Funding a Career in Primary Care

Primary care is the term used to describe physicians and health care providers in a wide variety of fields who often serve as a patient's primary contact with the health care industry.

Several programs can assist you in financing your education if you are committed to practicing in a primary care field. Each organization has a different definition of "primary care" and may require a contractual commitment from you. There are several things you should consider when you are researching these opportunities:

• Are you committed to primary care?
• What fields of medicine does the program consider primary care?
• What is the dollar amount associated with the scholarship or loan repayment program?
• Is there a service commitment? If so, for how long?
• Are there penalties associated with failure to complete any contractual obligation?
• Are there restrictions on practice type or location?
• Do you want to serve an underserved area or population?
• Is your current or future employer a nonprofit company?
• Are there tax consequences?
• Which program is the best fit for your needs?

Primary Care Loans

The Primary Care Loan program is a low-cost federal loan program for medical students committed to primary health care practice. Acceptable residency training activities for a Primary Care Loan borrower include:

• Family medicine
• Internal medicine
• Pediatrics
• Combined medicine/pediatrics
• Preventive medicine
• General practice

Acceptable practice activities for a Primary Care Loan borrower include:

• Primary care clinical practice
• Clinical preventive medicine
• Occupational medicine
• Public health
• Senior/chief resident in primary care residency program
• Faculty administrators, or policymakers certified in one of the following primary health care disciplines:
  
  • Geriatrics
  • Adolescent medicine
  • Adolescent pediatrics
  • Sports medicine
  • Master's in public health
  • Public policy fellowship
  • Primary care fellowship

Educational activity must be directly related to the health profession for which you obtained a Primary Care Loan. In addition, you must enter into the activity either before the end of your advanced professional training or no later than 12 months after you complete participation in that advanced professional training.

The related educational activity must meet the following criteria for a Primary Care Loan to obtain a deferment:

• Be part of a joint-degree program in conjunction with the health profession program for which you received the loan.
• Be required for licensure, registration or certification in the health profession for which you received the loan.
• Be a full-time educational program in public health, health administration or a health care discipline directly related to the health profession for you received the loan.

There are penalties assessed for participating in an unacceptable field of training or practice. Unacceptable practice activities include cardiology, gastroenterology, obstetrics/gynecology, surgery, dermatology, radiology, rehabilitation medicine, psychiatry, emergency medicine or other subspecialty training or certification.

The law requires that PCL recipients practice in primary care but does not specify that the practice be full-time. Even though part-time practice is acceptable, you will be in breach of service if your part-time status allows you to subspecialize. Additionally, you must fulfill your service obligation in the U.S. or one of its territories. Service outside the U.S. is only permitted you are in military service and assigned outside the U.S.

Certification of Primary Care Practice

Once you have entered and completed your residency training in an acceptable primary care area, you must practice in an acceptable primary health care area until your loan is paid in full. The Saint Louis University Office of Student Financial Services will send you the Post-Residency Certification Form to complete.

The first form will be sent to you upon completion of your residency training program when your Primary Care Loan will enter repayment. Succeeding forms will be sent to you annually based on the month that you originally entered repayment. You must certify that you are practicing in a primary care area and return the form to our office by the due date written on the form.

Repayment and Deferment

The Primary Care Loan, including accrued interest, will be repayable in equal and graduated monthly installments in amounts calculated on the basis of a 10 to 25 year repayment period.

Once you graduate, or if you cease to be enrolled on a full-time basis, your Primary Care Loan will enter into a 12-month grace period. A grace period is the time between graduation or ceasing to be enrolled full-time pursuing one of the health profession degrees listed above and the beginning of your loan repayment.

Saint Louis University is the lender of the loan, and your payments will be made to our billing agent, University Accounting Service. You are not required to make payments during the grace period, and any payments made during the grace period before your first interest accrual will be applied towards principal.

The status of all loan accounts is reported to a national credit bureau monthly.

Deferment

To qualify for deferment, you must be performing a specific activity and your account must be in “current” status. You must notify our office if you feel you qualify for one of the types of deferment or complete a deferment form.

The deferment form must be completed and certified by the appropriate official to verify that you were performing a qualifying activity. Certified deferment forms must be completed annually. Deferment request must be completed 30 days before the activity.

If the deferment form is for a residency, you must indicate your current medical specialty on the form in the space provided. The evidence must include certification by a program official or other authorized official that the activity meets deferment requirements. SLU has the right to deny a deferment request if you do not comply with the requirements as detailed in the regulations. You must contact the school when completing or terminating the deferment activity.

We strongly encourage you to submit the deferment form no more than 30 days before the end of your grace period or previous deferment. Failure to submit the deferment form by the end of your grace period or previous deferment may result in late charges and negative credit bureau reporting.

If you cease to perform the activity for which your account was deferred, you must notify the Office of Student Loans immediately by phone at 314-977-2407 or by email at haley.held@slu.edu. Your loan payments will only qualify for deferment for the period that you were doing the qualifying activity.

The table below lists the deferments applicable to the Primary Care Loans:

Penalties and Consequences of Noncompliance

Primary Care Loans are subject to compliance regulations and there are consequences of non-compliance.

If you receive a Primary Care Loan, you must enter and complete a residency training program in primary health care no later than four years after the date on which you graduate. SLU may allow you to submit the required documentation up to 120 days after the due date without placing you in default. If the required documentation is not submitted within 120 days of the due date, SLU must place you in default using the original due date. Applicable deferments do not extend the four-year time limit.

Loans made on or after March 23, 2010, accrue interest at a rate of 7 percent per year beginning on the date of noncompliance and using the outstanding principal borrowed at that time.

Loans made between November 13, 1998, and March 22, 2010, accrue interest at a rate of 18 percent per year beginning on the date of non-compliance and using the outstanding principal borrowed at that time. The length of repayment time does not change due to noncompliance. The borrower will no longer be eligible for deferments.

Cancellations

Your Primary Care Loan will be canceled in the event of your death or total and permanent disability with proper certification.