For more than a decade, medical school debt has been increasing at an alarming rate. Debt has always been the albatross around medical students’ necks, but today’s young physicians have it worse than any generation in history. According to the American Medical Student Association, more than 86 percent of medical school graduates carry educational debt.
There’s some good news, though: While it feels limiting, debt isn’t all-powerful. Physicians can still have the lives and careers they want while treating patients with the highest quality of care.
Debt Limits Choice for ER Physicians
Debt hits emergency-medicine physicians like it does no other medical professionals. Becker’s Hospital Review, citing data from a study published in the Annals of Emergency Medicine, reports that the average debt owed by emergency-medicine residents in the U.S. is almost 25 percent higher than the average mortgage nationwide.
“Increases in school debt for emergency-medicine residents have outpaced cost-of-living increases,” says Timothy Young, MD, of the department of emergency medicine at Loma Linda Medical Center in California and the study’s lead author. “In 2001, less than 20 percent of emergency-medicine residents had more than $150,000 of education debt. By contrast, currently we found an average educational debt of $212,000 for residents in our study.”
If debt continues to build at its current pace, many potential ER physicians may be boxed out of their chosen careers. It will simply be too expensive to pursue the work. Indeed, the study found that debt already has a significant influence on residents’ life decisions — not to mention that it contributes untold amounts of stress to an already stressful job.
A House or a Career?
Over the course of in-depth interviews with 48 emergency residents, Young and his research team learned that the average educational debt for residents, $212,000, is about 25 percent higher than the average national mortgage ($168,000). Attending medical school costs more than buying a house — by a substantial margin.
“People assume that doctors are all rich,” says Young. “The amount of debt most physicians carry well into adulthood is under-recognized, in some instances putting them well behind their peers in traditional markers of adulthood, such as purchasing a house or saving for retirement.”
Young’s study showed that most of the interviewed residents were using some form of repayment delay. Otherwise, their required monthly payments (more than $1,550, on average) would claim 37 percent of the nationwide reported average salary of $51,250.
How Debt Affects Opportunity
There’s a shift underway in healthcare. Entrepreneurial baby-boomer physicians are retiring, and millennial physicians are replacing them. But the hundreds of thousands of dollars in debt hanging over their heads are limiting their options.
It’s becoming more and more common to hear about medical students like Lauren Delana, who told The Do that with $275,000 in debt, she’s torn between choosing a specialty she feels passionately about and one that will afford her the best chance of making debt repayments.
Increasing numbers of students are foregoing psychiatry or internal medicine in favor of more lucrative specialties, such as pulmonary medicine. That’s not good news for the psychiatric profession, which, according to the Huffington Post, is already facing both a practitioner shortage and an aging workforce on the cusp of retirement.
But we can’t blame students for this predicament, or for the choices it forces on them. If they ever want to emerge from beneath debt mountain, they’ll need either a lucrative salary or the assistance of a loan repayment program.
You Can Still Have the Life You Want!
Initiatives such as the Department of Education’s Public Service Loan Forgiveness (PSLF) Program and the National Health Service Corps (NHSC) are designed to help medical students conquer their debt while working full-time.
PSLF forgives direct government loans after 120 total payments for physicians working at an eligible nonprofit. The NHSC is similar. Neither program is easy to get into — the NHSC is especially competitive — but they offer some hope.
And debt forgiveness isn’t the only way to have a full and fulfilling career, either. Hamad Husainy, an emergency-medicine resident, told To Do that his $263,000 in debt played a big part in his decision to work for a rural hospital rather than a crowded urban one.
“Your dollar takes you a lot further in rural areas,” said Husainy. “And as an emergency physician, you can often get a pay raise to work in a remote area.”
Locum tenens is another option for emergency-medicine residents looking for a solution. Emergency-medicine locum roles afford practitioners the personal freedom, work-life balance, and rewarding compensation so desired by today’s physicians.
