The Relationship Between Student Debt and Practice

Student debt levels have a large impact on chosen field.

In an online study titled, “Payback Time: The Association of Debt and Income with Medical Student Career Choice”, Dr. Martha Grayson (Albert Einstein College of Medicine of Yeshiva University who was at New York Medical College at the time of the study), Dale Newton, M.D. (East Carolina University, and Lori Foster Thompson, Ph.D. (North Carolina State University), examined how student debt and income expectations impact the decision of medical students to enter a high-paying specialty rather than primary care.

The interesting findings were published online on Sept. 19 in Medical Education. The authors surveyed more than 2,500 medical students attending either New York Medical College or the Brody School of Medicine. Over an 18-year period from 1992 to 2010, students were queried in their first and fourth years about the area of medicine they intended to enter, their forecasted debt upon graduation, their expected annual income they anticipated five years after completing residency, and the importance they placed on income in general.

It is not surprising that the medical students who anticipated high levels of debt upon graduation and who placed a premium on high income were more likely to enter a high-paying medical specialty. The behaviour is not surprising. We would anticipate that this issue will become exacerbated by proposed political solutions to drive down the cost of healthcare. Let’s think this through: higher tuition leads to higher student debt, which drives down the number of new doctors who go into family medicine.

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