Publications

Written by: Dahlia Chavez, LMSA National Publications Chair

MD Candidate at Rush Medical College

Over the past year, a wave of federal and state policy changes has quietly reshaped the financial and healthcare supports that many medical students rely on. These shifts are occurring with minimal public transparency and carry disproportionate consequences for low-income, first-generation, and underrepresented students in medicine.

Programs like these are essential for many trainees:

• EBT/SNAP to buy groceries
• Medicaid, especially for students managing chronic conditions or disabilities
• Grad PLUS loans to finance medical school when personal/family resources are limited
• Emergency grants and institutional aid to cover the gap between the cost of living and tuition

However, these systems are being cut, capped, or restructured — often without clear communication or alternatives.

Key Policy Changes Impacting Students

Grad PLUS Loan Cap (via the “Big Beautiful Bill”)

Starting in the 2026–2027 academic year, federal caps will be implemented on Grad PLUS loans, which currently allow professional students to borrow up to the full cost of attendance. Implications include:

• Students without financial support may no longer be able to afford medical school
• There is no alternative federal loan program that fully replaces this funding gap
• Private loans often require strong credit or a co-signer, which can be a barrier for low-income or first-generation students (1)
  

Medicaid Redeterminations Post-COVID

With the expiration of continuous Medicaid enrollment protections from the COVID era, states resumed eligibility redeterminations — and over 25 million people have been disenrolled, many of them procedurally, not due to true ineligibility (2).

Impacts on students include:

• Loss of coverage during rotations, illness, or mental health treatment
• Disruptions for residents or trainees in between institutions
• Lack of notification or appeals processes, especially for disabled students (3)

SNAP/EBT Benefit Restrictions

Recent changes in eligibility requirements are narrowing access to SNAP benefits, especially for single, non-parent adults or those labeled “able-bodied,” which often excludes people with invisible disabilities.

• Roughly 3.8 million college students are already food insecure (4)
• Some states are revoking exemptions that previously allowed low-income students to access EBT/SNAP while enrolled
• Students on clinical rotations or living independently are disproportionately affected (5)

DEI and Student Support Program Rollbacks

Legislation in several states has moved to:

• Prohibit state-funded DEI positions in universities and hospitals
• Eliminate or restrict the operation of DEI offices
• Create uncertainty around student-led organizations (e.g., LMSA, SNMA, ANAMS, APAMSA, etc.) and culturally responsive programming

This limits institutional accountability and the availability of support for historically excluded groups (6).

Why It Matters

While these policy changes may seem administrative, their combined effect poses a serious risk to the equity, accessibility, and sustainability of medical education:

• Removing Medicaid coverage without notice raises due process concerns (3)
• Capping loan access based on financial background or creditworthiness may conflict with Title VI protections (1)
• Defunding DEI offices may place institutions at odds with accreditation standards that require attention to diversity, equity, and inclusion (6)

In essence, this trend represents a systemic shift away from support models that have helped level the playing field in medical education.

What Can Be Done

We need data.

• Institutions should track and report the number of students losing financial aid, food assistance, health insurance, or other basic needs support.

We need accountability.

• Medical schools and hospitals should provide clear, transparent plans — not just general statements — on how they will adapt to these policy changes in budgets, policies, and student resources.

We need national coordination.

• Organizations like LMSA, NHMA, SNMA, APAMSA, ANAMS, and the AAMC must align advocacy efforts and work collaboratively to protect current and future medical students.

We need proactive institutional protections.

• Students facing disability, caregiving, financial hardship, or other structural barriers need explicit protections and pathways to appeal sudden losses in support.
  

This Affects All of Us

While the burden falls heaviest on underrepresented groups, these changes impact every level of the health system:

• If fewer students can afford to pursue medical training, the projected 124,000-physician shortage by 2034 will worsen (7)
• Existing physicians may face greater burnout, longer hours, and higher patient loads
• Healthcare disparities will grow — not just for underserved groups, but for the broader public

The pipeline to a diverse and sustainable physician workforce depends on predictable, equitable access to training. Without it, the long-term quality and accessibility of care in this country may decline.

What You Can Do Next

1. Ask Your School for Transparency

• What plans are in place if students lose Medicaid or financial aid?
• Are emergency resources still available? Will they increase?

2. Share Your Experience (If Safe)

• Anonymous stories help identify broader trends. Consider contributing to collective documentation efforts through LMSA or student organizations.

3.  Attend LMSA National Programming

• Learn how students and advocates across the country are navigating these changes and organizing in response.

4. Reach Out to National Organizations

• Get involved with LMSA’s Policy & Advocacy team, or reach out to NHMA, SNMA, APAMSA, ANAMS, and AAMC for coalition-building opportunities.

Tangible Comparisons to Understand the Scale

Issue	Tangible Comparison	Source
25M disenrolled from Medicaid	Equal to the population of Texas	KFF, 2024 (1)
3.8M food-insecure students	More than the population of Los Angeles	GAO, 2024 (2)
Potential Grad PLUS caps	Could affect students at 90+ medical schools	Harvard HSPH, 2024 (3)
SNAP cuts affect 7.5M students	Equivalent to filling every NFL stadium in the U.S. 10x	Urban Institute, 2025 (4)
$113B economic impact from cuts	Enough to fund free school lunches for 20 years	GWU, 2025 (5)
Physician shortage estimate	Up to 124,000 by 2034	AAMC, 2023 (6)

Sources

1. Harvard T.H. Chan School of Public Health
2. KFF Medicaid Unwinding Tracker
3. Commonwealth Fund
4. GAO Report: College Food Insecurity
5. Urban Institute: SNAP & Student Vulnerability
6. AAMC DEI Accreditation Guidelines
7. AAMC Physician Workforce Report

Written by: Dahlia Chavez, LMSA National Publications Chair

MD Candidate at Rush Medical College

As we enter November, a month rooted in remembrance, reflection, and gratitude across many LHS+ traditions, it’s a good moment to pause and name something medicine often overlooks:

Healing is not only physiology. Healing is also connection, meaning, and memory.

Meaning steadies us when life is unstable, and science backs what many of our cultures have known for generations. And in medicine, where demands never pause, we often forget that reflection and connection are not extras. They are necessary for surviving this field.

Structured reflection strengthens emotional regulation, supports professional identity formation, and reduces burnout, especially in training physicians (1,2). Reflection helps the brain integrate experiences rather than simply store stress. Whether you’re a pre-med analyzing your “why medicine” while refining a personal statement, a medical student navigating endless study cycles, a resident learning to adapt to unfamiliar environments, or an attending carrying moral injury, making meaning matters.

Gratitude practices are neurobiology at work. Evidence shows gratitude interventions can:

• increase positive affect (3)
• reduce depressive symptoms (4)
• improve sleep (5)
• support cardiovascular health (6)

Neurologically, gratitude activates the medial prefrontal cortex, training the brain to scan for hope rather than threat (3). This helps prevent constant threat-scanning, which can narrow our attention to only the negatives and slowly wear down our spirit and motivation.

Strong social bonds correlate with lower mortality risk, comparable to quitting smoking and exceeding the benefits of exercise (7). High-quality relationships reduce inflammation and buffer stress response systems (8). Put simply: connection heals the immune system as much as it heals the heart. In our communities, we know this deeply — so much of our culture centers on the heart and the soul.

When I started medical school, I moved from California, my lifelong home, to snowy Chicago, where I didn’t have family. That transition was more challenging than I expected. Balancing demanding coursework while feeling disconnected and homesick tested me in ways I hadn’t anticipated. I had to search for meaning, hope, and reasons to keep moving forward, especially on days when the cold felt endless and the loneliness hit hard.

What sustained me were the people I found along the way. Some of my peers became lifelong friends as we supported each other through challenges big and small. I’m blessed to have found mentors who remind me of my strength and help me build tools to adapt when doubts creep in. And the patients I meet in my community, especially as a Latina trainee, have grounded me again and again. Their trust, their stories, and their resilience reminded me why I chose medicine and why I belong in these spaces. Those relationships carried me forward when my confidence wavered and helped me continue on this path to becoming a physician.

For LHS+ communities, where connection, family, cultural memory, and collective resilience are core values, none of this is surprising. It is ancestral knowledge meeting modern Western research. Positive emotional states and stress-modulating practices have been linked to longer telomeres, while chronic stress accelerates shortening (9,10). Your mindset doesn’t just shape your day; it can shape your DNA aging curve. By releasing stress where we can, practicing gratitude, and holding onto what is good without ignoring reality, we create meaning in chaos and in ourselves. It is this meaning that answers — and continues to answer — the “why medicine?” question at every stage of training, because medicine is genuinely hard.

Whether you’re:

? A pre-med learning to claim your place
? A medical student buried in UWorld and expectations
?‍⚕️ A resident surviving on cafecito and grit
?‍⚕️ An attending holding decades of quiet stories

You deserve stillness. You deserve community. You deserve to feel pride, not just stress about your productivity.

And if your path looks different from what you imagined, that does not diminish you. Every journey in medicine is unique. Needing rest, support, time, space, or a different pace does not make you less deserving — it makes you human.

We are still only 6% of the physician workforce. That reminds us that these systems were not built with our communities in mind. Yet here you are. You are your ancestors’ wildest dreams, whether you feel “there” yet or not. Look at how far you have come in your family. Look at how far you have come in medicine; it’s likely farther than most.

This month, let’s honor memory — and honor ourselves. Honor your unique journey, and the power of being exactly where you are, learning to heal others while remembering to heal yourself, as a necessity. Ground yourself. Call your people. Practice gratitude. Show love loudly, even when no one else seems to be doing the same thing. Medicine needs your brilliance and your whole self, not a version hardened by systems that sometimes forget humanity at its core.

Keep going through the barriers and the doubt because you are needed. Your patients need you.

References

1. Wald HS, Borkan JM, Taylor JS, Anthony D, Reis SP. Fostering and evaluating reflective capacity in medical education. Acad Med. 2012;87(3):292-301.
2. Hanson JL, Rosenberg AR, Holmes CL, et al. Reflection and resilience: Enhancing resident well-being through a reflective writing group. J Gen Intern Med. 2020;35(2):532-538.
3. Kini P, Wong J, McInnis M, Gabana N, Brown JW. The effects of gratitude expression on neural activity. Front Psychol. 2016;7:970.
4. Wong YJ, Owen J, Gabana NT, et al. Does gratitude writing improve the mental health of psychotherapy clients? Couns Psychol Q. 2018;31(3):294-307.
5. Wood AM, Joseph S, Lloyd J, Atkins S. Gratitude influences sleep through the mechanism of pre-sleep cognitions. J Psychosom Res. 2009;66(1):43-48.
6. Mills PJ, Redwine L, Wilson K, et al. The role of gratitude in spiritual well-being in asymptomatic heart failure patients. Psychosom Med. 2015;77(4):366-373.
7. Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: A meta-analytic review. PLoS Med. 2010;7(7):e1000316.
8. Uchino BN. Social support and health: A review of physiological processes potentially underlying links to disease outcomes. Psychol Bull. 2006;132(2):226-244.
9. Epel ES, Blackburn EH, Lin J, et al. Accelerated telomere shortening in response to life stress. Proc Natl Acad Sci USA. 2004;101(49):17312-17315.
10. Schutte NS, Malouff JM. A meta-analytic review of the effects of mindfulness meditation on telomerase activity. Psychoneuroendocrinology. 2014;42:45-48.

A Not So Big Beautiful Holiday Season: 

By: Francisco Cordero, LMSA Diversity Committee

University of Vermont: Larner College of Medicine

As people across the country read themselves to travel back home to see family members, we find new uncomfortable conversations possibly taking place at the dinner table such as “How can I afford medical school?” Graduate level professional education has always been expensive and for those entering school next year they may simply not have the option to go due to affordability thanks to the Big Beautiful Bill.

The Latino community is particularly vulnerable to this new bill. About 6.5 % of the physician workforce in the United States is of Latino descent. 9.2% of the total nursing force is of Latino descent. Overall, we make up around 13% of the medical workforce. In a field in which we are already underrepresented, these numbers will be sure to decrease with this new bill. 

It’s time to stand for what is right. If there is money for war and private planes for governors, then surely there is money for education. Call your representatives today. Demand more of your country. It is always darkest before dawn, but dawn always arrives. Reach out to high school students and ensure their dreams are still possible. Lastly, remember to hope as it is one of the strongest stances we can take in these hard times. 

More information about The Big Beautiful Bill and Its Impact on The Latino Community

Big Beautiful Bill
Big Beautiful Bill and Impact on Latinos
Nursing No longer a Professional Degree
United States Workforce Statistics 

LMSA Diversity Committee Disabilities and Mental Health Resources Guide

We are pleased to present the Mental Health Resource Packet, created to support our students in prioritizing their well-being and mental health: https://shorturl.at/emxQY

Made by: Baylor Akhavan-Mora and Genesis Trejo 

We are excited to share the LMSA Diversity Committee Disability/Accommodations Resources Guide created to empower students by providing essential tools and support for navigating accommodations: https://shorturl.at/k3iDI

Mental Health Resources 

National Suicide Prevention Hotline
English: 1-800-273-TALK (8255)
Spanish: dial 1-888-628-9454 Crisis Text Line:
HOME to 741741 The Trevor Project
Monitor your Mental Health with Moodfit
Learn Mental Wellness Skills with Happify
Practice Wellness with Daily Affirmations from I AM
7 Cups: Free resource to find someone to talk to or listen to you. This is not licensed therapy but could be a healthy outlet to discuss things on your mind.

Answering the Call
By: Patricia Sánchez Hernández, LMSA Diversity Committee

University of Puerto Rico School of Medicine

Happy New Year, LMSA Familia!

As we welcome January and approach Martin Luther King Jr. Day, this is an important moment to pause and reflect on Dr. King’s lifelong commitment to justice—especially his call for equity in healthcare. In 1966, he reminded the nation that “of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

Nearly six decades later, the communities we serve—particularly those historically underrepresented in medicine—continue to face barriers in access, outcomes, and representation. In a rapidly shifting social and political landscape, efforts to advance health equity are being examined, questioned, and at times challenged. Amid these changes, medical students and physicians hold a powerful role: we are uniquely positioned to help shape a more just, compassionate, and inclusive healthcare system.

This MLK Day, I encourage each of us to honor Dr. King’s legacy by identifying one meaningful way to contribute to his vision. That might look like working across sectors to uplift communities, supporting local advocacy initiatives, engaging in research centered on underserved populations, examining the equity within our curricula, or opening honest conversations with peers. It can also be as simple—and as impactful—as practicing cultural humility and compassion with every patient encounter.

No contribution is too small. As Dr. King said, “Everybody can be great, because everybody can serve.”

Let’s carry that spirit with us into the year ahead.

For more resources on Dr. Martin Luther King Jr. and health equity:

MLK Biography at NobelPrize.org

Racial equity in healthcare: turning Martin Luther King Jr’s dream of racial equality into a 21st century reality (Australia)

Navigating Diversity, Equity, and Inclusion (DEI) in Medical School (LMSA Resource Packet)

Health equity CME & education resources (AMA)

LMSA Diversity Committee Disabilities and Mental Health Resources Guide

We are pleased to present the Mental Health Resource Packet, created to support our students in prioritizing their well-being and mental health: https://shorturl.at/emxQY

Made by: Baylor Akhavan-Mora and Genesis Trejo 

We are excited to share the LMSA Diversity Committee Disability/Accommodations Resources Guide created to empower students by providing essential tools and support for navigating accommodations: https://shorturl.at/k3iDI

Mental Health Resources 

National Suicide Prevention Hotline
English: 1-800-273-TALK (8255)
Spanish: dial 1-888-628-9454 Crisis Text Line:
HOME to 741741 The Trevor Project
Monitor your Mental Health with Moodfit
Learn Mental Wellness Skills with Happify
Practice Wellness with Daily Affirmations from I AM
7 Cups: Free resource to find someone to talk to or listen to you. This is not licensed therapy but could be a healthy outlet to discuss things on your mind.