Bernard J. Wolfson, KFF Health News

Medical educators and health professionals warn that new federal student loan caps in President Donald Trump’s tax cut law could make it more expensive for many people to become doctors and could exacerbate physician shortages nationwide.

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And, they warn, the economic burden will steer many medical students to lucrative specialties in more affluent, urban areas rather than lower-paying primary care jobs in underserved and rural communities, where doctors are in shortest supply.

“The growing financial barriers may deter some individuals from pursuing a career in medicine, particularly those from low-income backgrounds,” said Deena McRae, a psychiatrist and associate vice president for academic health sciences at University of California Health.

The new federal loan limits, which are enshrined in the GOP legislation signed by Trump on July 4, cap the amount professional degree students can borrow at $50,000 a year, up to a maximum of $200,000 — well below the average cost of a four-year medical school education.

For students who graduated this year with an MD degree from a four-year medical school in the United States, the median cost of attendance was $318,825, according to Kristen Earle, director of student financial services at the Association of American Medical Colleges. And for those who entered a U.S. medical school in the 2024-25 academic year, the median first-year cost was $83,700.

Health care experts and politicians on both sides of the aisle agree that medical schools must find ways to lower their costs, but critics of the loan caps say limiting federal lending isn’t the answer. Congressional Republicans, who voted for the caps, say they are intended to stem a sharp rise in federal student lending over the past two decades that has driven the cost of attendance higher.

“Uncapped loan limits gave no incentives for schools to reduce any of their costs, recognizing that taxpayers, students, or students’ families would eventually foot the bill,” said Sara Robertson, a spokesperson for the GOP-controlled House Committee on Education and Workforce. “Our reforms and loan limits will put downward pressure on costs to provide better outcomes and lower debt for all students.”

The budget law brings back caps for graduate and professional education that Congress eliminated in 2006. Since then, students have been able to get federal loans that cover the total cost of their degree programs. Reimposing the caps, along with other changes to federal student loans, is expected to save the federal government $349 billion over 10 years, according to the Congressional Budget Office.

Whether the new federal loan policy will push down tuition costs remains to be seen.

Robertson pointed to a 2023 study by the National Bureau of Economic Research showing that the more generous federal lending policy since 2006 has led to “significantly higher program prices” in graduate education. The study also found that the additional federal support failed to increase enrollment in graduate programs, including for underrepresented students.

However, data provided by the Association of American Medical Colleges shows that cost-of-living increases, not tuition, drove up the expense of studying medicine in recent years.

Students already in medical school who have taken out federal loans before the new rules take effect on July 1 will be exempted from the cap. But students whose loans are capped under the new law will need to make up the difference, in many cases by taking out private sector loans, which typically have less flexible repayment terms and require a strong credit rating — a heavy lift for students from low-income communities.

Robertson cited a 2017 analysis showing that nearly 60% of graduate students could have obtained a private loan at a lower interest rate than any available federal loan. Federal loans, however, come with advantages that private loans don’t. For instance, federal loans can include monthly repayments calibrated to income, and they offer two debt forgiveness paths, including the Public Service Loan Forgiveness program, which erases the balance for those who work in a government or nonprofit organization and make their monthly payments for 10 years.

Critics and proponents agree on at least one thing: Now is the time for medical schools to think creatively about lowering costs for students. This might include reduced tuition, more chances for debt forgiveness, and accelerated programs that allow students to graduate in three years rather than four, reducing costs by 25% and getting them more quickly into paid jobs.

“I hope that coming out of this, medical schools and others find a way to seize the moment and help us figure out how to reduce the total cost of medical school,” said Martha Santana-Chin, CEO of L.A. Care. “Maybe this is an opportunity for us to rethink how the system is working.”

Roughly a fifth of medical schools offering an MD degree have accelerated programs, including the University of California-Davis, according to the Consortium of Accelerated Medical Pathway Programs.

A data analysis of eight medical schools led by the NYU Grossman School of Medicine, whose core MD curriculum is three years, shows that students in three-year programs derive a lifetime financial gain totaling over $240,000 due to the cost savings of less time in medical school, interest not paid on the corresponding amount not borrowed, and faster progression to a salaried position.

In addition to lowering costs, accelerated medical programs seek to address health care workforce shortages by training physicians more quickly. And with the new loan caps about to make it more difficult for many students to finance their medical education, these programs suddenly have a new timeliness.

Students who spend three years in medical school instead of four have lower debt and get to a higher salary sooner, said Caroline Roberts, a family physician and director of rural education at the University of North Carolina’s School of Medicine. UNC offers a three-year track for students who want to be primary care doctors and work in rural areas of the state, where doctor shortages are a major problem.

Zoe Priddy, who is in her second year of UNC’s three-year program, said that if the federal loan limits had been in place at the time she was making plans to attend medical school, she would have needed a job that paid better than the research lab where she worked after completing her undergraduate degree.

“I would have had to change my trajectory if I still wanted to pursue medicine, and I don’t know if it would have been possible for me,” Priddy said. However, the lower debt associated with the three-year track “eased my decision” to go into pediatrics, a lower-paying specialty, she said.

(KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of KFF — the independent source for health policy research, polling and journalism.)

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

As the Vikings have prepared to take on the Baltimore Ravens on Sunday — a tall task that starts and stops with trying to contain superstar quarterback Lamar Jackson — they have leaned heavily on a secret weapon in practice.

That would be journeyman running back Cam Akers.

Minnesota Vikings running back Cam Akers (31) picks up some yardage in the fourth quarter of a NFL game against the Cincinnati Bengals at U.S. Bank Stadium in Minneapolis on Sunday, Sept. 21, 2025. (John Autey / Pioneer Press)

Though most people know him for the position he currently plays, Akers was an incredible quarterback once upon a time at Clinton High School in Mississippi.

His stats will forever be the stuff of legend in his home state. He was the 2016 Mississippi Gatorade Player of the Year as a senior after throwing for 3,128 yards and 31 touchdowns, and rushing for 2,105 yards and 34 touchdowns. The numbers were astounding by the time he graduated, as he had passed for 8,140 yards and 78 touchdowns, and rushed for 5,103 yards and 71 touchdowns.

That dual threat ability has served the Vikings well this week in practice as they’ve had Akers occasionally line up in the shotgun as a way to mimic some of Jackson’s unique abilities. As he went over some of his reps, Akers bashfully admitted that he threw an interception to edge rusher Andrew Van Ginkel.

“They were telling me who to throw it to, so take that with a grain of salt,” he added with a smile. “It wasn’t like I was just back there throwing it up.”

The process of preparing for Jackson has extended far beyond simply having Akers take some snaps here and there. It’s been a total team effort as the Vikings have tried to put together a game plan to stop the perennial MVP candidate who has proven to be virtually unstoppable.

“It’s a huge test for us,” defensive coordinator Brian Flores said. “They’ve got one of the most dynamic players probably ever.”

That’s not even hyperbole when analyzing Jackson, 28, and his singular skill set.

He’s been able to blend accuracy and athleticism unlike anybody the NFL has ever seen, throwing for 21,132 yards and 180 touchdowns, and rushing for 6,353 yards and 34 touchdowns so far in his career. He also boasts a 103.5 passer rating, which currently ranks as the best career mark of all time, and has completed 65.2 percent of his passes.

Not bad considering some scouts believed Jackson would never make it as a quarterback at the highest level.

“What I think Lamar has done at such a high level to become one of the best at the position in the NFL is make the throws in rhythm accurately,” head coach Kevin O’Connell said. “He’s an elite thrower of the football.”

As somebody who grew up in Florida less than an hour away from Jackson, safety Josh Metellus has a different perspective on his rise up the ranks. He has seen Jackson go from a prospect oozing with potential to the face of a franchise who will eventually wear a gold jacket.

“He’s one of one,” Metellus said. “There’s only so much we can do to get ready for him.”

Lamar Jackson, quarterback de los Ravens de Baltimore, se dispone a lanzar un pase ante los Dolphins de Miami el jueves 30 de octubre de 2025 (AP Foto/Rebecca Blackwell)

It helps that the Vikings have already gotten some experience going up against mobile quarterbacks. They were recently torched by Philadelphia Eagles quarterback Jalen Hurts, who regularly escaped pressure before launching the ball downfield, then by Los Angeles Chargers quarterback Justin Herbert, who scrambled for big gains without much resistance.

“They were able to extend plays,” Metellus said. “That kind of screwed us (up) a little bit.”

That’s a big part of Jackson’s game, so the Vikings have done everything in their power to make sure they’re ready for it. To prep for the possibility of him creating off schedule, for example, O’Connell has waited to blow the whistle this week in practice until long after he usually would.

“Just to make sure the guys on the backend are plastering coverage and understanding that some of the big plays that they make are not how they were drawn up,” O’Connell said. “We’re going to have to be as good as we’ve been against this challenge.”

The position players that Jackson gets to throw to understand the assignment whenever he’s able to buy himself some time. It turns into backyard football from time to time, and when that happens, that’s when the Ravens are at their most dangerous.

“It’s about disruption,” O’Connell said. “It’s about getting him off the spot. The player that gets him off the spot is more than likely not going to be able to always make the play. Who’s the next guy there?”

As much as the Vikings prepare for it, however, it’s inevitable Jackson is going to break contain at some point. It’s about minimizing the damage when he does something special with the ball in his hands.

“You can’t stop him,” Metellus said. “It’s more about limiting his explosiveness.”

It helps that the defense is operating essentially at full strength. It’s not a coincidence that the return of Van Ginkel last weekend unlocked something in the Vikings that helped them upset the Detroit Lions on the road.

“There’s a calmness when we’ve got all our guys out there and we’re healthy,” linebacker Blake Cashman said. “We can trust that everybody is going to be in the right spot as it pertains to our assignment on the play call.”

That has been on display from the defense time and time again this week in practice as rookie quarterback Max Brosmer or veteran quarterback John Wolford have also done their part to get everybody ready for what Jackson brings to the table.

“I have to do my best to emulate a little bit of what he does,” Brosmer said. “His pocket awareness and the way he moves around.”

Luckily for the Vikings, they’ve also have had Akers in their back pocket, which has helped them better prepare for Jackson to some degree.

“It’s been fun giving them a look and getting some work in,” Akers said. “Just doing my part to help the team.”

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A stunning new study offers early evidence that COVID-19 vaccines might have a secret superpower: a precisely timed mRNA shot could help many cancer patients live longer.

The work still requires validation, but the strength of the signal in the study — which analyzed differences in outcomes between cancer patients who did and did not receive mRNA vaccinations during the pandemic — should be sufficient motivation to direct resources toward quickly obtaining a definitive answer. COVID vaccines are inexpensive, widely distributed and easily accessible at most local pharmacies, such as CVS. If the findings hold true, they could offer a simple and cost-effective way to improve patients’ lives.

Yet the current administration’s dismissive stance toward mRNA science, particularly COVID vaccines, could impede that effort. This new research should push the nation’s health leaders to reconsider the enormous potential of this Nobel Prize-winning technology.

The study, published last month in Nature, originated from a curious observation made by Adam Grippin, a radiation oncologist at the University of Texas MD Anderson Cancer Center, while working on his PhD thesis at the University of Florida. He was helping to develop personalized mRNA vaccines for people with brain cancer, designed to train the immune system to recognize specific markers on a patient’s tumor and launch an attack. But when testing the bespoke shots in animals, Grippin noticed that even the placebo shots — which contained mRNA entirely unrelated to the cancer — also activated the immune system to kill tumors.

“Since then, I have spent pretty much every day thinking about the results,” Grippin told me. The implication was that there could be an easily accessible, off-the-shelf shot capable of stimulating the immune system to fight cancer.

Grippin and his colleagues analyzed medical records from more than 1,000 patients with advanced lung and skin cancers who had undergone treatment with a type of immunotherapy called checkpoint inhibitors. People who received an mRNA-based COVID vaccine — it didn’t matter whether it was Pfizer or Moderna’s — up to 100 days before starting immunotherapy were twice as likely to be alive as those who either didn’t receive the vaccine or got it outside that time window.

The researchers also looked at whether the flu and pneumonia shots produced a similar effect (they didn’t) and whether patients who received a COVID vaccine in tandem with other cancer treatments benefited (they did not).

To understand what makes the mRNA shots special, the researchers examined blood and tissue samples and found that the COVID shots appeared to activate the innate immune system — a fundamental, early-warning defense mechanism that alerts other parts of the immune system to prepare for an attack.

That something as simple as a COVID vaccine might improve survival in cancer patients receiving standard immunotherapy has taken oncologists by surprise — in a good way. “My initial reaction was surprise and maybe disbelief,” says Ryan Sullivan, director of the Melanoma Center at Massachusetts General Hospital. Scientists are natural skeptics, and his first instinct was to look for flaws. Yet after carefully reviewing the paper, he concluded that the researchers had done extensive work to explain their findings and account for potential confounding factors. “The data are really good,” Sullivan says. He added that the sheer number of patients included in the retrospective study made the results especially compelling.

Of course, all of this needs to be confirmed in a randomized, placebo-controlled study, and the MD Anderson doctors are already planning one. Ideally, clinical trials will be paired with basic research to help scientists answer the many questions this discovery has raised.

For example, the benefit only appeared when people received their COVID shot within a specific window before starting immunotherapy. Determining the optimal timing to maximize that benefit would be crucial if this were to become part of standard treatment guidelines. After all, a doctor might be speaking with a patient who has newly diagnosed advanced cancer and feels an urgency to start treatment — should they wait a few days after vaccination, or would a few months be better?

Cancer immunotherapy is used to treat many common cancers, including breast, colon and bladder, and doctors want to know if the COVID shot might also help extend survival for those patients. Physicians at MD Anderson have conducted comprehensive reviews of every patient receiving immunotherapy at their facilities since 2018 and have a paper under review that is expected to provide an early answer soon.

Researchers also want to know whether the effect, if validated, can be improved upon. The mRNA in COVID vaccines carries instructions for making the coronavirus’ spike protein, but what if a vaccine instead delivered instructions for a protein that could more precisely stimulate that innate immune response?

All of these questions deserve urgent exploration. Unfortunately, the discovery comes at a particularly difficult moment for mRNA vaccines. Health Secretary Robert F. Kennedy Jr., a notorious source of vaccine misinformation during the pandemic, is now in a position of authority over the nation’s research agenda and health policy. He has been steadily undermining support for COVID vaccines by unilaterally narrowing the Centers for Disease Control and Prevention’s recommendations and terminating funding for nearly two dozen mRNA vaccine-related grants.

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Philanthropy and Big Pharma will likely step in to help fund clinical trials. But the consensus among academics is that obtaining government funding for mRNA research will be extremely difficult — if not impossible  — for many projects.

The potential to help cancer patients is profound. The simplicity of the idea — that someone about to start immunotherapy could simply pop into their local pharmacy for an inexpensive shot that might prolong their life — should be enough to inspire everyone to put aside politics and invest in pursuing this promising finding.

Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News.

While having lunch together earlier this year, Beth Gausman and Harlene Hagen began talking about a past project of Twin City Home and Community.

“About halfway through our meal,” Gausman recalls, “Harlene says to me, very casually, ‘You know, we did a cookbook … actually, we did two cookbooks, and we earned thousands of dollars for scholarships.’”

Gausman had no idea — and neither did many other newer members of TCHC, whose backgrounds include experience in the fields of study similar or related to family and consumer sciences (formerly known as home economics).

“I said to her, ‘We need to do a program on this,’” Gausman said.

Their conversation came just in time to honor a significant number: On Wednesday, dozens of TCHC members and their guests filled a large room at Roseville Lutheran Church to celebrate the 50th anniversary of that first cookbook, “Cooking in Minnesota,” which was first published in October 1975, followed in 1983 by “More Cooking in Minnesota.”

The cookbooks, as precise and organized as a home ec teacher’s pantry, are filled with family-favorite recipes ranging from Wild-Rice Barley Casserole to Finnish Pulla Coffee Bread. The cookbooks, about 80,000 copies, sold through the 2000s in Minnesota and beyond and, along with other philanthropic efforts by the organization, raised $822,404 in scholarships and grants (minus operating expenses).

Today, the cookbooks are out of print, but a few copies are available here and there online, and they are preserved in the archives and collections of the University of Minnesota and the Minnesota Historical Society.

‘Fresh Apple Cake’ and vintage memories

Marcia Copeland, right, talks about her recipe for Danish Aebleskiver with Elaine Christiansen during a celebration of the 50th anniversary of”Cooking in Minnesota,” which Copeland helped edit and Christiansen served as chairperson. (John Autey / Pioneer Press)

On Wednesday, a long table of refreshments was set just as it was at an original cookbook launch party, down to the baskets of apples and the Fresh Apple Cake (from “Cooking in Minnesota,” page 118), along with other creations (including Chocolate Mint Brownies, Pumpkin Bars and Blueberry Lemon Muffins).

The organization was able to re-create such moments and delve into the history of its two cookbooks with the help of the University of Minnesota, which in its archives holds a collection of records of Twin City Home and Community, which originally operated under the umbrella of what was then called the American Association of Home Economists.

During the program Wednesday, copies of some of those archival materials were displayed on the tables. They provided a glimpse into that era.

“You’ll find a sense of the communication and determination to involve all 250 to 300 members and their families who joined in wholeheartedly on our wild ride into publishing and philanthropy in the early ’70s,” said 95-year-old Elaine Christiansen of Falcon Heights, who served as the cookbooks’ chairperson and is best known today as the longest-serving volunteer at the Hamline Church Dining Hall at the Minnesota State Fair.

The program in Roseville became a kind of oral history as Christiansen shared the story behind the cookbooks along with one of its editors, Marcia Copeland of Plymouth (co-editor Betsy Norum, an icon in Family and Consumer Sciences, passed away in 1994).

Copeland wore red in honor of her background as the director of the Betty Crocker Kitchens at General Mills. But back when she was asked to help cook up this cookbook, she was at home with her young son.

“Have you ever taken on a project that you knew was too big for you?” Copeland said. “Well, I did, and it was called, ‘Cooking in Minnesota.’ And I’m glad that I did. Had I known how much work was involved, I might have thought twice!”

The process involved blind testing of the recipes by members, tasting by their families and an editing process that strove for recipe uniformity and accuracy.

It wasn’t just about the recipes, though; Copeland said the cookbooks illustrated a shifting in the American palate.

“I want to give you the background on why we did a cookbook,” she told the group. “World War II was over: 1945 was a time when the soldiers came home. They had eaten regular pasta in Italy, they had eaten wiener schnitzel, they had eaten Aebleskiver, they had eaten all kinds of things that we hadn’t, or if we had, the ingredients weren’t available.”

After the war, she said, that began changing.

“I’ll never forget reading Julia Child for the first time or Jacques Pépin, the ones that became very important to us and helped set the table, literally, for better cookbooks, better recipes,” Copeland said. “We didn’t have to eat a can of spaghetti and serve it for dinner. We knew what good food was and we wanted to share that with the world, which is what we did.”

‘The lift to my spirit’

“Cooking in Minnesota” and “More Cooking in Minnesota” sold about 80,000 copies from the 1970s into the 2000s, with money raised for scholarships and grants. (John Autey / Pioneer Press)

Geri Skogen was one of the organization’s scholarship recipients, receiving $1,200 in 1983. On Wednesday, she spoke to the group about the gift’s impact.

“While the dollars were very significant to my master’s degree progress, it was the lift to my spirit that I remember so well,” Skogen said.

At the time, Skogen had resigned from her Extension position in Carlton County to attend graduate school at the University of Minnesota in the Twin Cities and was missing her colleagues and church friends in Cloquet, Minn.

“Your scholarship was an affirming wink and a nod, a pat on the back and ‘You go, girl!’ statement that I have never forgotten,” she said.

Skogen went on to earn a master’s degree and worked as assistant to the department head in the Department of Food Science and Nutrition at the University of Minnesota for nearly 25 years.

“I was ‘home’ in who I was and the responsibilities and challenges before me,” she said. “Thank you TCHC for helping get me ‘home.’”

Cooking today

A member of the Twin City Home and Community samples Pumpkin Bars as featured in the groups celebrated cookbook, “Cooking in Minnesota” at Roseville Lutheran Church on Wednesday, Nov. 5, 2025. (John Autey / Pioneer Press)

In October 1975, columnist Eleanor Ostman wrote about the cookbook’s debut for the St. Paul paper, a report that included a photograph by Bob Walsh of Christiansen with her four sons.

The caption read: “Earned treat for the four Christiansen teenagers is a sample of Saucy Apple Swirl Cake which their mom, Elaine (Mrs. Martin) Christiansen, Falcon Heights, submitted to ‘Cooking in Minnesota,’ which she produced with members of the Twin Cities Home Economists in Homemaking (as it was known then). She suggested the project three years ago when she was president and the membership made her chairman. All recipes were tested by the home economists including the chairman who once had her sons … taste test four lasagna recipes in one day. Mrs. Christiansen is one of the managers for the annual Pillsbury Bake-Off and is also in charge of 5 cooks and 30 workers serving a thousand people per meal at the State Fair Grounds 4-H building.”

So many years later, Christiansen listened as members shared their thoughts and memories of the cookbooks.

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The carrot cake recipe was used in her sister’s restaurant, one woman said, and it was a hit.

A teacher said a Braille version of the cookbook was dog-eared from use at a school for the blind.

Hagen, who sparked the idea for this anniversary program, said she still uses the books for reference for pan sizes and other basics when she is unsure of the accuracy of online recipe instructions.

And another member, whose 10-year-old son was a witness to the intense process involved in creating a cookbook, recalled that he asked if the third cookbook would be called: “(I Am Sick of) Cooking in Minnesota.”

But what is cooking in Minnesota like today?

For Christiansen, her most recent meal was a bit simpler and involved a modern-day staple that would be perfect in an updated version of the cookbook, especially for these chilly November days.

“I like to buy a rotisserie chicken — I can get six or eight meals out of it from salad to sandwiches to a casserole to broth,” she said. “I just cooked up the bones to make a nice, warm bowl of vegetable soup.”

Fresh Apple Cake

Ingredients:

1/2 cup shortening
1 cup granulated sugar
1/2 cup brown sugar, packed
1 cup buttermilk or soured milk*
2 teaspoons soda
2 eggs, beaten
2-1/4 cups all-purpose flour
1/2 teaspoon nutmeg
1/2 teaspoon cinnamon
1/4 teaspoon cloves
1/4 teaspoon salt
2 cups chopped apples (2 or 3 medium)

* Milk can be soured by combining 1 tablespoon vinegar or lemon juice and enough milk to measure 1 cup.

Topping:

Combine 1/2 cup chopped nuts, 1/4 cup brown sugar (packed), 1/4 cup granulated sugar and a dash of cinnamon.

Directions:

Heat oven to 350.

Grease and flour a 13x9x2-inch pan.

Cream shortening and sugars.

Dissolve soda in milk; stir into shortening mixture. Add eggs, flour, spices and salt; beat until thoroughly mixed.

Fold in apples; pour into pan. Sprinkle with topping.

Bake 30 minutes or until wooden pick inserted in center comes out clean.

— Recipe by Evelyn Hagen from “Cooking in Minnesota.”