After Antonia M. Villarruel got her master’s degree at the University of Pennsylvania in 1982, she wanted to work in a community-based clinic, helping the underserved, specifically in the working-class neighborhood in Detroit where she grew up.

But she had loans to pay and the salary wasn’t enough. She couldn’t afford it.

On Monday, the University of Pennsylvania, where Villarruel is now dean of the nursing school, announced it has received a $125 million gift for a tuition-free program to recruit, train, and deploy a group of nurse practitioners to work in underserved communities across the country. The gift from Penn alumnus Leonard A. Lauder, chairman emeritus of The Este Lauder Companies, is the largest ever for an American nursing school, Penn said.

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Students selected for the new two-year graduate program will finish debt free.

“I understand the work that people are doing in communities a lot of times with less resources,” Villarruel said. “For us to develop a program, because there are people like me out there that want to do the same thing, means everything to me.”

Penn’s program is unusual in that it will provide money to students up front, rather than through loan forgiveness, and contribute funding to some of the community-based health sites in the Philadelphia region that will help train the students, she said.

The gift was in planning before the coronavirus, Villarruel said, but the pandemic underscored its need even more, highlighting the already severe shortage of primary care physicians and large disparities in access to quality health care. According to the Association of American Medical Colleges, the United States could experience a shortage of between 37,800 and 124,000 physicians by 2034, both in primary and specialty care.

Nurse practitioners, who have higher levels of education and training than nurses with bachelor’s degrees, can diagnose patients, order and interpret tests, and prescribe medication. They provide primary care, help manage chronic illnesses, and serve in leadership roles, sometimes managing or operating community clinics.

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“Now more than ever, the country needs greater and more equitable access to quality primary care — and highly skilled nurse practitioners are the key to making that happen,” Lauder said in a statement. “The program will ensure that more Americans receive the essential health care services that everyone deserves.”

Lauder, 88, a billionaire who made his fortune through the cosmetics company founded by his parents, is a graduate of Penn’s Wharton School. With a net worth of $31.5 billion as of Saturday, according to the daily Bloomberg Billionaires Index, Lauder is the 43rd richest person in the world.

The first cadre of 10 fellows in the Leonard A. Lauder Community Care Nurse Practitioner Program will start in the fall. More will be added in subsequent years, increasing to 40 per year.

“This will give us a chance to course correct as we move forward, a chance to develop and strengthen the curriculum and to work on training with and for our community partners,” Villarruel said. “They have things to teach us as well.”

During the full-time primary care program, fellows will do at least half their clinical education at community-based sites in the greater Philadelphia area that provide direct patient care. It could be a federally qualified health center or in a school or through Project Home.

And upon graduation, they must practice or serve in an underserved community, anywhere in the country for two years. Once accepted to the graduate nursing program, the primary criteria for selection as a fellow is a commitment to work in underserved neighborhoods and a desire to promote health equity, Villarruel said.

The gift will cover students’ tuition and fees — currently $78,720 annually — as well as stipends for living expenses for those with financial need, Villarruel said. It also will pay for a professor who will oversee the program, including helping with curriculum and supporting the community sites where fellows work.

And it will provide funds to some community partner health sites for their help with the clinical education of the fellows.

“All schools of nursing are having issues finding clinical training sites, so we wanted to make a similar investment in communities to be sure that they were involved,” Villarruel said. “It’s a very different setting when you have to deal with illness, but also illness in the context of not good housing, lack of transportation, and food insecurity.”

She said she hopes the gift inspires others to want to contribute to nursing education.

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“This is the most timely and consequential gift not only for our university but for our country,” former Penn president Amy Gutmann said in a statement. “It is unprecedented in its potential to address America’s most critical need of providing primary health care to all who currently lack it by investing in nurses.”

Stephen P. Fera, executive vice president of Independence Blue Cross, which supports a network of community-based clinics and will be one of the program’s partners, said adding high-quality nurse practitioners will improve access to care.

“This is a key priority of the Independence Blue Cross Foundation,” he said in a statement. “The program will build and strengthen our individual and collective efforts toward improving the health and well-being of communities.”