Dr. ROBINSON. We have accepted three and one has already turned us down.

Senator EAGLETON. He is going elsewhere?

Dr. ROBINSON. She is turning us down because she can't afford it. She is going to try it the next year.

Senator EAGLETON. So you have two black students?

Dr. ROBINSON. Yes, in this entering class, and this girl would have come in if she had the finances to do it.

Senator EAGLETON. Don't you have any kind of a scholarship?

Dr. ROBINSON. We have Federal scholarship aid, and I was going to mention that this has been greatly reduced. This year, in spite of an increase of 29 students and a general recession in this area, the scholarship funds have been reduced to $93,727 from a level the year before of $101,000 and the loan funds were reduced from $117,000 to $87,000. Remember, there was not anywhere near full funding on that loan program.

To substitute for these Federal loans these students are encouraged to seek loans, federally guaranteed loans, from banks, but those who come from the ghetto aren't going to get them. Those from the rural areas aren't going to get them either, because they are from small communities where the banks have already obligated their money for crops and to their regular customers, so it won't work. After all, this loan money comes back anyhow. I think it will have to be, in the case of the critically disadvantaged, straight scholarships.

Senator EAGLETON. The amendments we made, where we reduced the rate and subsidized the difference between 7 percent and the going rate, does that apply to graduate loans?

Dr. ROBINSON. Yes, but it isn't working. Students come back and tell us the banker isn't interested, and that he doesn't have the money to loan them. You can see what happens, he has his money committed to his prime customers and he is not going to take some young student just starting out. It really hasn't worked.

I think it will have to go back, if you are going to make the program effective, to the scholarship and the Federal loan program. As I pointed out the loan program is one in which the money is returned, it comes back into the Treasury and can be used over and over again. We have some private funds of that sort which have been going on here for years. These are rotating funds. Originally some came from the Kellogg Foundation and other private sources such as the American Dental Trades Association, the International College of Dentists, dental societies and bequests. The dentists' wives in the State of Kansas, collect all the old amalgam scrap and put it in what they call the "Silver Lining Fund." They have placed some $30,000 in that fund which is constantly turning over as loan money for students. You don't lose on it, you actually gain from the interest charged. You see what I mean by the revolving type loan fund. So I don't think Federal student loans are something which is taking away from the Federal reserve, they are really just loans that are being turned over.

Senator EAGLETON. The loan statistics on all student type loans, there is a remarkable repayment factor, and there are very few deadbeat defaults.

Dr. ROBINSON. By the time you get to the health professions there is very few failing out of school so, therefore, there is even less default.

What I am really trying to point out is that we have problems associated with the lack of full funding of the Health Professions Assistance Act or even close to full funding.

We increased our class, as I mentioned, by 29 students last year, but we didn't get anything extra under the basic education improvement grant for that, although the formula said we should have $500 per student. This year we are taking in another 29, so now we are 58 students behind in this funding. It might not sound like a lot but it amounts to some $29,000, and that might have paid for two instructors to help keep a reasonable faculty's student ratio in this area.

Senator, dental education is expensive. It costs the student, it costs the university. He not only has the expense of his tuition and his living, but he has his instruments to buy. I just checked and find that in the first year it is close to $800 that he must invest in instruments. In the second year he has to buy about the same amount of instruments in dental school, and there is no loan for this particular type of thing. Then, in addition to this, the cost of education to a university of dental education is more than $7,000 per year per student, and nobody is going to be able to collect that much in tuition from students, so it has to be subsidized some way or the other.

Federal aid is necessary if we are to fulfill the health manpower needs of the Nation, and this is what has been promised to the people. Senator EAGLETON. Thank you, doctor, thank you very much. (The prepared statement of Dr. Robinson is as follows:)

PREPARED STATEMENT OF DR. HAMILTON B. G. ROBINSON, DEAN OF THE UNIVERSITY OF

MISSOURI-KANSAS CITY SCHOOL OF DENTISTRY

Mr. Chairman and Members of the Committee:

I am Dr. Hamilton B. G. Robinson, Dean of the University of Missouri-Kansas City School of Dentistry.

Since this is your first visit to this facility and possibly to any health facility recently completed with partial funding through the Health Professions Education Assistance Programs, I will take a few moments to describe our facility and program. This building was completed in January 1970 at a total cost of $7,568,760 of which $4,011,916 was through an H.P.E.A. grant, $1,500,000 from a Missouri State appropriation, $108,035 from the City of Kansas City and $1,948,809 from private gifts of alumni and other friends of the School. It is built to accommodate 800 students. There is only one dental school in the United States with a greater capacity. Some of its special features are full color television facilities with 60 monitors and 74 remote pick-up points, a visual aid anatomy laboratory permitting teaching of human anatomy without the dissection of cadavers, three specially equipped lecture halls and 303 individual dental operatories. In addition to its educational program for 600 predoctoral dental students, 100 graduate students, 100 dental hygiene students and 30 dental technician students it affords dental treatment at the rate of some 100,000 patient visits per year.

Efforts are being directed at increasing the numbers of health professionals by increasing the size of the classes,

At

i.e., from 121 to 150 dental students per class, and by designing programs to reduce the time required to prepare dental students to render effective dental health care for patients. the same time paradental personnel is being trained at the school to aid in meeting the needs of the public. Dental hygienists follow a four-year program and dental assistants enrolled at Metropolitan Junior College receive their clinical training at the dental school. A unique new program has some 30 disadvantaged students enrolled in a dental laboratory technicians training program. One very excellent program funded by Federal grants since 1957 is that designed to teach dental students how to effectively utilize chairside assistants in their future practices, thus stretching their productivity for the public benefit. Unfortunately, these Dental Assistance Utilization programs now in existence at all U.S. dental schools with the aid of Federal grants are to be phased out of Federal funding in the near future.

The dental school clinic has been developed to simplify transition from dental school programs to dental health care for the public. In the dental school clinic comprehensive dental health care for patients is emphasized. Each student has four years of clinical experience beginning with assisting in the first year and ending with almost full-time clinical activity in the fourth year. Students are also assigned to public and pri

vate hospitals, and hopefully soon will render their quality

dental care at public clinics.

Our computer system will link

extramural treatment areas with the school, allowing the development of a better system of dental health care through centralized records and quality control.

The curriculum has been reconstructed to get away from the lock-step programs of the past that assumed equal backgrounds, equal effort and comparable goals for all predoctoral dental students. One month of each semester is devoted to "ElectiveEnrichment Programs" that permit the dental student to be involved in special areas of interest such as community programs, research activities, specialty programs and hospital programs; to "catch up" if a certain subject has presented problems; or to explore advanced subjects. The time for the enrichment programs was gained by eliminating any duplication of material in the various courses and by improved methods of teaching supplemented through the biomedical communications systems. With the completion of the biomedical communications system and the computer assisted instruction it is expected that some students will be able to graduate in less than the traditional four years and others will be allowed more than four years rather than to be lost for future dental health care due to circumstances that slowed their progress below the average.

Our students come primarily from Missouri, Kansas, New Mexico, Arkansas, Oklahoma, Colorado, Utah and Hawaii. None of these states have dental schools of their own, although two of them are in the planning stage. Most of the graduates return to their native states although a few are attracted to other