Key Facts
Physician Assistant, Physical Therapy, Occupational Therapy, and Audiology programs have a 100% gap rate under the new federal loan caps. Every single program in these fields costs more than the applicable federal limit. No students in these programs can cover their full cost of attendance with federal loans alone.
This makes the healthcare pipeline one of the most uniformly affected sectors of graduate education under the Reconciliation Act of 2025.
This article covers the specific funding gap for each program, why PA students are disproportionately affected, and what options exist for covering the difference.
Why These Programs Have a 100% Gap Rate
Most graduate programs have some schools with low enough COA to fall within federal caps. Healthcare clinical programs do not.
The clinical training requirements for PA, PT, OT, and AuD programs drive costs above typical graduate rates. Programs include significant clinical rotation components, smaller cohort sizes, expensive simulation facilities, and in most cases three to four years of full-time study. These structural factors push COA above federal cap levels at virtually every institution.
The result: unlike law or business, where choosing a lower-cost state school can dramatically reduce the gap, healthcare program students face a gap regardless of which school they attend.
Physician Assistant Programs (PA): The Worst-Affected Group
PA programs carry the sharpest mismatch between cost and federal support of any healthcare program type. The reason is classification: PA programs (MSPAS, MPAS degrees) are classified as graduate programs, not professional programs, under federal loan rules.
That means PA students get the $20,500 per year graduate cap -- the same cap as an MBA student -- despite program costs approaching medical school levels.
| School | Program | COA/Year | Federal Cap | Gap/Year | Total Gap |
|---|---|---|---|---|---|
| George Washington | MSPAS | $105,000 | $20,500 | $84,500 | $169,000 (2 yr) |
| Northeastern | MSPAS | $98,000 | $20,500 | $77,500 | $155,000 (2 yr) |
| Emory | MPAS | $94,000 | $20,500 | $73,500 | $147,000 (2 yr) |
| Yale | PA | $91,000 | $20,500 | $70,500 | $141,000 (2 yr) |
| University of Utah (OOS) | MPAS | $78,000 | $20,500 | $57,500 | $115,000 (2 yr) |
| University of Utah (in-state) | MPAS | $55,000 | $20,500 | $34,500 | $69,000 (2 yr) |
PA programs are typically two years. The gap at private programs is $70,000 to $85,000 per year -- among the highest annual gaps of any program type. In-state public programs offer substantially lower gaps, but most PA applicants cross state lines for admission.
PA salary and repayment context
Physician assistants earn $115,000 to $135,000 per year in most markets, with specialty PAs reaching $150,000 or more. The debt-to-income ratio for PA graduates borrowing $150,000 to $200,000 in private loans is meaningful but manageable for most practice settings -- unlike veterinarians in general practice or social workers, where income is insufficient to service large private balances.
PA students are misclassified relative to their actual training and practice scope. MD, DPT, and DDS students receive the higher $50,000 professional cap. PA students -- who undergo similarly rigorous clinical training and practice at a near-physician level -- face the $20,500 graduate cap. This is the single biggest structural inequity in the new loan cap framework.
Physical Therapy Programs (DPT): Professional Cap, Still a Gap
DPT programs benefit from the $50,000 professional cap. But most programs still exceed it.
| School | Program | COA/Year | Federal Cap | Gap/Year | Total Gap |
|---|---|---|---|---|---|
| Northwestern | DPT | $85,000 | $50,000 | $35,000 | $105,000 (3 yr) |
| USC | DPT | $83,000 | $50,000 | $33,000 | $99,000 (3 yr) |
| Emory | DPT | $80,000 | $50,000 | $30,000 | $90,000 (3 yr) |
| Washington University | DPT | $79,000 | $50,000 | $29,000 | $87,000 (3 yr) |
| University of Michigan (in-state) | DPT | $55,000 | $50,000 | $5,000 | $15,000 (3 yr) |
DPT programs are typically three years. The gap at private programs is $29,000 to $35,000 per year, or $87,000 to $105,000 total. In-state public DPT programs bring the gap close to zero -- University of Michigan in-state leaves only a $5,000 annual gap.
PT salary and repayment context
Physical therapists earn $85,000 to $105,000 per year in outpatient, hospital, and home health settings. Specialty areas (sports, neurology, pediatrics) can reach $110,000 or more. The debt-to-income ratio is tighter than for PA or MD graduates, which makes loan sizing more consequential for DPT students.
Occupational Therapy Programs (OT): Split by Degree Level
OT students face different caps depending on their degree target:
- MOT/MSOT (master's level): Graduate category, $20,500 cap
- OTD (doctoral level): Professional category, $50,000 cap
Most OT students enter at the master's level, which faces the lower cap. OTD programs are growing in prevalence but MOT/MSOT remains the more common entry point.
| School | Program | COA/Year | Federal Cap | Gap/Year | Total Gap |
|---|---|---|---|---|---|
| USC | MOT | $78,000 | $20,500 | $57,500 | $115,000 (2 yr) |
| Boston University | MSOT | $75,000 | $20,500 | $54,500 | $109,000 (2 yr) |
| Tufts | MOT | $73,000 | $20,500 | $52,500 | $105,000 (2 yr) |
| Ohio State (OTD) | OTD | $68,000 | $50,000 | $18,000 | $54,000 (3 yr) |
| University of Florida (in-state MOT) | MOT | $42,000 | $20,500 | $21,500 | $43,000 (2 yr) |
OTD students at public universities have the most favorable funding situation of any clinical healthcare program: the $50,000 professional cap covers a large portion of in-state COA, leaving modest gaps.
OT salary and repayment context
Occupational therapists earn $80,000 to $100,000 per year across hospital, outpatient, school, and home health settings. The debt-to-income ratio for OT graduates at private MOT programs with $100,000+ in private debt is challenging relative to starting salary.
Audiology Programs (AuD): Smaller Gaps, Still Universal
AuD programs are four years and classified as professional programs, giving students the $50,000 cap. COA is generally lower than other clinical healthcare programs, leaving smaller but still universal gaps.
| School | Program | COA/Year | Federal Cap | Gap/Year | Total Gap |
|---|---|---|---|---|---|
| Gallaudet | AuD | $75,000 | $50,000 | $25,000 | $100,000 (4 yr) |
| Salus University | AuD | $72,000 | $50,000 | $22,000 | $88,000 (4 yr) |
| Rush University | AuD | $70,000 | $50,000 | $20,000 | $80,000 (4 yr) |
| University of Arizona (OOS) | AuD | $65,000 | $50,000 | $15,000 | $60,000 (4 yr) |
| University of Arizona (in-state) | AuD | $52,000 | $50,000 | $2,000 | $8,000 (4 yr) |
AuD students at in-state public programs face gaps of $2,000 to $8,000 per year -- the smallest gaps of any healthcare program type. Private AuD programs leave gaps of $15,000 to $25,000 per year.
Audiologists earn $85,000 to $110,000 per year. The debt-to-income ratio for AuD graduates is generally more favorable than for OT or PA students.
Covering the Gap Across These Programs
The same private lending options apply across all healthcare programs. The key differentiating factor is which programs qualify for loan forgiveness programs:
- PSLF: OTs, PTs, and audiologists at qualifying nonprofit employers can access PSLF on federal loans after 10 years. PA students working at nonprofit health systems also qualify. These programs only apply to federal loans.
- NHSC: The National Health Service Corps covers some primary care-adjacent professions in shortage areas. PAs qualify; PT, OT, and AuD eligibility depends on the specific NHSC program and year.
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Practical Approach by Program
PA students: In-state public programs cut gaps nearly in half. If an in-state program is academically acceptable, the financial case for staying in-state is stronger for PA than for almost any other healthcare program. For private programs, size private debt relative to your intended specialty -- specialist PAs earn meaningfully more than primary care PAs.
DPT students: In-state public programs often fall within or near the $50,000 cap. The gap at private programs is large relative to PT starting salary. Consider whether a higher-ranked private program justifies the additional $60,000 to $90,000 in private debt compared to an in-state alternative.
OT students (MOT/MSOT): The graduate cap creates a larger proportional problem than for DPT students. OTD programs at public universities are the most financially efficient path. If pursuing an MOT at a private school, minimize private debt and model your total balance against OT starting salary in your target practice setting.
AuD students: In-state public programs are often near the $50,000 cap. Private programs leave manageable gaps relative to audiology salary. For most AuD students, this is the easiest debt-to-income math of any clinical healthcare program.
Frequently Asked Questions
Are PA students classified as graduate or professional?
PA programs are classified as graduate programs ($20,500 cap), not professional programs ($50,000 cap), despite clinical training and scope of practice comparable to professional degrees. This is the largest structural inequity in the new cap framework.
Are DPT programs professional or graduate?
DPT programs are professional programs, giving students the $50,000 cap. Most programs still exceed the cap, leaving gaps of $15,000 to $35,000 per year at most institutions.
Do OT students face the graduate or professional cap?
MOT/MSOT students face the graduate cap ($20,500). OTD students face the professional cap ($50,000). Most OT students enter at the master's level.
What is the federal cap for AuD students?
AuD is classified as a professional program ($50,000 cap). In-state public AuD programs often fall close to the cap, leaving small gaps. Private programs leave gaps of $15,000 to $25,000 per year.
Are there forgiveness programs for these professions?
PSLF applies to federal loans at qualifying nonprofit employers for all these professions. NHSC covers some PA and primary care roles in shortage areas. Neither program applies to private loans.
How do I calculate my exact gap?
Use the Loan Cliff calculator with your school and program type to get your specific uncovered amount based on IPEDS 2024 cost of attendance data and the statutory caps.