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Blog » Guest Blog: The What and The Why: A Deeper Level of Advocacy

Guest Blog: The What and The Why: A Deeper Level of Advocacy

December 14, 2017

By Shawn Hamm, MPH, OMS-IV, Alabama College of Osteopathic Medicine

When we advocate for a cause we are passionate about, we often focus largely on the what, sharing critical points of information online, in letters to Congress, and during heated discussions. Recently, in an effort to build awareness on social media about the importance of the Public Service Loan Forgiveness (PSLF) Program, I found that I was doing just that, making a case for the what. I shared the following PSLF facts:

  • Over three quarters of a million Americans are currently enrolled in the PSLF Program
  • The ABA Journal reports that roughly one-fourth of jobs in the U.S. economy are considered public interest positions
  • Sixty-five percent of osteopathic medical students graduating in the 2016-2017 academic year who planned to enter a loan-forgiveness program planned on entering the PSLF Program.


Following my social media post, a family friend asked the question, “Can you explain to me why the PSLF Program better serves our community?” I then realized I was missing a critical component in my advocacy efforts. I was missing the why. Time and time again, advocates are told to share their personal story. Yet, the why can be easily overlooked when you are trying to make your case day in and day out. We must remember as advocates not to lose sight of the why, which is the driving force behind our advocacy. In the case of the PSLF Program, there will be serious consequences if the recently proposed PROSPER Act by the House of Representatives is passed as written. As outlined in AACOM’s recent statement on the House proposal to reauthorize the Higher Education Act, the PROSPER Act would:

  • Eliminate the PSLF Program for new borrowers
  • Replace the Direct Loan Program—including Grad PLUS loans—with a new Federal ONE Loan Program with borrowing capped for graduate students at $28,500 per year
  • Fail to reinstate Perkins Loans for graduate students
  • Threaten federal subsidized loans for undergraduate students


Here is my take on why we must advocate for the PSLF Program, and how it helps graduate students, medical students, residents, and the future physician workforce better serve communities across the US:

The US is currently facing a serious physician shortage, and the need for primary care physicians is growing exponentially. Primary care physicians working in medically underserved areas at non-profit hospitals or clinics typically receive drastically lower salaries than their physician colleagues working in communities with better health care access in the private sector.

The PSLF Program provides financial relief and incentive for brand new physicians to work in communities in need, especially those of us who have more than $300,000 in federal student loan debt. In exchange for serving an underserved community, some of my student loans will be forgiven. Without the PSLF Program, physicians may need to accept jobs in communities with more competitive salaries in order to repay their student loans, leaving underserved communities at greater risk.

I also depend on Income-Based Repayment for my student loans, because my monthly payment would be approximately $2,500 – 3,500 without it. It is unclear as of yet what my monthly payment would be under the new Income-Based Repayment model proposed by the PROSPER Act. Making the choice to serve an underserved community, accept a lower salary, and attempt to pay a monthly loan repayment of uncertain magnitude would be nearly impossible. The PSLF Program provides incentive for future primary care physicians, such as myself, to serve a rural, underserved community that would otherwise not have access to a primary care physician at all.

In your advocacy efforts, always remember to address the what and share the why. It opens the door for dialogue and discussion that hopefully leads to greater understanding and more effective communication about the issues you are passionate about. If the PROSPER Act were passed and the PSLF Program eliminated, think about how this would impact you and your fellow colleagues.

Stay informed of health policy and legislation that will impact you now and in the future by joining the ED to MED campaign. Utilize the resources available on ED to MED’s website to contact Congress, and share your personal story today!

The views and opinions expressed are those of the author(s) and do not imply endorsement by AACOM.

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