I entered the vehicle outside the bus terminal in Lowell, Massachusetts, where my father awaited my arrival. He appeared anxious as he handed me an envelope. Inside was my acceptance letter for medical school. We erupted in cheers.

Accompanying the acceptance letter was the anticipated cost of attendance: approximately $70,000 for the first year, rising to almost $90,000 by the fourth. I would have to borrow the full amount. My parents, both employed at a nail salon, earned a combined income of around $30,000 annually. I was the first in my family to pursue higher education, and I already carried undergraduate debt. By the time I graduated from medical school, my total debt would exceed $300,000.

The only reason I could attend medical school was through federal student loans. I now practice as a primary care physician in Massachusetts, just 40 minutes from where I was raised. I treat patients at a clinic that primarily caters to Vietnamese immigrants, individuals like my parents. It has been incredibly fulfilling to contribute in this manner.

However, with the recent bill passed by Congress, I likely would not have had the opportunity to attend medical school.

The “Big Beautiful Bill” introduces extensive new restrictions on federal student aid. The version approved by the House imposes a federal borrowing cap for professional students at $150,000, including any undergraduate debt, and eliminates Grad PLUS loans, which previously allowed students to finance the full cost of attendance. These limits will take effect in 2026.

This cap may seem adequate at first glance, but when considering the actual expenses of medical education, it falls short. According to the Association of American Medical Colleges, the median debt for medical graduates who have debt stands at about $200,000, with over 20 percent of students borrowing more than $300,000. The average total cost of attendance frequently surpasses this figure. These statistics account for students from various backgrounds, including those receiving significant financial assistance from their families.

The distribution of this burden is not equitable. Students hailing from low-income families such as mine are significantly more inclined to borrow and often borrow larger amounts. We seldom have access to family savings or accumulated wealth. For us, federal student loans are neither a luxury nor a financial instrument; they are the sole means of achieving our goal of becoming physicians.

Once these new borrowing limits are implemented, students from disadvantaged backgrounds may have to resort to private loans with inferior terms or may find themselves entirely excluded from the field of medicine. This represents a subtle constriction of opportunity that will disproportionately impact the very students our profession needs the most.

Studies indicate that students from lower-income and underrepresented backgrounds are more inclined to enter primary care and tend to serve in rural and underserved communities. We also offer perspectives shaped by challenges, language, and culture—insights that are critically missing in a field where over half of medical students come from families within the top income quintile.

Imposing limits on federal loans will not significantly lower tuition. It will not foster a more equitable system. Instead, it will render medicine increasingly inaccessible to those lacking familial wealth. It will exacerbate the shortage of primary care physicians. Furthermore, it poses a threat to the diversity of the future physician workforce, making it less community-oriented and less in tune with the patients who depend on us the most.

To become a physician, I required an opportunity. Federal loans were the key that allowed me to serve my community. This legislation will shut that door for the upcoming generation.

Tom Phan is an internal medicine physician.