,875) declined from 22.6 per cent to 15 per cent.
The study received responses from 2,994 of the 4,383 Canadian medical students enrolled in 2001, and found an overall decrease in self-reported income across all 12 Canadian medical schools.
Jeff Kwong and his co-authors pointed out that the high tuition fees had put a strain on Ontario students. Twice as many first-year students (25.4 per cent) as fourth-year students (13.3 per cent) in Ontario felt that financial considerations would be a major influence on their choice of specialty.
They also found that the number of students expecting to graduate with very high debt (C$100,000 or more) increased in Ontario but not elsewhere in Canada.
The study concludes that medical school tuition fees in Ontario, such as at the University of Toronto, which saw annual fees rise from C$4,844 in 1997-98 to C$14,000 in 2000-01, are associated with changes in the medical school population.
"At Ontario medical schools, there are now fewer students from lower-income families and more students with large debts."
They concede that provinces with relatively stable tuition fees have also seen lower numbers of low-income students, and that the rising fees have not negatively affected national enrolment rates.
Joel Duff, Ontario chair of the Canadian Federation of Students, said: "It confirms what we already knew." They have argued that deregulation of fees, such as the Ontario government's decision in 1998 to let dentistry and medical fees see what the market will bear, have caused accessibility problems for students from lower-income families.
The organisation will raise the study's findings when it meets with the province's education minister soon.