By Andrew Landstrom
Published: June / July 2008

Debt is a constant preoccupation of the medical student mind. In the fall of 2007, Congress eliminated the 20/220 pathway for economic hardship deferment with the passage of the College Cost Reduction and Access Act. A strong grassroots effort on the part of physicians and residents eventually earned the pathway a reprieve. The narrow victory and continued tenuous future of the 20/220 pathway underscores a need for improved legislative literacy and advocacy within the medical student community.

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