When fourth year medical student Tom Smith finished his application for residency, he was required to pay hundreds of dollars more in processing fees than he expected. The more applications he sent out, the more he was charged, forcing him to balance the ever-increasing competitive landscape of medicine with the dystopian hellscape of his checking account. So he did what any medical student not related to a millionaire had to do - he took out more loans to cover the additional cost. 

After the transaction cleared, reducing SD Smith’s credit score to an even 10, a large phone with a flashing red light went off in the NBME headquarters for the third time that day. Dr. Lex Luthor, President of the NBME and former Gringotts Goblin, interrupted the current meeting (“How can we keep pretending Step 3 matters?”) to clear the room. The board members slowly filed out, each fully aware of what was about to happen. 

Dr. Luthor took a deep breath and hit the secret button underneath his desk. The door slammed shut, the windows shuttered closed, and smooth jazz filled the room as the lighting dimmed to a sultry yellow. He picked up the phone and answered it. A computer’s voice moaned “Score Release Fee” into his ear. This journalist watched as Lex’ eyes rolled back and he sighed with ecstasy at the thought of a financially struggling young adult funneling student loan money directly into his pocket. He squirted a small amount of lotion into his hands and began to unbutton his shirt. This journalist was still in the room but Lex seemed to forget he was there. 

The computer voice continued. 

“You just made 150 whole dollars.”

Lex took a deep breath in.

“By charging for a service… which cost you zero dollars.”

Lex sighed.

“Our profit margins are higher than Walmart.”

Lex moaned softly.

“Who runs a nonprofit with zero oversight?”

“I do.” Lex said, now pinching his nipples with vigor.

“Who’s a big bad medical licensing daddy”

“I’m a big bad medical licensing daddy.” The NBME President moaned. “Daddy’s getting a new boat this year.”

As he pleasured himself, the phone rang again, with a louder and more intense light. He hit the red button and the voice spoke again, this time saying “IMG paying ECFMG fees.”

At this, his moaning hit a steep crescendo and he rolled his eyes back. 

“Computer, I’m almost there!”

The computer switched every screen to a ticker tape of the current student loan crisis. The numbers flashed 1.74 trillion and counting. The goblin arched his back one last time, gave his nipples a final squeeze, and then collapsed back into his chair. After a few sighs, he sat up, fixed his tie, cleared his throat, and said to this journalist: “We’re doing all we can to minimize costs for medical students, make sure you say that. Now get out of here and ask my assistant to bring me a glass of water.”