Are audiologists, nurse practitioners, physical therapists, or speech-language pathologists not “professionals”? The Department of Education seems to think so.
These are providers who earn rigorous master’s or doctoral degrees, pass national certification exams, maintain licensure, are legally required to report suspected abuse and follow strict codes of ethics. They are, by every reasonable measure, highly trained professionals who form the backbone of modern health care.
Yet under a new rule proposed by the Department of Education’s RISE Committee — created after the 2025 One Big Beautiful Bill Act — these and at least seven other health care provider disciplines would be denied “professional” status for the purposes of accessing federal student loans.
And the consequences won’t just be bureaucratic. They will be deeply personal — for women, for future clinicians and for millions of rural Americans already struggling to find basic health care.
Under the proposed rule, only students in 11 graduate programs — including medicine, dentistry, veterinary medicine, law, pharmacy, optometry, theology, clinical psychology and a few others — would qualify for higher federal borrowing limits (up to $50,000 per year, $200,000 total).
Everyone else would be capped at $20,500 per year and $100,000 total. Almost zero full-time graduate health professions programs can be delivered for less than $7,000 per semester, which means that prospective students would need to supplement with private loans, which are more costly, do not quality for programs such as Public Service Loan Forgiveness and are unattainable for those without strong credit scores.
In other words: If you want to become a physician assistant, occupational therapist, dietitian, mental health counselor or clinical social worker, you may no longer be able to borrow enough to pay for the education your own state requires you to complete. That’s not a minor policy shift. It’s a gate slammed shut.
And let’s be clear about who stands behind that gate: overwhelmingly women. Below is a list of affected graduate programs offered by several local universities, the degree required to enter the profession, and the proportion of women in each profession.
• Speech-language pathology, master’s, 95%-96%
• Dietitian/nutritionist, master’s, 90%
• Occupational therapy, master’s/doctorate, 89%-92%
• Audiology, doctorate, 80%-90%
• Nurse Practitioner, master’s, 87%-88%
• Clinical social work, master’s, 83%-90%
• Mental health counseling, master’s, 71%-78%
• Physician assistant, master’s, 70%
• Physical therapy, doctorate, 65%-70%
• Athletic training, master’s, 58%-60%
• Nurse anesthetist, doctorate, 53%-58%
Limiting federal borrowing to only $20,500 per year means limiting entry into these fields. And limiting entry into these fields means limiting women’s economic mobility and professional advancement.
This is not gender-neutral policy. It is gendered impact masquerading as administrative simplification.
Rural health care in America is already in crisis. According to the Health Resources and Services Administration, 92% of rural counties are primary care shortage areas, and by 2037, physician supply will meet just 68% of rural demand.
Who fills the gap? Increasingly, advanced practice providers (APPs) — nurse practitioners, physician assistants and other non-physician clinicians.
APPs now make up 41% of providers in U.S. physician practices. Their share of total health care visits grew from 14% to 25% between 2013 and 2019.
Physical therapists, too, now manage many patients as first-contact providers within their scope of practice.
The proposed loan rules threaten the very pipeline that supplies rural America with these providers. When students cannot borrow enough to complete their degrees — and when private loans (if accessible at all) come with punishing terms and are ineligible for Public Service Loan Forgiveness — fewer will enter these professions.
Fewer graduates means fewer rural clinics. Fewer rural clinics means fewer rural providers. And fewer rural providers means more avoidable suffering and more preventable deaths.
This is not speculation. It is predictable, measurable and entirely avoidable.
The Department of Education’s proposed rule does not reflect the realities of today’s health care landscape. It does not reflect the training of these professions. It does not reflect the needs of our health system — or our communities.
And it certainly does not reflect the values of a country that professes to care about women’s equality, rural health and access to economic mobility and educational opportunity.
If implemented, the rule change will reshape graduate education and the health care workforce for decades. But it is not final. A 31-day public comment period has just opened.
We must not waste it.
Submit public comments urging the Department of Education to revise the definition of “professional” graduate programs here.
Contact your senators and representatives and demand that they pass a bill to expand the list of “professional” programs to include all graduate health care fields.
Share this information widely — many affected students and providers haven’t even heard the proposal exists.
If we stay silent, the damage will be done in our classrooms, in our clinics, in our rural communities and in the careers of tens of thousands of hard-working people whose professions are being quietly devalued by policy fiat.
If we speak up — loudly, collectively and persistently — we still have time to change the outcome.
Ally Bove is a licensed physical therapist, researcher and educator from Baldwin. Susan Graff is a licensed physician assistant, researcher and educator from O’Hara. Bridget Keown is a historian, researcher and educator from Oakland.