CLEVELAND - The 32 students entering the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University later this year will be given the gift of a tuition-free education in a move similar to programs at institutions including Harvard and Mayo Medical School.

The aim is to free students from feeling that they have to choose high-paying specialties to pay off the debt, rather than going into academic and research-oriented medicine.

The Cleveland Clinic, through its endowment and hospital operations, will pay the $43,500 tuition bill to Case, with which the program is affiliated. More scholarship aid will be given to current students.

"Too much student debt has the potential to hinder their academic careers," said Dr. Andrew Fishleder, executive dean of the Lerner College of Medicine. "Debt has become a problem."

Fishleder said students graduating from private medical schools have an average debt of about $160,000.

The Clinic provides students a $23,000 stipend during the fifth year, when the students are typically involved in research projects and aren't required to pay tuition. It hopes to raise money to offer the tuition scholarships in the future entirely through its endowment.

Dr. Toby Cosgrove, chief executive of the Clinic, said the new policy will attract an even higher caliber of students to apply for admittance.

More than 1,400 applied for the 32 slots.

"I applaud the Clinic's plan," said Dr. Pamela Davis, dean of Case's school of medicine. "One of my big goals is raise more scholarship money."

Even with the high costs of medical education, new schools are opening and established schools are expanding their class sizes to help offset an anticipated shortage of doctors.

Other medical schools have already greatly reduced their tuition costs, or are about to, freeing up students who may want to practice in fields that are lower-paying but greatly needed, such as geriatrics and family medicine.

The Mayo Medical School has had a generous scholarship program for the past 20 years that enabled about 60 percent of the students to attend tuition free.

The 50 students starting at Mayo this summer will each get $25,000 to use toward tuition of $29,200.

Students can also get $2,000 to $5,000 a year more based on need, said David Dahlen, director of student financial aid at Mayo, based in Rochester, Minn.

The University of Central Florida in Orlando, which will open its college of medicine in 2009, announced that its entry class of 40 students will pay no tuition and will have their living expenses paid for during the four-year program.

Harvard University recently announced plans, starting next year, to eliminate the $12,500 family contribution expected for medical students in those families with incomes of $120,000 a year or less.