As the United States faces a growing shortage of physicians, dentists, and other health professionals, a central question is shaping the future of care: who can afford to enter the field, and who cannot.
In response, colleges and universities are expanding the use of federally funded scholarship programs to reduce financial barriers and build a health workforce that better reflects the populations it serves.
At the center of these efforts is the Scholarships for Disadvantaged Students (SDS) program, administered by the Health Resources and Services Administration. The program provides funding to health professions schools to offer tuition assistance to students from economically disadvantaged backgrounds, lowering one of the most significant barriers to entering the field.
The cost of medical education continues to shape both entry into the profession and career decisions after graduation. According to HRSA’s Advisory Committee on Graduate Medical Education, high levels of student debt are associated with a decreased likelihood of pursuing primary care or practicing in underserved areas, where shortages remain most acute.
Federal scholarship programs are designed to counter that trend. Students from disadvantaged backgrounds are more likely to return to communities similar to those in which they were raised, improving access to care in areas that have historically faced provider shortages.
Yet financial aid alone is not enough to ensure success or long-term workforce impact.
“We’re seeing the most meaningful progress in programs that go beyond financial aid,” said Uché Blackstock, a Harvard-trained emergency physician and founder of Advancing Health Equity, a consulting firm launched in 2019 to dismantle racism in healthcare and close racial health disparity gaps. “Scholarships are essential, especially given the cost of medical education, but funding alone isn’t enough.”
The most effective programs, she said, combine financial support with mentorship, academic preparation, and community building. This approach reflects a broader shift in how institutions are designing workforce pathways, moving beyond access toward long-term student success.
Research from the National Academies of Sciences, Engineering, and Medicine supports this model, finding that students are more likely to persist in health professions programs when financial aid is paired with structured academic and social support.
At institutions such as the University of Texas Health Science Center at San Antonio, scholarship funding is paired with mentorship and advising systems designed to support students from matriculation through graduation. These models reflect a growing emphasis on retention, not just recruitment.
That shift is critical. Historically, efforts to diversify the health professions have focused heavily on admissions. Increasingly, institutions are recognizing that supporting students after they enroll is equally important.
“We’re also seeing progress in early pipeline initiatives that engage students in high school or college,” Blackstock said. “These programs help shape identity and expand what students believe is possible long before the application process begins.”
Such programs aim to address disparities earlier in the educational pathway. Exposure to health careers, academic preparation, and mentorship can all influence whether students pursue and persist in medical and dental education.
Community-based clinical training is another key component. By placing students in clinics and health centers that serve diverse populations, universities provide hands-on experience while reinforcing a commitment to addressing gaps in care. Federal findings show that students who train in these environments are more likely to practice in them after graduation.
Despite these advances, structural barriers continue to limit access.
“Cost continues to be a major challenge, and it extends beyond tuition,” Blackstock said, pointing to application fees, test preparation, interview travel, and relocation expenses as significant hurdles for many students.
Admissions processes also present challenges. Heavy reliance on standardized test scores and traditional metrics can reinforce inequities, as these measures often reflect access to opportunity rather than potential.
“Standardized test scores and certain types of experiences are not neutral,” Blackstock said. “They are shaped by systemic inequities.”
Even after gaining admission, students may encounter environments that affect their ability to succeed. Isolation, bias, and limited access to mentorship can influence both well-being and long-term retention in the field.
These layered challenges highlight the limits of scholarship programs when implemented in isolation.
“Scholarship programs are an important part of the solution, but they cannot fully address these challenges on their own,” Blackstock said.
Federal data reflects this reality. While HRSA-supported programs train thousands of students each year, individuals from economically disadvantaged backgrounds remain underrepresented in many health professions, particularly in medicine and dentistry.
Addressing these gaps will require a more comprehensive approach.
“We need to move from a focus on diversity as an outcome to a focus on system design,” Blackstock said.
That shift involves investing across the entire pathway into health professions, from early education through training and into leadership. It also requires reexamining how institutions define merit and evaluate candidates.
Institutions, she added, must take responsibility for the environments they create.
“Recruitment without support will never lead to lasting change,” Blackstock said.
The case for this work extends beyond access. A more representative health workforce has been associated with improved patient communication, increased trust, and better adherence to treatment, particularly among populations that have historically faced barriers to care.
The National Academies has identified workforce diversity as a key factor in improving health outcomes and reducing disparities, reinforcing the link between education policy and patient care.
For higher education leaders, this framing positions scholarship programs as more than financial aid. They are a strategic tool for shaping the future of the health workforce.
Institutions that effectively combine funding with mentorship, academic support, and workforce-aligned training are better positioned to address both educational access and gaps in care delivery.
The challenge moving forward will be sustaining and scaling these efforts. Rising education costs, evolving workforce demands, and persistent inequities underscore the need for continued investment and innovation.
Expanding access to health professions education is not only about who gets in. It is about who is supported, who graduates, and ultimately, who serves.
Without sustained investment in both funding and system design, the gap between workforce needs and workforce reality is likely to persist. But with it, institutions have an opportunity to do more than diversify their student bodies. They can help reshape the future of care itself.
